This book discusses current trends in contraceptive use, socioeconomic and program variables that affect the demand for and supply of children, and the relationship of increased contraceptive use to recent fertility declines.

Experts estimate that nearly 60 percent of all U.S. pregnancies--and 81 percent of pregnancies among adolescents--are unintended. Yet the topic of preventing these unintended pregnancies has long been treated gingerly because of personal sensitivities and public controversies, especially the angry debate over abortion. Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are wanted. Now, current issues--health care and welfare reform, and the new international focus on population--are drawing attention to the consequences of unintended pregnancy. In this climate The Best Intentions offers a timely exploration of family planning issues from a distinguished panel of experts. This committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the United States on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention programs. The Best Intentions explores problematic definitions--"unintended" versus "unwanted" versus "mistimed"--and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they bear. Why does unintended pregnancy occur? In discussions of "reasons behind the rates," the book examines Americans' ambivalence about sexuality and the many other social, cultural, religious, and economic factors that affect our approach to contraception. The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. And the book looks at such practical issues as the attitudes of doctors toward birth control and the place of contraception in both health insurance and "managed care." The Best Intentions offers frank discussion, synthesis of data, and policy recommendations on one of today's most sensitive social topics. This book will be important to policymakers, health and social service personnel, foundation executives, opinion leaders, researchers, and concerned individuals. May

One million women are "missing" from India's population due to female neglect of various sorts--and possibly one million more due to acts of direct elimination before birth. Within that context, this collection employs several field surveys to explore the connections between population, gender, and development by way of two distinct sets of conditions. The first set involves individual endowments--the resources that a household will allocate to its women. The second set concerns the ways in which the productive and reproductive roles of men and women are structured in societies. With the help of theoretical reviews and empirical studies, this book illustrates the powerful, intermediary effects of gender relations in modifying or reinforcing gender biases.

Background: Despite international efforts to improve reproductive health indicators, little attention is paid to the contributions of contextual factors to modern contraceptive coverage, especially in the Latin America and the Caribbean (LAC) region. This study aimed to identify the association between Gender Inequality and Health Expenditure with demand for family planning satisfied by modern contraceptive methods (DFPSm) in sexually active women from LAC countries.Methods: Our analyses included data from the most recent (post-2010) Demographic and Health Survey or Multiple Indicator Cluster Survey from 14 LAC countries. Descriptive analyses and multilevel logistic regressions were performed. Six individual-level factors were included. The effect of the contextual factors Gender Inequality Index (GII) and Current Health Expenditure on DFPSm was investigated.Findings: DFPSm ranged from 41·8% (95% CI: 40·2 - 43·5) in Haiti to 85·6% (95% CI: 84·9 - 86·3) in Colombia, with an overall median coverage of 77·8%. A direct association between the odds of DFPSm and woman's education, wealth index, and the number of children was identified. Women from the third GII tertile were less likely (OR: 0·32, 95% CI: 0·13 - 0·76) to have DFPSm than those living in countries from the first tertile.Interpretation: Knowing the contribution of country-level factors to modern contraception may allow macro-level actions focused on the population's reproductive needs. In this sense, gender inequalities play an important role, as well as individual factors such as wealth and education.Funding Information: This work was supported by the Bill and Melinda Gates Foundation [OPP1199234] and [INV-010051]. The Associação Brasileira de Saúde Coletiva (ABRASCO) also acts as sponsor of the study.Declaration of Interests: The authors do not report any conflicting interests.

The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.