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 sexually transmitted diseases (STDs).
The electronic and print media should reinforce the material presented in schools and elsewhere, thereby helping to educate adults as well as school-aged children about contraception and reproductive health. The media should present accurate material on the benefits and risks of contraception and should broaden current messages about preventing STDs to include preventing unintended pregnancy as well. Media producers, advertisers, story writers, and others should also balance current entertainment programming so that, at a minimum, sexual activity is preceded by a mutual understanding of both partners regarding its possible consequences, and accompanied by contraception when appropriate. Similarly, advertising of contraceptive products and public service announcements regarding unintended pregnancy and contraception should be more plentiful.
Through a combination of financial and structural factors, the health care system in the United States makes access to prescription-based methods of contraception a complicated, sometimes expensive proposition. Private health insurance often does not cover contraceptive costs; the various restrictions on Medicaid eligibility make it an unreliable source of steady financing for contraception except for very poor women who already have a child; and the net decline in public investment in family planning services (especially those services supported by Title X of the Public Health Service Act), in the face of higher costs and sicker patients, may have decreased access to care for those who depend on publicly financed services, particularly adolescents and low-income women. Condoms, the most accessible form of contraception, provide valuable protection against STDs but must be accompanied by other contraceptive methods to afford maximum protection against unintended pregnancy. Unfortunately, other accessible nonprescription methods, such as foam and other spermicides, neither prevent the transmission of STDs nor offer the best protection against unintended pregnancy.
The campaign to reduce unintended pregnancy should promote increased access to contraception generally, but especially to the more effective prescription-based methods that require contact with a health care professional. Financial barriers in particular should be reduced by (1) increasing the proportion of all health insurance policies that cover contraceptive services and supplies, including both male and female sterilization, with no copayments or other cost-sharing requirements, as for other selected preventive health services; (2) extending Medicaid coverage for all postpartum women for 2 years following