Introduction
We are interested in the motives for visiting a gynaecological practice in a town in northern Croatia in order to:
• Evaluate the present situation and
• Predict problems, which we are going to have in the near future.

Materials and methods
• The information was used from patients' files from 1971 to 1995, when this study was finished.
• The breaking point happened in 1991, when gynaecologists agreed not to perform deliberate abortions any more.
• The presumption was that this event would reflect our patients' motives for coming, so the material was divided as follows:
• In the period from 1971 to 1990 when we examined 741 files.
• In the period from 1991 to 1995 when we examined 845 files.
• And in 1995 only when we examined 416 files.
• Altogether 2002 files were examined.
• The data from the files were taken at random.
• The last visit to a gynaecologist was taken into consideration.
• The exception was made when the visit was:
• The control check up after the abortion. The abortion was a reason, because it caused the check up.
• In case a woman has an IUD, it is registered in the file, because it is a permanent state.

"The International Classification of Diseases and Related Health Problems &emdash; tenth revision" was used in the definition of medical diagnoses for establishing the permanent categories, as it is shown in Table I.

• In the categorization there is an expression "pregnancy diagnostic". The expression relates to an early diagnostic with amenorrhoea of a few days, when it is urgent for a woman to know if she is pregnant or not, because she might want an abortion.
• Normal evidence of pregnant women for whom files are opened is kept separately in the evidence.
• The patients are divided into two groups according to their age:
- Younger than 40 and
- Older than 40
• Because of a large number of diagnoses and complicated relationships among them, it seemed useful to summarize the data into three groups:
• Disease
• Pregnancy prevention
• A healthy woman, coming for a check up once a year.

Results
• The gained results are shown in two ways:
In percentages, with related graphs according to periods of time, and according to particular diagnoses. They were divided into two age groups, younger than 40, and older than 40.

Figure 1 shows visiting frequency of the patients under 40 in the period from 1971 to 1990. It is obvious that abortions were the main reason for the patients' visits.
In the period from 1991 to 1995 the reasons were pregnancy diagnostic and inserting of an intrauterine device.
In 1995, the reason for a visit was the same, but in even more drastic form. In the last two time categories, the abortion, as a reason for a visit is very rare.

Figure 2
A display of the reasons for visiting of patients older than 40,
according to diagnostic categories and periods of time

The main reason for a visit of the patients older than 40 is health control in all periods of time. (Figure 2)

The results gained by the statistic evaluation are shown in this chapter by numbers and graphically, sorted into four paragraphs.
- The review of the visits according to the age of the patients and diagnostic categories related to the periods of time;
- The comparison of the results concerning reasons for visits according to the age of the patients and diagnostic categories as well as the diagnostic groups according to the periods of time;
- The comparison of the data of reasons for visits of the patients concerning disease, pregnancy and health control;
- Viewing of the data about the visits of the patients during the observation period according to particular diagnostic categories.

Figure 3
The comparison of the data about the reasons of visits of the patients under 40 years of age
according to diagnostic categories from 1971 to 1990 and the data from 1991 to 1995.

H0 : The reasons for visits in both periods are equally distributed.
Calculated value c 2 is 154,455. The hypothesis H0 is rejected.

The three most frequent reasons for visiting a gynaecologist of the patients younger than 40 in the period from 1971 to 1990 are abortions, colpitis and health control. In the period from 1991 to 1995 it is the early pregnancy diagnostic, inserting of an intrauterine device and colpitis. We can see that hypothesis Ho is rejected.

Figure 4
The comparison of the data about the reasons for visits of the patients under the age of 40
according to diagnostic groups from 1971 to 1990 and the data from 1991 to 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c 2 is 0,109. The hypothesis H0 is accepted.

When we summarised the same data from diagnostic categories into the diagnostic groups "disease", "pregnancy prevention" and "health control" &endash; we can see that the hypothesis Ho is accepted and that the reasons for visits are equally distributed.

Figure 5
The comparison of the data about the reasons for visits of the patients under the age of 40
according to diagnostic categories from 1971 to 1990 and the data from 1995.

H0 The reasons for visits in both periods are equally distributed.
Calculated value c_ is 113,757. The hypothesis H0 is rejected.

In the comparison of the data in the period until 1990 and 1995 only, we can see that the motives in 1995 are early pregnancy diagnostic, inserting of an intrauterine device and a birth control pill.

Figure 6
The comparison of the data about reasons for visits of the patients under 40
according to diagnostic groups from 1971 to 1990 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 1,516. The hypothesis H0 is accepted

But when we summarise the categories in the three main categories we can see that the reasons for visits are equally distributed and that the hypothesis Ho is accepted.

Figure 7
The comparison of the data about reasons for visits of the patients under 40
according to diagnostic categories from 1991 to 1995 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2is 38,383. The hypothesis H0 is rejected.

In 1995 the reasons for visits remain the same as in the period from 1991 to 1995, which are early pregnancy diagnostic, IUD and pills, but the frequency of visits is a little lower.

Figure 8
The comparison of the data about reasons for visits of the patients under 40
according to diagnostic groups from 1991 to 1995 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 2,683. The hypothesis H0 is accepted.

In the summarised groups there is no difference in the visit distribution, so the hypothesis Ho is accepted as well.

Figure 9
The comparison of the data about reasons for visits of the patients older than 40
according to diagnostic categories from 1971 to 1990 and the data from 1991 to 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 132,255. The hypothesis H0 is rejected.

In the period until 1990 at the patients older then 40, the motives for coming were mostly health control, tumours and incontinence. Later from 1991 to 1995 health control was still the most important, but it is followed immediately by inserting of the IUD and early pregnancy diagnostic. The hypothesis Ho about the distribution is rejected in both periods.

Figure 10
The comparison of the data about reasons for visits of the patients older than 40
according to diagnostic groups from 1971 to 1990 and the data from 1991 to 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 67,024. The hypothesis H0 is rejected.

The motives for coming are not equal.

Figure 11
The comparison of the data about reasons for visits of the patients older than 40
according to diagnostic categories from 1971 to 1990 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 76,378. The hypothesis H0 is rejected.

In the period until 1990 and in 1995 only the motives are not changed.

Figure 12
The comparison of the data about reasons for visits of the patients older than 40
according to diagnostic groups from 1971 to 1990 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 61,562. The hypothesis H0 is rejected.

In the summarised groups, the differences in the distribution appear, the frequency of visits caused by disease and health control is lower, so the hypothesis Ho is rejected.

Figure 13
The comparison of the data about reasons for visits of the patients older than 40
according to diagnostic categories from 1991 to 1995 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed.
Calculated value c2 is 38,641. The hypothesis H0 is rejected.

The scheme of the visits in both periods is practically not changed, the reasons are the same, but the frequency is lower.

Figure 14
The comparison of the data for visits of the patients older than 40
according to diagnostic groups from 1991 to 1995 and the data from 1995.

H0: The reasons for visits in both periods are equally distributed. Calculated value c2 is 6,05.
Hypothesis H0 is accepted since it is in the area of round figures.
And the same is shown at the summarised groups.

Commentary
Surprisingly, the statistic evaluation does not show significant differences in summarised groups over all observed periods, although the differences in particular categories are statistically highly significant. To explain this apparent paradox, we decomposed the category "pregnancy prevention" to its component parts and then combined them in different ways within the category itself. It can be seen that the component parts "deliberate abortion" - "early pregnancy diagnostic" and "intrauterine device &endash; contraception" are complementary motives. The abortion rate is showing statistical decrease, but the early pregnancy diagnostic rate is increasing.

Discussion
o What does this large number of numerical data tell us?
o It is obvious that there are statistically significant differences during the observed periods of time related to the motives for visits.
o In 1991 gynaecologists stopped performing deliberate abortions. Changes were expected in the category of abortions, but they manifested much wider.
o Evaluating the whole population, the motives for a visit to a gynaecological practice have changed in their frequency.
o Most of all, the relation of the patients according to their age changed, what can be seen in figure 15.

Figure 15
The relation of women's visits to a gynaecological practice &endash;
younger and older age groups in observed time intervals

In first time category, population is mostly composed of older women,
and in last time category of women younger than forty.

o Since 1991, the most important reason for visiting a gynaecologist was a pregnancy diagnosis, followed by the category of health control of older women, and then the patients with IUD in both age groups. (They were rare in the past period.) The number of birth control pill users is also growing.

o Observing the integrating categories "disease", "pregnancy prevention" and "health control" we can see the fact that the visit frequency among the categories has not statistically changed.

o Decomposing the category "pregnancy prevention" to its component parts: "deliberate abortion", and "IUD &endash; contraception", we can see that they are complement motives. The percentage of abortions is falling, but "early pregnancy diagnostic" is rising (so the abortion can be performed elsewhere), as well as inserting of an IUD and taking birth control pills (to prevent pregnancy).

o On the last two graphs it is obvious that the hypothesis about the equal distribution is accepted in spite of decomposing to the component parts. The reason for it is that in both time period's abortions are not performed, and women are led to doctor's office by the same motives, as when the abortions were performed according to the wishes of the patients.

Conclusion
o Summarising the categories it is obvious that, in fact, there was no change of the motives for women to come to the doctor's office, the women changed only the formal motive. Instead of an abortion, they come for an early pregnancy diagnostic, and then they disappear from the evidence, (because they probably go elsewhere for an intervention), and then they insert an intrauterine device in significantly larger number.

o So, we come to the conclusion that women in the observed area don't want to bear children, as it is the situation in Europe, both east and west. Also the suspension of performing abortions cannot prevent them from fulfilling their intention not to have children in some other way, probably with help of an IUD.
It is the fact that the suspension of a surgical abortion didn't decrease a number of abortions.
A number of chemical abortion (with a help of IUD) increased, which shows the need for a new evangelisation, both for individuals, a well as married couples.
The truth is that the low regulations are very important. But the change of mentality of the contemporary culture concerning human relation towards children is much more important.
Instead of today's fear and anxiety before coming of a new baby, we should bear in mind the message from Bethlehem about faith and joy for every new human life.
We need a radical change of mentality from the culture of selfishness and death into the culture of altruism and life.