Objective: 1) Overall objective is to detect changes in reproductive health of women due to chan- ges in the system of social and health care. 2) The particular objective of this part of the study (part V) is to compare the incidence of induced abortions and contraceptive use in the Czech Republic and selected developed countries during last 20 years. Design: Retrospective comparative epidemiological study. Setting: Institute for the Care of Mother and Child, Praha 4 - Podolí. Methods: Input data for the Czech Republic use came from the results of the four previous parts of the study. The data from similar studies in selected countries were divided into two groups. Seven countries of Central Europe formed the first group, the second group consisted of 14 countries of Western and Northern Europe and 4 developed countries over-the-ocean. The both groups were ordered according to the reliability of reported data. Results: The cause of higher number of induced abortions and lower number of women using effective contraception in the Czech Republic compared to other developed countries falls into sixties when different social approach towards induced abortion legislation and concurrent deve- lopment of planned parenthood began. This is being documented by comparison of data on use of induced abortions and contraceptive use among women of different age groups, while using internationally accepted indicators. Although the number of induced abortions did not change substantially in western countries during last 20 years (there has been even slight increase in some of them since 1993), the number of induced abortions in the Czech Republic decreased markedly, and this fact, together with increased use of contraception since 1993 led to decrease of difference in between these two variables, compared to western countries. Conclusions: The 2-3 fold higher number of induced abortions in the Czech Republic than in countries of the second group before 1993 decreased substantially; there were only 19.3 induced abortions per 1000 women in the Czech Republic in 1997 compared to average of 14.1 induced abortions in developed countries. Use of effective contraceptive methods is lower in the Czech Republic due to low use of sterilization.

        Key words: epidemiology, induced abortion, contraception, abortion rate, abortion ratio