The Best Intentions -- Copyright -- Acknowledgments -- Contents -- The Best Intentions -- Summary -- COMMITTEE RECOMMENDATIONS -- The Campaign to Reduce Unintended Pregnancy -- Campaign Leadership -- 1 Introduction -- FOCUS OF THIS REPORT -- STUDY METHODS AND REPORT ORGANIZATION -- 2 Demography of Unintended Pregnancy -- TERMINOLOGY -- PERCENTAGE RATES OF UNINTENDED PREGNANCY -- WOMEN AT RISK OF UNINTENED PREGNANCY -- WOMEN WHO HAVE UNINTENDED PREGNANCIES -- TRENDS IN UNINTENDED PREGNANCY -- Overall Trends for All Women -- Trends Among Currently Married Women -- Trends Among Never-Married Women -- Trends in Births Unwanted at Conception -- THE ROLE OF ABORTION -- Factors That Affect Who Obtains an Abortion -- INTERNATIONAL COMPARISONS -- U.S. Abortion Rates Versus Other Western Democracies -- CONCLUSION -- REFERENCES -- 3 Consequences of Unintended Pregnancy -- ABORTION AS A CONSEQUENCE OF UNINTENDED PREGNANCY -- Medical Complications -- Rates of Complications -- Psychological Issues -- Political Issues -- MATERNAL DEMOGRAPHIC STATUS -- Adolescent Childbearing: Socioeconomic Issues -- Adolescent Childbearing: Medical Issues -- Childbearing at Older Ages: Socioeconomic and Medical Issues -- Childbearing by Single Women -- THE EFFECTS OF INTENDEDNESS -- Methodological Concerns -- Prenatal Care -- Behavioral Risks in Pregnancy -- Low Birthweight -- Infant Mortality -- Poor Child Health and Development -- Consequences for the Parents -- Mothers -- Fathers -- PRECONCEPTION CARE -- THE DEMOGRAPHIC IMPLICATIONS OF REDUCING UNINTENDED PREGNANCY -- CONCLUSION -- REFERENCES -- 4 Patterns of Contraceptive Use -- PATTERNS OF CONTRACEPTIVE USE AND UNINTENDED PREGNANCY -- Unintended Pregnancy Among Women Using No Contraception (Group C) -- Unintended Pregnancy Among Women Using Contraception (Groups A and B) -- Contraceptive Sterilization.

Reversible Contraception -- Current Choices Among Reversible Methods -- Reversible Contraceptive Methods: Types and Trends -- CONTRACEPTIVE USE AMONG MEN -- Use of Male Methods of Contraception at First Intercourse -- Use of Male Methods by Married Men -- Age and Condom Use -- Race, Ethnicity, and Condom Use -- Socioeconomic Status and Condom Use -- USE OF DUAL CONTRACEPTIVE METHODS -- SEXUALLY TRANSMITTED DISEASES -- CONCLUSION -- REFERENCES -- 5 Basic Requirements: Contraceptive Knowledge and Access -- KNOWLEDGE, SKILLS, AND SCHOOL-BASED EDUCATION -- Contraceptive Knowledge -- Contraceptive Skills -- School-Based Education and Information -- ACCESS TO CONTRACEPTION -- Data on Overall Access -- Financial Barriers -- Private Insurance -- Health Maintenance Organizations -- Public Sector Programs -- Contraceptive Pricing -- The Provider Base for Contraception -- Bureaucratic Hurdles -- MISSED OPPORTUNITIES -- CONCLUSION -- REFERENCES -- 6 Personal and Interpersonal Determinants of Contraceptive Use -- A COMMENT ON AVAILABLE DATA -- UNDERLYING THEMES -- SINGLE FACTOR INVESTIGATIONS -- Personality Characteristics -- Attitudes and Feelings About Sexuality and Fertility -- Attitudes and Feelings About Contraceptive Methods -- Substance Abuse, Peer Influences and Family Relationships -- Alcohol and Substance Use -- Parents and Peers -- Partner and Couple Issues -- CONCLUSION -- REFERENCES -- 7 Socioeconomic and Cultural Influences on Contraceptive Use -- DIVERSITY IN U.S. CULTURE -- Cultural and Ethnic Diversity -- Religious and Political Diversity -- CONFLICTING VIEWS ABOUT SEXUALITY -- The Media -- International Comparisons -- ECONOMIC INFLUENCES ON FERTILITY -- AFDC and Other Transfer Programs -- Potential Influences -- Empirical Findings -- RACISM -- Race, Welfare, and Birth Control -- Genocide -- VIOLENCE -- GENDER BIAS -- OPPOSITION TO ABORTION.

CONCLUSION -- REFERENCES -- 8 Programs to Reduce Unintended Pregnancy -- NATIONAL PROGRAMS -- LOCAL PROGRAMS -- Historical Perspective -- Program Search and Selection -- Evaluated Programs -- A Comment on Program Evaluation -- Cost -- Methodological Issues -- Social Environment -- CROSS-CUTTING THEMES -- THE FISCAL IMPACT OF FAMILY PLANNING FUNDING -- Program Reactions to Funding Withdrawal -- Treatment of Mistimed and Unwanted Pregnancies -- Program Eligibility Versus Participation -- Incomplete Accounting for Public Revenue Effects -- CONCLUSION -- REFERENCES10 -- 9 Conclusions and Recommendations -- A NEW SOCIAL NORM -- THE CAMPAIGN TO REDUCE UNINTENDED PREGNANCY -- Campaign Goal 1: Improve knowledge about contraception, unintended pregnancy, and reproductive health. -- Campaign Goal 2: Increase access to contraception. -- Campaign Goal 3: Explicitly address the major roles that feelings, attitudes, and motivation play ... -- Campaign Goal 4: Develop and scrupulously evaluate a variety of local programs to reduce unintende ... -- Campaign Goal 5: Stimulate research to (a) develop new contraceptive methods for both men and wome ... -- CAMPAIGN LEADERSHIP -- REFERENCES -- Appendixes -- A Commissioned and Contributed Papers -- B The Political Storms over Family Planning: Supplement to Chapters 1 and 7 -- Historical Background -- Conclusion -- C The National Survey of Family Growth: Principal Source of Statistics on Unintended Pregnancy: Supplement to Chapter 2 -- Definitions and Measurement Issues -- NSFG Plans for the Future -- Improving Abortion Reporting -- Clarifying Questions on Unwanted and Mistimed Pregnancies -- Measuring Ambivalence about Pregnancy -- Improving Questions on Unplanned Pregnancies and Use of Contraception -- REFERENCES -- D Tables of Odds Ratios: Supplement to Chapter 3.

E Technical Notes on the Recalculation Exercise: Supplement to Chapter 3 -- Births Unwanted at Conception -- Births Mistimed at Conception -- F Summaries of Evaluated Programs: Supplement to Chapter 8 -- Community of Caring -- Primary Reference: -- Condom Mailing Program -- Primary Reference: -- Elmira Nurse Home Visiting Program -- Primary References: -- Facts and Feelings -- Primary Reference: -- Girls Incorporated Preventing Adolescent Pregnancy -- Primary References: -- Group Cognitive Behavior Curriculum -- Primary References: -- McCabe Center -- Primary References: -- New Chance -- Primary References: -- The Ounce of Prevention Fund's Parents Too Soon Program -- Primary Reference: -- Postponing Sexual Involvement -- Primary References: -- Project Redirection -- Primary References: -- Project Taking Charge -- Primary References: -- Reducing the Risk -- Primary References: -- Reproductive Health Screening of Male Adolescents -- Primary References: -- School/Community Program for Sexual Risk Reduction Among Teens -- Primary References: -- Self Center -- Primary References: -- Six School-Based Clinics -- Primary Reference: -- St. Paul School-Based Health Clinics -- Primary References: -- Success Express -- Primary References: -- Summer Training and Education Program -- Primary Reference: -- Teenage Parent Demonstration -- Primary References: -- Teen Outreach Program -- Primary References: -- Teen Talk -- Primary References: -- G Assessing Program Effectiveness and Cost-Effectiveness: Supplement to Chapter 8 -- Assessing Program Effectiveness -- Assessing Cost-Effectiveness -- Cost-Effectiveness in Family Planning -- Dimensions of Cost-Effectiveness -- Translating Service Statistics into Measures of Contraceptive Protection -- Predicting Net Program Effects Without Individual Data -- Estimating the Cost Functions -- Summary -- Conclusions.

REFERENCES -- Index.