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

Although it is expected that Long-Acting and Permanent Methods of Contraception should be more acceptable owing to greater benefits, they have engendered considerable controversy. Political, ethical, and safety questions have emerged, stemming from the ways in which these contraceptives have been developed and used over the course of this century. At the heart of the concern is the issue of reproductive rights and freedom. While many researchers have assessed demographic and socio-cultural factors influencing contraceptive use in Africa, few attempts have been made to assess the same in Kenya. This book examines socio-economic and communication-based socio-cultural factors that can encourage or inhibit the up-take of LAPMs including problems associated with their use such as the prospects of new methods that are likely to emerge from ongoing research and development. It also examines the use and/or abuse of LAMPs and describes new reproductive health shifts. Thus this book will be especially useful to Medical and community health workers, community media workers and policy makers.

Family planning programs have been highly successful over the past 30 years in providing women in developing countries with desired access to contraceptive services and helping to reduce fertility rates. Notwithstanding this success, there is still an urgent need for these programs. The world's population is increasing, with annual population growth still approximately 80 million people. Nearly all of this growth is occurring in developing nations, where fertility rates remain relatively high. This high fertility runs counter to the preferences expressed by millions of women, who actually want to have smaller families. Family planning programs are also desirable because they are associated with a range of other benefits, most notably improvements in women's and children's health. Host countries provide about 60 to 75 percent of funding for family planning. However, funding and technical assistance from donor nations, especially the United States, have been crucial to the past success of family planning programs and are equally important for strengthening and expanding program efforts to meet future challenges.

This book analyzes the origins and rationale of family planning programs and how they have evolved based on experience in different country settings.