The need to develop new contraceptive methods for both men and women is compelling. One of the reasons that unintended pregnancy continues to occur is that the available contraceptive methods are not always well suited to personal preferences or to various ages and life stages. Particularly glaring is the lack of effective male methods of reversible contraception other than the condom.
There is also a clear need for more health services research in the field of pregnancy prevention. For example, little is known about how access to prescription-based methods of contraception is enhanced or restricted by the many managed care arrangements now shaping health services.
Finally, there is a pressing need for more interdisciplinary research to understand the complex relationships among the cultural, economic, social, biological, and psychological factors that lie behind widely varying patterns of contraceptive use and therefore unintended pregnancy. Research on personal feelings, attitudes, and beliefs as they affect contraceptive use, and especially several recent ethnographic investigations of motivation, offer particularly intriguing explanations for the observed phenomena. Careful work is needed to integrate these ideas with the more traditional explanations of unintended pregnancy, such as inaccessible contraceptive services or insufficient knowledge about how to prevent pregnancy. Research is also needed on factors outside of individuals (such as the impact of media messages on the contraceptive behavior of individuals), on factors within couples (such as the relative power and influence of women and men in decisions to use or not use particular methods of contraception), and on the combination of individual, couple, and environmental factors considered together. In all such multivariate research, it will be important to study the determinants of sexual behavior as well as contraceptive use, inasmuch as the two are often intimately connected and may jointly influence the risk of unintended pregnancy.
Progress toward achieving the five campaign goals outlined above would be enhanced by the existence of a readily identifiable, public–private consortium whose mission is to lead the recommended campaign. Funding and leadership of the consortium should be provided by private foundations, given their proven capacity to draw many disparate groups together around a shared concern. Members of this consortium should be recruited from numerous sectors, both public and private, and especially from the groups that speak on behalf of children and their needs, such as the maternal and child health community.