• The Consequences of Unintended Pregnancy
• Contraception and Unintended Pregnancy
• Committee Recommendations

SUMMARY 1

1 INTRODUCTION 11

Focus of this Report, 17
Study Methods and Report Organization, 17


2 DEMOGRAPHY OF UNINTENDED PREGNANCY 21

Terminology, 21
Percentage Rates of Unintended Pregnancy, 25
Women at Risk of Unintended Pregnancy, 28
Women Who Have Unintended Pregnancies, 31
Trends in Unintended Pregnancy, 33
The Role of Abortion, 41
International Comparisons, 42
Conclusion, 47


3 CONSEQUENCES OF UNINTENDED PREGNANCY 50

Abortion as a Consequence of Unintended Pregnancy, 51
Maternal Demographic Status, 55
The Effects of Intendedness, 63
Preconception Care, 76
The Demographic Implications of Reducing Unintended
Pregnancy, 79
Conclusion, 80


4 PATTERNS OF CONTRACEPTIVE USE 91

Patterns of Contraceptive Use and Unintended Pregnancy, 92
Contraceptive Use Among Men, 111
Use of Dual Contraceptive Methods, 118
Sexually Transmitted Diseases, 119
Conclusion, 122


5 BASIC REQUIREMENTS: CONTRACEPTIVE KNOWLEDGE
AND ACCESS 126

Knowledge, Skills, and School-Based Education, 127
Access to Contraception, 135
Missed Opportunities, 150
Conclusion, 153


6 PERSONAL AND INTERPERSONAL DETERMINANTS OF
CONTRACEPTIVE USE 160

A Comment on Available Data, 161
Underlying Themes, 161
Single Factor Investigations, 166
Conclusion, 176


7 SOCIOECONOMIC AND CULTURAL INFLUENCES ON
CONTRACEPTIVE USE 183

Diversity in U.S. Culture, 184
Conflicting Views About Sexuality, 188
Economic Influences on Fertility, 194
Racism, 198
Violence, 203
Gender Bias, 205
Opposition to Abortion, 208
Conclusion, 211


8 PROGRAMS TO REDUCE UNINTENDED PREGNANCY 218

National Programs, 218
Local Programs, 223
Cross-Cutting Themes, 231
The Fiscal Impact of Family Planning Funding, 240
Conclusion, 244


9 CONCLUSIONS AND RECOMMENDATIONS 250

A New Social Norm, 251
The Campaign to Reduce Unintended Pregnancy, 253
Campaign Leadership, 270


APPENDIXES

A Commissioned and Contributed Papers, 275
B The Political Storms over Family Planning: Supplement to
Chapters 1 and 7, 278
C The National Survey of Family Growth: Principal Source of
Statistics on Unintended Pregnancy: Supplement to Chapter 2, 286
D Tables of Odds Ratios: Supplement to Chapter 3, 296
E Technical Notes on the Recalculation Exercise: Supplement to
Chapter 3, 308
F Summaries of Evaluated Programs: Supplement to Chapter 8, 311
G Assessing Program Effectiveness and Cost-Effectiveness
Supplement to Chapter 8, 338


INDEX 367

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