often to women's sexual greed or wantonness that makes them neglect home and family in the search for lovers and to the need to control this tendency (see, e.g., Constantinides, 1985). This image of women's insatiable sexuality can affect their sexual and reproductive health. In the early days of Mexico's family planning programs, men's fear that women who were not pregnant and exhausted from child care would become sexually promiscuous and cheat on their husbands was found to be a potential barrier to the success of the programs (Folch-Lyon, Macorra, and Shearer, 1981).
There are also cultures in which premarital sexual activity by young girls is condoned, even encouraged, and a resulting pregnancy is welcomed; this is a pattern in much of sub-Saharan Africa (see, e.g., Caldwell, Caldwell, and Quiggin, 1989; Meekers, 1990, 1992; van de Walle, 1990). One difficulty in interpreting the meaning of this practice lies in the fluid definition of marriage that prevails in much of Africa and the Caribbean, so that sexual activity is hard to classify as either pre- or postmarital (for a review, see Bledsoe and Cohen, 1993). Marriage is a process in which cohabitation, ceremonies, and childbirth can occur in varying sequence: the issue is not so much whether a birth occurs to parents who have had a marriage ceremony, but whether the birth is considered socially legitimate. That legitimacy involves, among other things, whether the newborn has an acknowledged father, whether the adolescent parents are in a stable union, whether the union has the approval of the larger kin group, and so on.
Even in cultures that have traditionally frowned on premarital female sexual activity, there have recently been strong signs of change. There are reports of increases in premarital sexual activity from all regions. Several surveys of young unmarried women report that they are now under strong social and peer group pressure to engage in premarital sex: in Thailand (see, e.g., Thongkrajai et al., 1993); Nigeria (Renne, 1993; Feyisetan and Pebley, 1989; Oyeneye and Kawonise, 1993); Senegal (Diawara, 1979); Ghana (Anarfi, 1993); Kenya (Ferguson, gitonga, and Kabira, 1988); Côte d'Ivoire (Meekers, 1990); Liberia (Taylor, 1984); North Africa (Mernissi, 1977); and India (Kapur, 1973; Savara and Sridhar, 1994).
Two major reasons for an apparent rise in premarital sexual activity have been proposed. The first is that ages at first marriage have risen, so that women now have more years "at risk" of premarital sexual activity. This reason has been proposed as the major cause of the rise in premarital adolescent sexual behavior in much of Africa (Bledsoe and Cohen, 1993). Premarital pregnancies can pose an increasing social problem if they disrupt young women's schooling, their chances for desirable marriage, and other preparation for adult roles, even when age-specific fertility rates are decreasing (Bledsoe and Cohen, 1993).