Consequences Of Unintended Pregnancy Research Articles

Adolescent marriage a violation of sexual and reproductive health rights: Trend, spatial variation and covariate analysis from national family health survey

IntroductionTen-to-Nineteen-year adolescent period is a very sensitive time for both boys and girls. Especially adolescent girls suffer more due to early marriage and its consequences of unintended pregnancy, unsafe abortion, high risk for sexually transmitted disease etc. ObjectiveThis study tried to analyse trend and spatial variation of adolescent girls' marriage practice in India. Further, this study is also tried to identify major socio-economic factors responsible for adolescent girl's marriage. MethodsPresent study utilized different rounds of National Family Health Survey (NFHS) data. Trend analysis carried out with the help of 3rd, 4th and 5th round of NFHS data. Bivariate distribution and logistic regression are used for identifying determining factors for adolescent girls’ marriage. ResultsTrend analysis result reveals the declining trend of early adolescent girls' marriage in India. However, the data reveals early girl's marriage practice is still very high. This practice is more in the states of Tripura (31%) followed by West Bengal (28%). Place of residence, wealth status, education status and mass media exposure are the main determining factors in early marriage. ConclusionMost of the states in Eastern and North-Eastern states are having high prevalence of adolescent marriage. Thus, there is an urgent need to focus on these states along with addressing socio-economic disparities. Further, there is a need of effective interventions of girl specific programmes like Beti Bachao Beti Padhao, Balika Samridhi yojana etc. working for empowerment and wellbeing of adolescent girls.

Induced Abortion and Life Satisfaction in Germany: The Role of Selection Processes and Short-Term Effects

AbstractUnintended pregnancies resulting in induced abortion are occasionally associated with poor psychological well-being. In the literature, this is attributed to either (1) the consequences of abortion, (2) the consequences of unintended pregnancy, or (3) specific selection processes. This longitudinal study addresses these explanations based on data from the German family panel “pairfam” (n = 3,604 women). It compares changes in life satisfaction among different groups of women: Those who had an abortion, those who had a live birth, and those who were not pregnant. A matching procedure ensures the comparability of the groups. The results show that women reported temporarily lower life satisfaction immediately after abortion than similar women following live birth or in absence of pregnancy, while no significant group differences were found in the long run. However, abortion is preceded by significantly lower pre-event life satisfaction than live birth or absence of pregnancy. Persistent poor well-being should therefore primarily be considered a selection criterion for abortions resulting from unintended pregnancies rather than as their consequence.

Prevalence and determinants of unintended pregnancy in Ethiopia: narrative synthesis and meta-analysis

BackgroundUnintended pregnancy has enormous health, social and psychological impacts. Thus, comprehensive local evidence is required to guide interventions to prevent the occurrence and consequences of unintended pregnancy. This systematic review was conducted to examine the prevalence and determinants of unintended pregnancy in Ethiopia. MethodsThe review was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis Without Meta-analysis (SWiM) guideline. Electronic databases including Medline/PubMed, Cochrane Library, CINAHL, Google scholar, and African journal online were searched to retrieve studies published from January 1/1990 to October 30/2020. Grey literatures were accessed from the online libraries of academic institutions in Ethiopia using the Google search engine. The qualities of the studies were assessed using Joanna Briggs Institute critical appraisal checklists. The retrieved studies were analyzed using STATA software version 13. The prevalence of unintended pregnancy was pooled using the random-effects model. The evidences on the determinants of unintended pregnancy were summarized in a narrative format. The statistical heterogeneity between studies was quantified by using the I-square values. Sub-group analysis and meta-regressions were done to identify the sources of heterogeneity among studies. ResultsA total of 250 studies were retrieved of which 25 studies with 23,030 women were included for meta-analysis. Only 24 studies scrutinized the determinants of unintended pregnancy. The overall prevalence of unintended pregnancy was 30 % (95% CI; 27–33 %) with high heterogeneity among studies (I2 = 95.06 %). The pooled prevalence of unwanted and mistimed pregnancy was 12 &17% respectively. The study region was the source of heterogeneity whereas study setting, study year, sample size, and study quality score were not the sources of heterogeneity (p > 0.1). Unintended pregnancy was positively associated with a low level of education, poverty, multiparity, rural residence, extreme ages, being unmarried, lack of decision-making power, inaccessibility of health facilities, poor knowledge, and non-use of contraceptives. ConclusionsThe pooled prevalence of unintended pregnancy in Ethiopia was high. Empowering women and ensuring the accessibility of quality family planning services can reduce the prevailing high prevalence of unintended pregnancy. Interventions that target rural, poor, unmarried, multiparous, less-educated, and adolescent women are also important to avert untended pregnancy in Ethiopia.

Postplacental Placement of Intrauterine Devices: Acceptability, Reasons for Refusal and Proposals to Increase its Use.

To evaluate the acceptability of postplacental placement of intrauterine devices (PPIUD), reasons for refusal and suggested policies to increase its use. Cross-sectional study conducted at the Women Hospital of the Universidade de Campinas, Campinas, SP, Brazil. Postplacental placement of intrauterine devices was offered to women admitted in labor who did not present infections, uterine malformation, twin pregnancy, preterm birth, and were at least 18 years old. In case of refusal, the parturient was asked to give their reasons and the answers were classified as misinformation about contraception or other reasons. The following were considered misinformation: fear of pain, bleeding, contraception failure and future infertility. Bivariate analysis was performed. Amongst 241 invited women, the refusal rate was of 41.9%. Misinformation corresponded to 50.5% of all refusals, and the reasons were: fear of pain (39.9%); fear of contraception failure (4.9%); fear of bleeding (3.9%); fear of future infertility (1.9%); other reasons for refusal were 49.5%. Parturients aged between 18 and 27 years old refused the PPIUD more frequently due to misinformation (67.4%), and older parturients (between 28 and 43 years old) refused frequently due to other reasons (63.6%) (p = 0.002). The mean age of those who declined the PPIUD due to misinformation was 27.3 ± 6.4 years old, while those who declined for other reasons had a mean age of 29.9 ± 5.9 years old (p = 0.017). The refusal of the PPIUD was high, especially amongst young women and due to misinformation. It is necessary to develop educative measures during antenatal care to counsel women about contraception, reproductive health and consequences of unintended pregnancy.

Uptake of Long-Acting Reversible Contraceptive Methods in Enugu State University Teaching Hospital Enugu, South-East, Nigeria.

Background: Long Acting Reversible Contraceptive (LARC) methods provide very effective contraception for extended periods that do not depend on clients’ daily compliances or adherences. They are the ideal methods for the prevention of the harmful consequences of unintended pregnancies in most women including adolescents. Objectives: To determine the uptake rate of LARC in ESUTH Enugu, assess the characteristics of the acceptors, identify barriers, and make recommendations. Method: The new client register in ESUTH, Enugu was reviewed retrospectively from December 31, 2015 back to January 1, 2011. Data on clients’ characteristics, and uptakes of LARC and Non-LARC were extracted from the register, entered in Excel 2007 software, analyzed, and presented using percentages and graphs. Results: A total of 1737 clients accepted the available family planning methods during the five-year study period. One thousand five hundred and sixty seven (90.21%) accepted LARC while 170(9.79%) only accepted non-LARC. The LARC uptake rate was 90.21%. Majority of the clients were 30-39 years of age 1121(64.54%), 690 (39.72%) had secondary education, 821(47.27%) had tertiary education, and Christians were 1510 (86.93%). The acceptors increased as parity increased with a peak at Para 4 of 490(28.21%). Clients less than 20 years (0.06%), not educated (1.27%), and Para 0 (0.4%) rarely access the family planning clinic. The LARC acceptors opted for jadelle 526(30.28%) and implanon 465(26.77%) sub-dermal implants, depo-provera 276(15.89%), interval intrauterine contraceptive device 232(13.36%), noristerat 48(2.76%), and postpartum intrauterine contraceptive device 20(1.15%). Conclusion: There is a very high uptake of LARC in Enugu. Jadelle and implanon constitute over 50% of the LARC uptakes. Adolescents (< 20 years), less educated and low parity clients rarely access the family planning clinic.

Sexual Violence and Consequences of Unintended Pregnancy among the Street Based Sex Workers in Nepal

Unintended pregnancy, concerning particularly in street based female sex workers (SFSWs) who solicit in streets or public places for sex, is closely associated with sexual relation involuntarily and often unwillingly. It seriously challenges in physical, mental, social and economic wellbeing hazardously. The aim of the study is to explore the sexual violence, use of contraception and events and consequences of unintended pregnancy, the study of which is lacking up to the present time in Nepal. A cross-sectional study is conducted using mixed method consisting of questionnaire-based survey with 110 SFSWs along with case studies and observations. Respondents are identified by using snowball sampling technique. The findings are presented descriptively after arranging in different themes. Results show that almost all the SFSWs had experienced sexual violence at least once after involving in sex trade; 74 percent had threatening experience and 87 percent induced abortion among the unintended pregnancy from clients. The results indicate that the forced prostitution and threatening experience to follow clients' interest and unprotected sex are significantly hazardous for SFSWs' overall health. High prevalence of sexual violence and unintended pregnancy result in poor health outcomes for SFSWs. Assuring the sexual health and life safety of SFSWs from group sexual violence is another risk area for further exploration.

"A Baby Was an Added Burden": Predictors and Consequences of Unintended Pregnancies for Female Sex Workers in Mombasa, Kenya: A Mixed-Methods Study.

IntroductionFemale sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya.MethodsA prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant during the study, and interviews with five key informants. These data were transcribed, translated and analysed thematically.ResultsFour hundred women were enrolled, with 92% remaining in the cohort after one year. Fifty-seven percent reported using a modern contraceptive method (including condoms when used consistently). Over one-third (36%) of women were using condoms inconsistently without another method. Twenty-four percent had an unintended pregnancy during the study. Younger age, having an emotional partner and using traditional or no contraception, or condoms only, were independent predictors of unintended pregnancy. Women attributed pregnancy to forgetting to use contraception and being pressured not to by clients and emotional partners, as well as “bad luck”. They described numerous negative consequences of unintended pregnancy.ConclusionModern contraceptive uptake is surprisingly low in this at-risk population, which in turn has a high rate of unintended pregnancy. The latter may result in financial hardship, social stigma, risk of abandonment, or dangerous abortion practices. FSWs face considerable barriers to the adoption of dual method contraceptive use, including low levels of control in their emotional and commercial relationships. Reproductive health services need to be incorporated into programs for sexually transmitted infections and HIV, which address the socially-determined barriers to contraceptive use.

Death and Desirability: Retrospective Reporting of Unintended Pregnancy After a Child's Death.

Social scientists have long debated how to best measure pregnancy intentions. The standard measure relies on mothers' retrospective reports of their intentions at the time of conception. Because women have already given birth at the time of this report, the resulting children's health-including their vital status-may influence their mothers' responses. We hypothesize that women are less likely to report that deceased children were from unintended pregnancies, which may explain why some cross-sectional studies have shown that children from unintended pregnancies have higher survival, despite the fact that longitudinal studies have shown the opposite is true. Using Demographic and Health Survey data from 31 sub-Saharan African countries, we confirm that mothers are less likely to report that deceased children resulted from unintended pregnancies compared with surviving children. However, the opposite is true for unhealthy children: mothers more commonly report that unhealthy children were from unintended pregnancies compared with healthier children. The results suggest that mothers (1) revise their recall of intentions after the traumatic experience of child death and/or (2) alter their reports in the face-to-face interview. The study challenges the reliability of retrospective reports of pregnancy intentions in high-mortality settings and thus also our current knowledge of the levels and consequences of unintended pregnancies in these contexts.

Update on Hormonal Contraception and Obesity

As the prevalence of obesity increases among women of reproductive age, providers must be aware of the safe and effective contraceptive methods available to reduce the adverse consequences of unintended pregnancy in this population. Hormonal contraception, in particular, has potential for increased risk in obese women. In addition, some pharmacokinetic studies suggest that contraceptive efficacy may be compromised in obese women. This review summarizes the known potential risks and variations in efficacy for hormonal contraception in obese and overweight women and in women following bariatric surgery.

Prevalence and determinants of unintended childbirth in Ethiopia.

BackgroundEthiopia’s population policy specifically aims to reduce TFR from 7.7 to 4.0 and to increase contraceptive use from 4.0% to 44.0% between 1990 and 2015. In 2011, the use of contraceptive methods increased seven-fold from 4.0% to 27%; and the TFR declined by 38% to 4.8. The use of modern contraceptives is, however, much higher in the capital Addis Ababa (56%) and other urban areas but very low in rural areas (23%) far below the national average (27%). In 2011, one in four Ethiopian women had an unmet need for contraception. The main aim of this study was to assess the pattern and examine the socioeconomic and demographic correlates of unintended childbirth among women 15-49 years in Ethiopia.MethodsData from the 2011 nationally representative Ethiopia Demographic and Health Survey are used. It covered 16,515 women of which 7,759 had at least one birth and thus included for this study. Multivariate logistic regression is used to see the net effects of each explanatory variable over the outcome variable.ResultsThe study found that nearly one in three (32%) births was unintended; and about two-thirds of these were mistimed. The regression model shows that the burden of unintended births in Ethiopia falls more heavily on young, unmarried, higher wealth, high parity, and ethnic majority women and those with less than secondary education and with large household size. These variables showed statistical significance with the outcome variable.ConclusionThe study found a relatively high prevalence of unintended childbirth in Ethiopia and this implies high levels of unmet need for child spacing and limiting. There is much need for better targeted family planning programs and strategies to strengthen and improve access to contraceptive services, to raise educational levels, and related information and communication particularly for those affected groups including young, unmarried, multipara, and those with less than secondary level of education. Further quantitative and qualitative research on the consequences of unintended pregnancy and childbirth related to prenatal and perinatal outcomes are vital to document process of change in the problem overtime.

The burden of unintended pregnancies in Brazil: a social and public health system cost analysis.

BackgroundUnintended pregnancy (UP) is an unmet medical need with consequences worldwide. We evaluate the costs of UP based on pregnancies in Brazil from for the year 2010.MethodsThe consequences of UP were evaluated using decision analysis based on pregnancy rates and outcomes as miscarriage, induced abortion, and live birth, which were factored into the analysis. The model discriminated between maternal and child outcomes and accounted for costs (in Brazilian currency [Real$, R$]) within the Brazilian public health service attributed to preterm birth, neonatal admission, cerebral palsy, and neonatal and maternal mortality. Event probabilities were obtained from local resources.ResultsWe estimate that 1.8 million UPs resulted in 159,151 miscarriages, 48,769 induced abortions, 1.58 million live births, and 312 maternal deaths, including ten (3%) attributed to unsafe abortions. The total estimated costs attributed to UP are R$4.1 billion annually, including R$32 million (0.8%) and R$4.07 billion (99.2%) attributed to miscarriages and births and complications, respectively. Direct birth costs accounted for approximately R$1.22 billion (30.0%), with labor and delivery responsible for most costs (R$988 million; 24.3%) for the year 2010. The remainder of costs were for infant complications (R$2.84 billion; 72.3%) with hospital readmission during the first year accounting for approximately R$2.15 billion (52.9%). Based on the national cost, we estimate the cost per UP to be R$2,293.ConclusionDespite weaknesses in precise estimates in annual pregnancies and induced abortions, our estimates reflect the costs of UP for different pregnancy outcomes. The main costs associated with UP are in those carried to parturition. The health cost of abortion represents a small proportion of total costs as these are paid for outside of the public health system. Consequently, reductions in UP will generate not only cost savings, but reductions in woman and child morbidity and mortality.

Adolescent Mothers' Subjective Well-Being and Mothering Challenges in a Yoruba Community, Southwest Nigeria

Well-being varies within cultures and context. Studies on the well-being and mothering challenges of adolescents in Nigeria have focused on the general poor well-being of adolescent mothers rather than exploring their agency and subjective well-being within specific context. This study explores adolescent mothers' (13–20 years) subjective well-being by focusing on their childbirth, mothering experiences, and available network of supports. Thirty face-to-face in-depth interviews were conducted through the support of four informants and peer referrals. Content analysis was used to identify salient themes and patterns. Findings showed that a high proportion of the adolescent mothers had stigmatizing experiences among which include dropping out of school, and lack of supports from families, friends, and the society. Where available, supports were perceived as inadequate in contributing to their well-being and that of their children. Some of the adolescent mothers were apprehensive of losing their children to ill health while emphasizing that their present challenges could affect their children's future. However, the adolescent mothers invoked their agency by subtly using strategies such as petty trading and apprenticeship to reduce the social consequences of unintended pregnancy and earn a living. Recognizing adolescent mothers' agency in policies targeted toward their empowerment would be of benefit.

Risk factors for and consequences of unintended pregnancy among Latina and white populations in Utah, 2004-2007

Risk factors for and consequences of unintended pregnancy among Latina and white populations in Utah, 2004-2007

“It is Not Just about Me”: A Relational Understanding of Young Women's Sexual Negotiations

Social work has historically been reactive in approaching young women's sexuality, often focusing on the consequences of unintended pregnancy. This pattern has inadvertently perpetuated the silencing of young women's sexual selves, leaving them vulnerable in sexual decision making. This article presents a new conceptual model to explore relational influences on young women's sexual negotiations. It extends the theory of planned behavior, previously used to predict contraceptive use, by incorporating the self‐in‐relation model, which addresses gender differences in decision making. A case scenario depicts how practitioners can explore the difficulties of sexual negotiation and develop possible solutions in a manner that is consistent with young women's lived experiences.

Rights to emergency contraception

Emergency contraception (EC) provides women with a safe means of preventing pregnancy following unprotected sexual intercourse or potential contraceptive failure, and is accepted as a legitimate method of fertility control. The right of women to access EC, along with other contraceptive methods, needs to be affirmed. The consequences of unintended pregnancy are serious, imposing appreciable burdens on children, women, men, and families. Every child has the right to be a wanted child and not enter this world because its mother was denied access to EC. For maximum effectiveness, barriers to access must be removed. It is essential that EC pills are available over-the-counter with no minimum age for access. There is a tension between the rights of women to access EC without medical or legal intervention and the rights of providers who have a conscientious objection to provision on religious or moral grounds. The principles of autonomy, non-maleficence, and beneficence all weigh in favor of the rights of a woman faced with the possibility of an unintended pregnancy to unrestricted access to EC against providers whose religious views are opposed to this.

Prevention and Women's Reproductive Health: A Matter of Concern

The recent legislation on abortion in South Dakota and the subsequent copycat legislation proposed in nine other states (Alan Guttmacher Institute, 2006a) are a grim reminder of the continuing assault on women's reproductive health by state legislatures. The South Dakota law makes it a felony for physicians to perform abortions except to save the life of the mother. Amendments to make exceptions for cases of rape and incest were introduced for consideration; however, they were defeated. With the recent appointment changes to the Supreme Court, states may be viewing legislation such as the South Dakota law as an opportunity to overturn the landmark case of Roe v. Wade (which legalized abortion in the United States on a national level) and return abortion policy to the states. Although this movement may reflect the sentiment of some states to control abortion policy, it is interesting to note that many states already determine abortion policy for poor women, who have been unable to obtain a Medicaid-funded abortion since the implementation of the Hyde Amendment in 1977. The Hyde Amendment (P.L. 94-439) prohibited the use of federal funding for abortion except in cases of life endangerment, rape, or incest. Thirty-two states follow that federal standard established with this amendment and provide Medicaid abortions only in these exceptional cases (Alan Guttmacher Institute, 2006b). South Dakota refuses to fund Medicaid abortions for rape and incest, which is a violation of the federal standards. Poor women, however, are most at risk of having an unintended pregnancy and obtaining an abortion. Half of all pregnancies in the United States are unintended, but the rate of unintended pregnancy varies by income. In 2001 women whose incomes placed them below the federal poverty level were four times as likely to experience an unintended pregnancy and three times as likely to have an abortion as women whose incomes placed them above 200 percent of the poverty level (Finer & Henshaw, 2006). Furthermore, the rate of unintended pregnancy was stable, at 49 percent, between 1994 and 2001, but it increased by 29 percent among women below the poverty level and increased by 26 percent for women between 100 percent and 200 percent of the poverty level. The abortion rate among U.S. women decreased during these years, as did the proportion of unintended pregnancies that resulted in abortion (Finer & Henshaw). Data from the National Center for Health Statistics (2005) reveal that unwanted births increased from 9 percent in 1995 to 14 percent in 2002. The data also show that women whose pregnancies are unintended are disproportionately young, unmarried, African American, and have low income. Ironically, the proportion of publicly funded family planning agencies receiving Medicaid funding--clinics that typically serve this population--fell from 91 percent to 81 percent between 1995 and 2003 (Lindberg, Frost, Sten, & Dailard, 2006). Given the social, health, and economic consequences of unintended pregnancy (Brown & Eisenberg, 1995), it would seem logical to enact policies and implement programs targeting its reduction. The opposite seems to be occurring. Policies continue to be developed that deny the reality of human behavior and biological phenomenon. An example of such a policy is abstinence-only sex education, which sometimes provides incorrect information about the consequences of sexual behavior and abortion (U.S. House of Representatives, 2006). Some research findings on abstinence-only programs indicate that they may delay intercourse, but do not prevent intercourse and sexual behavior (Bruckner & Bearman, 2005; Jemmott, Jemmott, & Fong, 1998) or have no effect on sexual behavior (Texas Department of State Health Services, 2005). In addition, many school districts forbid the provision of positive information about contraception (Landy, Kaeser, & Richards, 1999), and two-thirds of the states have policies that would allow sex education in the schools only if the students obtain parental consent to participate in the program (Gold & Nash, 2001). …

Consequences for Infants of Parental Disagreement in Pregnancy Intention

Despite the well-established literature on couples' pregnancy intentions and on the consequences of unintended pregnancy, the effects of parents' disagreement in fertility intentions has not been explored. Parental disagreement in pregnancy intention, as well as a father's pregnancy intention, may affect infant health. Logistic regression analyses using 1979-1992 data from the National Longitudinal Survey of Youth assess effects of unintendedness and parents' disagreement on outcomes related to infants' health and development. Analyses are conducted separately for married and unmarried women; for women of each marital status, one set of analyses includes extensive controls for socioeconomic background, and a second compares effects of intended and unintended pregnancies within the same family. Infants whose conception was intended by their mother but not their father are at elevated risk of adverse health events. When a pregnancy was not intended by the mother, risks are higher than they are if both parents intended the pregnancy, but they differ little according to father's intention. Thus, it may be useful to classify pregnancies as intended by both parents or not intended by at least one. In comparisons of siblings, unintended fertility (so defined) is associated with delayed prenatal care and reduced initiation of breastfeeding. Information on both parents' fertility intentions is needed to identify infants at risk of adverse health and developmental outcomes.

Reducing unintended pregnancy by increasing access to emergency contraceptive pills.

National and state data on the health, social, and economic consequences of unintended pregnancy prompted Washington policy makers to identify strategies to reduce such pregnancies. Though not well known, emergency contraceptive pills (ECPs) are a safe and effective contraceptive method that can prevent pregnancy if taken within 72 hr after unprotected intercourse. A coalition conceived the idea of enabling pharmacists to prescribe ECPs directly to women through collaborative drug therapy agreements (CDTAs) with physicians. Following a feasibility study, five agencies initiated a novel pilot project in western Washington. Key components included informing pharmacists about ECPs and CDTAs; developing tools, providing training, and developing systems to establish pharmacist/ prescriber collaborative agreements; conducting a public awareness campaign; evaluating the impact of the project; and disseminating the results. More than 1000 pharmacists received training in all aspects of providing ECPs and 140 pharmacies participated in the project, with more than 145 CDTA on file. In the 16 months of pharmacy service provision, 11,969 ECP prescriptions were provided, possibly preventing 700 or more unintended pregnancies. The media launch led to 200 broadcast stories and increased calls to the ECP Hotline from 116 to an average of 1160 per month. Enabling pharmacists to provide ECPs directly to women is a convenient delivery system for a time-limited therapy. It increases the chances that women will use the therapy effectively and connects women without a provider to a source of care. By increasing access to an effective contraceptive, this projects supports the Washington State goal of reducing unintended pregnancy.

The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families

This report concerns unintended pregnancy and its consequences in the United States and represents the collaborative efforts of several groups and individuals. It notes that an estimated 57% of all U.S. pregnancies are unintended and that women of all ages not just adolescents are affected. The book "offers specific recommendations to put the United States on par with other developed nations in terms of unintended pregnancy rates; considers the effectiveness of over 20 pregnancy prevention programs; explores problematic definitions--unintended versus unwanted versus mistimed--and presents data on pregnancy rates and trends; summarizes the health and social consequences of unintended pregnancies for both men and women and for the children they bear; examines Americans ambivalence about sexuality and the many other social cultural religious and economic factors that affect our approach to contraception; [and] explores the complicated web of peer pressure life aspirations and notions of romance that shape an individuals decisions about sex contraception and pregnancy." (EXCERPT)