these first two, trying to make room for nonmarital sexual activity under certain circumstances, but frowning on nonmarital childbearing, for example.

Concern about this underlying disagreement led the committee to three observations. First, the polarizing arguments about sexual activity have obscured common goals that many share, such as the desirability of all children being born into welcoming families who have planned for them and celebrate their arrival. Focusing on this common ground might help to foster a less adversarial, more tolerant environment, and thus make it easier to discuss contraception candidly and to organize a coherent set of intervention programs that are widely understood and supported. It would be particularly helpful if more people understood that the United States does not differ appreciably from many other countries in its patterns of sexual activity, but it does report higher levels of unintended pregnancy.

Second, abstinence cannot be counted on as the major means to reduce unintended pregnancy. Most of the men and women at risk of unintended pregnancy are beyond adolescence and many are married (Chapter 2), and for this large majority, the primary prevention strategy should be increasing contraceptive use. However, the committee unequivocally supports abstinence as one of many methods available to prevent pregnancy. Furthermore, it urges that young teenagers be counseled and encouraged to resist precocious sexual involvement. Sexual intercourse should occur in the context of a major interpersonal commitment based on mutual consent and caring and on the exercise of personal responsibility, which includes taking steps to avoid both unintended pregnancy and STDs. In this context, it is important to add that the committee did not define the age or life stages at which sexual behavior is appropriate; such decisions are matters best left to family, religious bodies, and other social and moral institutions. This issue is at the heart, however, of the disagreement described above.

Third, it is critically important that officials at all levels of government and public life not misinterpret or over-react to opposition regarding the strategies to reduce unintended pregnancy that are articulated in this report. Although there are some who object, for example, to comprehensive, high-quality sex education in schools or to helping all sexually active individuals gain access to contraception, these are minority views in many communities and they should not be allowed to paralyze efforts to mount major public health campaigns, such as the one outlined here.

One other comment should be made. Even if all five of the campaign elements outlined above and discussed in detail below were put into place, some number of unintended pregnancies would continue to occur. This is because many contraceptive methods have appreciable failure rates even under the best circumstances, and the individuals who use them are not always as careful as is required for maximum efficacy. In addition, there will still probably be some couples who take the risk of using no contraception at all for a period of time, despite having no clear desire

The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement