David E. Newton - Birth Control

Sandy Becker

Kirk Brennan

Linda Heiden

Emily Hirsch

Joyce Krensky

David L. Levine

Liesl Nydegger

Marissa Quenqua

Ilka Sankari

Unplanned pregnancies are a crucial fact of life in the United States and other countries of the world today. In 2011, the year for which the most recent data are available, 45 out of every 1,000 pregnancies (an estimated 2.8 million pregnancies) in the United States were unplanned. That number means that about 5 percent of reproductive-age women in the country were having an unintended pregnancy every year. Of this number, 27 percent (out of 45 percent) were unexpected pregnancies that a women or couple had hoped for sometime later in their lives. The other 18 percent were pregnancies that were just not wanted under any circumstance. These numbers are the highest for any developed country in the world.

The rate of unplanned pregnancies was very different for various subgroups of women: five times as great among women below the poverty rate compared to those above the poverty rate; the highest for women in the age group 1519 years for any age group of women; twice as high for black women as for their white counterparts; and nearly twice as great for women without a high school diploma as for those with a diploma. Roughly half of all unintended pregnancies (42 percent, not counting miscarriages) end in abortion; the remaining 58 percent end in childbirth.

Methods are available, of course, to reduce the risk of unplanned pregnancy: contraceptives. In the United States today, 18 contraceptive devices and methods have been approved by the U.S. Food and Drug Administration for use by women and men. The efficacy of these options varies from 100 percent (abstinence, vasectomy, and tubal ligation) to about 75 percent (fertility awareness-based methods, spermicides, withdrawal, and vaginal sponge). Even with the accessibility of these devices and methods, however, a surprisingly low number of reproductive-age women (and their partners)about 62 percentactually make use of contraception during their reproductive lives.

For a variety of reasons, young adults are especially at risk for unintended pregnancies. They may not be well informed about birth control; are discouraged by parents, friends, or others from using the most effective means of contraception; or do not have easy access to contraceptive devices. Sex education that includes information about contraception is now available in a large fraction of American schools. But those programs may emphasize only one form of contraception (abstinence) or skip over the topic entirely. For a variety of reasons, then, adolescents are more limited in their access to contraception than are women and men of almost any age.

This book is designed to help remedy that situation. It provides factual information about contraception, along with a variety of tools with which readers can learn more about the topic. focuses on basic issues, such as history and the nature of contraceptives themselves: how they work and how effective they are likely to be. Humans have been concerned about contraception throughout history. In the earliest days, women and men invented devices and methods that now seem more than primitive; they were sometimes harmful and even life threatening. In fact, it was not until the early 20th century that even the simplest effective contraceptive devices had been developed and brought to the marketplace. The invention of the pill in the late 1960s, for example, not only changed the nation and the worlds birth control practices but also revolutionized the role of women in society.