Chapter 6 discusses the second set of factors affecting unintended pregnancy—the complex web of individual motivation, feeling, attitudes, and beliefs that shape contraceptive use as well as sexual activity. This section contains some of the most provocative and important material in the report, inasmuch as it touches on the more emotional, sometimes irrational, dimensions of human behavior and male–female relationships that are so closely connected to the occurrence of any pregnancy, intended or not.

Chapter 7 addresses numerous social forces that influence fertility and the effective use of contraception: political and religious diversity, views about sexuality, historical and ongoing racism, economic factors, cultural and ethnic diversity, gender bias, the far-reaching effects of the antiabortion movement, and the pervasive influence of violence in American life. The broad scope of this chapter is highly consistent with deliberations at the recent United Nations International Conference on Population and Development in Cairo, which addressed both men and women in fertility decisions, the integral part that socioeconomic and cultural environments play in reproductive behavior, the pervasive influence of gender bias and other women's issues in population trends, and the importance of addressing human sexuality as part of reproductive health services and policies (United Nations, 1994).

Chapter 8 reviews several pregnancy prevention programs to determine whether there is a strong knowledge base at the local level about how to reduce unintended pregnancy. Although there are literally hundreds of programs recently completed or currently under way in the United States that in some way address unintended pregnancy, this chapter focuses squarely on the few that have been evaluated. The chapter also comments on both Medicaid and the Title X program because they are major sources of public funding for family planning services nationwide.

The final chapter, Chapter 9, presents the committee's conclusions and recommendations. These are addressed to public policy, provision of services, and, in particular, research.

As the foregoing overview suggests, this report is confined to an analysis of unintended pregnancy in the United States. Nonetheless, the report does occasionally draw on international data in order to put certain U.S. numbers into perspective, to consider how other countries may have handled particular problems, or to ponder the feasibility of selected remedies.


Bumpass L, Sweet J. Children's experience in single-parent families: Implications of cohabitation and marital transitions. Fam Plann Perspect. 1989; 21:256–260.

Carnegie Corporation of New York. Starting Points: Meeting the Needs of Our Youngest Children. New York, NY; 1994.

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