Abstract
<h3>To the Editor.</h3> —Adolescent pregnancy is associated with a variety of individual and societal costs, as the study by Ms Spitz and colleagues<sup>1</sup>notes, and the phenomenon has become an increasingly important element in policy debate. Conservatives and liberals alike are eager to uncover the root causes of adolescent childbirth. We were surprised, therefore, at the study's concluding statement that "95% of adolescent pregnancies are unintended," implying that adolescent pregnancy is accidental. First, we wonder how this 95% figure was obtained. Surveying teens with children about their intent is problematic. Whatever the teen's prepregnancy state of mind, if she has now been hit by the reality of child rearing, her current feeling will likely be that she did not intend these particular consequences. Citing this 95% figure, without questioning further, obscures deeper issues facing American adolescents. Perhaps adolescent childbirth has less to do with sex and contraception and more to do with
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