| Abstract |
Background: In Greece, family planning (FP) was strongly connected with the demographic issue the country was facing during the post-war period. Unlike other countries, in Greece the concern was about the decline of the growth rate, not the rapid population growth. In this framework, FP was more likely to be interpreted as the meaning of planned parenthood, not birth control. The priority according to FP was driven largely by the concern of high abortion rates. Greece had high rates of illegal abortions and abortion practice was the main form of birth control. Family planning services were not provided by governmental programs and state had not developed a policy on contraceptive use. This study reviews the history of family planning in Greece from eugenics to legislation. This study provides a historic overview of FP in the second half of the twentieth century, more specifically between the mid-1950s and the mid-1980s. It presents the family planning movement by non-governmental organizations in national level, and policies and laws relevant to FP.
Methodology: The data presented is based on desk research with the aim to gather and analyze relevant credible information from documents existing in primary and secondary resources. Special interest is given in primary and secondary recourses from Nikolaos Louros Archive. More specifically, the data for non-governmental organizations based on primary and secondly resources from Nikolaos Louros Foundation, private archive of Virginia Tsouderou -journalist and politician and first president of Family Planning Association-, private archive of the Professor and one of the first members of Family Planning Association Vaso Margaritidou, the One-Member Court of First Instance of Athens and the Multi-Member Court of First Instance of Thessaloniki. Data on the laws and governmental policies were collected from the Greek legislation, compiled with secondary resources from the Department of Primary Health Care of the Ministry of Health, and primary and secondary resources of the Family Planning Center of Alexandra Maternity Hospital in Athens and the Family Planning Center of Venizelio – Pananio General Hospital in Heraklion, Crete. Demographical data was based on secondary resources of the National Statistical Service of Greece. Secondary resources from relevant books, magazines, and published articles were identified in PubMed and Scopus databases, were also used.
The data was collected and categorized according to key themes and were analyzed by thematic analysis. To ensure reliability, a wide source of data from primary and secondary sources were gathered. Data source triangulation was used by cross-verifying both primary and secondly resources to ensure validity.
Results: By 1980, several key steps towards the promotion of family planning can be identified by non-governmental organizations. First, the Hellenic Eugenic Society (HES) introduced the idea of FP in Greece and provided family planning services by Alexandra Maternity Hospital under Nikolaos Louros direction. The Society was the official representative of the International Planned Parenthood Federation (IPPF) in Greece the first years of its operation. Foreign institutions and experts in the field of family planning were highly interested in Society’s action (American Eugenics Society INC, British Eugenics Society, Margaret Sanger Research Bureau, International Planned Parenthood Federation). All the necessary advices in cases of sterility and Planned Parenthood were provided at the Fertility and Sterility Out-patient Department of Alexandra Maternity Hospital. In 1966, the HES initiated the Premarital and Marital Advisory Center at the Out-patient Obstetric Department of Alexandra Maternity Hospital. Being aware of the international medical achievements, Louros was the first in Greece who realized the importance of FP. Nikolaos Louros contribution to Obstetrics and Gynecology is important and multifaceted. He supported every effort aiming to protect maternity and the child and adopted a new approach regarding the problem of home-based obstetric help to the destitute woman. Moreover, he underlined the need of prevention approaches in daily clinical practice and supported every effort aimed at preventing and early diagnosis of cervical cancer. Professor’s contribution was outstanding as he achieved the Pap-test to reach every corner of the country.
It was an important mark in history the establishment of the first Family Planning Center in Greece in 1974, in Alexandra Maternity Hospital by the Greek Association of Family Planning. A further essential step was accomplished by the Family Planning Association, with a primary focus on sensitizing both the public and state authorities, by disseminating FP and contraception information. In 1985, it became a member of the IPPF. The Cultural and Educational Family Planning Association of Northern Greece acted at a local level. Women's organizations pursued an intense activity on publicize information about abortion and contraceptive methods. By the mid-1980s, the Greek government launched FP at national level providing family planning services through the national health system. In 1980, state legalized family planning under the Law No. 1036 1980. In 1982 under the Law No. 1278, all the responsibilities of the Advisory Committee for Genetics and Family Planning Issues vested in the Central Health Council to organize an information campaign at the national level. In 1983, by the Law No. 1397 the state established the National Health System. According to article 15 of this Law, family planning was included under the Health Centers. Although originally under the first law, non-governmental organizations can provide family planning services under the supervision of the state, under the Law No. 1397/1983 FP is under state supervision excluding non-governmental organizations. With the family planning program having become more specific by that time, the Ministry of Health, Welfare and Social Insurance concentrated its efforts to disseminate through a nationwide information campaign to the public that they can access family planning services. Meanwhile, for the first time family planning seminars for health care professionals were conducted by the Ministry. In 1983, 10 new Family Planning Centers were established in state hospitals Centers were staffed by specialized professionals: Obstetrician, midwife, visiting nurse and social worker. Free advice and information on family planning issues was provided. The principles and contents of family planning were those defined by the World Health Organization.
Conclusion: The institution of FP in our country throughout the period considered is divided in two phases: the first phase which is characterized by selfless efforts of private sector and NGOs, and the second which is characterized by legislative and regulatory processes. Non-governmental organizations are the protagonist in FP for more than 20 years in Greece by promoting FP and contributing to its legislation. Recognizing the importance of FP, the Greek government institutionalized FP in 1980 and launched family planning services at national level. Governmental and non-governmental institutions and experts from abroad (International Planned Parenthood Federation, The Population Activities Office of United Nations) played a pivotal role in the efforts of the public sector and the non-governmental organizations by providing financial, advisory and technical support.
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