Index
A
Abortion
access issues, 209-211, 256, 282
age variables in, 42
as consequence of unintended pregnancy, 18, 23, 50, 51, 80, 210
denied, and subsequent child well-being, 73
effect of federal family planning programs on, 221-222
insurance coverage, 139
for intended pregnancies, 25 n.2
international comparisons, 42-47
marital status and, 41-42
medical risk, 51-52
neonatal mortality and, 72
number of, 2, 21, 26, 41, 51, 210
opposition movement, 208-211
percentage rates, 2, 26, 41, 45, 251
psychological issues, 53-54
public policy development, 282-285
rate of complications, 52-53
religious debate, 186-188
research, 211, 230, 281, 285, 288, 290
socioeconomic variables in, 42
sociopolitical controversy, 16, 54, 251
voting behavior and, 187-188
Abstinence, 111
as one means to prevent pregnancy, 103
efficacy, 9, 101, 255, 258, 265
in evaluated programs, 9, 232-236, 265
as pregnancy-reduction intervention, effectiveness of recommendations, 5, 255
in school-based sex education programs, 15-16, 134-135
Access to contraception, 18, 126, 127
anti-abortion movement and, 208-211
bureaucratic obstacles, 148-150
in evaluated programs, 236-238
financial barriers to, 6-7, 139-145, 259-262
in health maintenance organizations, 140
individual psychological factors in, 169
insurance system and, 139-140, 153, 259, 260
international comparisons, 136-137
issues in, 135-136
most effective contraceptives and, 138
obstacles for adolescents, 138
obstacles to, 138-139, 153-154
obstacles to research, 135
provider base and, 7, 145-148, 261-262
racial differences, 198
recommendations, 4, 6-7, 254, 257, 259-262
sterilization, 149-150
through public health programs, 137-138, 140-143, 148-149, 154
type of contraceptive method and, 135-136
Advertising, 6, 189, 191-193, 259
Age
abortion and, 42
choice of contraceptive method and, 103
condom use and, 110
father's, parenting styles and, 76
miscarriage risk, 60
risk of unintended pregnancy, 28, 34
sexual activity trends, 96, 116, 172, 189, 255
unintended pregnancy distribution, 31, 55, 250
See also Teenage pregnancy;
Women over 40 years old
Agency for Health Care Policy and Research, 266
AIDS. See HIV/AIDS
Aid to Families with Dependent Children, 56, 141, 195-197
Alan Guttmacher Institute, 18, 25, 45
Attitudes
about contraceptive advertising, 191
about contraceptive methods, 171-172, 267, 268
about sex education in schools, 132
about sexuality in U.S. culture, 188-189
health system contraceptive policy and, 137
issues in research on pregnancy intendedness, 64-66, 165-166, 269-270, 288-289, 290-292
of physicians toward discussing sex and other related topics, 147
during pregnancy, shift in, 22-23
racist, birth control policy and, 198-203
sexual, international comparison of, 193-194
See also Individual behavior and decision-making;
Social and cultural values
B
Baby Boom, 194
Benefit:burden ratio, 161-162
Benefit:cost analysis, 241, 339
Block grants, 142, 218-219, 261
Breast cancer, 52
Bureau of Primary Care, 266
C
Campaign to reduce unintended pregnancy, 253-271
Centers for Disease Control and Prevention, 25, 266
Cervical cap, 111
Child abuse and neglect
later unintended pregnancy risk, 104-105
unintended pregnancy as risk factor, 1, 73-74, 81, 251
Child advocacy groups, 270-271
Child care, 74
Child health and well-being
developmental effects of pregnancy intendedness, 72-74, 81
effects of reducing unintended pregnancy, 79-80, 82
methodological issues in outcomes research, 64-66
outcomes research, 296
preventive public health interventions, 12
See also Fetal and neonatal health
Clinical Laboratories Improvement Act, 143
Community level programs, 218-244
Community of Caring, 227, 311-312
Condom Mailing Program, 227, 312-313
age patterns in use of, 115-116
as contraceptive method of choice, 103, 108
determinants of use, 174-175
in dual-method contraception, 91, 118-119, 122, 258, 259-260
race and ethnicity as factors in use of, 116
socioeconomic factors in use of, 117
use in first intercourse, 111-115, 116
user attitudes, 171-172
Congenital malformations, 60-61, 78-79 n.6
Contraceptive methods
access to most effective, 138
advertising, 6, 191-192, 258-259
coitus-dependent, 101, 110-111, 122, 171
coitus-independent, 8, 101, 103, 109-110, 122, 171, 258, 263, 267
dual-method, 91, 118-119, 122, 258, 259-260
effectiveness, 109, 111, 115, 122
emergency contraception, 128 n. 1, 146, 147, 258, 283-284
failure of method, technological failure in, 99-100, 172, 255-256, 267
failure rates, 101
hormonal implants and injections, 99, 103, 109-110
individual attitudes about, 171-172, 264, 267, 268
individual changes in use of or of type used, 94-96
insurance coverage, 139-140
long-term performance, 101-102
prescription vs. nonprescription, 135-136
pricing, 144-145
professional counseling in, 8, 261, 262-263
research in, 5, 9, 10, 266-267
reversible, 92, 94, 98, 99-103, 108-111, 122, 139, 267
sexually transmitted disease prevention, 119-122, 150-151, 153
side effects, 111
sterilization, 98-99
technical development, 16
technical shortcomings, 126-127
training of health care professionals, 7, 8, 145-148, 259-260, 261 -262, 263
See also Contraceptive use;
specific method
Contraceptive sponge, 136
Contraceptive use
abortion debate and, 16
access to contraception and, 136
by adolescents, 108, 111, 115-116, 117, 129, 164-165
attitudes about contraceptive methods and, 171-172, 264, 267, 268
attitudes about fertility and, 169-170
attitudes about sexuality and, 168-169, 176
benefit:
causes of unintended pregnancy in, 2, 91, 122
determinants of, 2-3, 16-17, 18, 268
family functioning as factor in, 173-174
federal funding for, 9, 218, 220, 264-265
first intercourse, 96, 111-115, 116
health risk in, 128
impact of income support payments in, 196-198
legal environment, 16
mass media portrayals, 189-190, 191, 192
misuse, 18, 99-100, 101, 126, 171
motivational perspective, 162-165
opportunities for counseling through existing systems, 150-153
partner and couple issues, 174-176, 207
patterns of, 9, 92-96, 103, 108-111, 265
personal factors in, 4, 7-8, 18-19, 160, 167, 168-170, 176, 253, 254, 262-263
planning of sexual activity and, 170
potential effects on birthrate, 72
public interest groups, 270-271
racist connotations in welfare policies, 198-203
recommendations for public education, 5-6, 256-259
recommendations for public policy, 4, 5-6, 254-257, 263
religious practice and dogma, 185-188, 279-282
research considerations, 66, 161, 176, 268, 292-295
research needs, 266-270
school-based sex education and, 131-135, 257
self-image and, 167
sexually transmitted disease risk and, 150-151, 153
sociocultural/socioeconomic factors in, 183-185
substance abuse and, 172-173, 176
trends, 138
unintended pregnancy in nonusers, 96, 122
unintended pregnancy in users, 98, 99-100, 122
user knowledge for, 126, 127-130, 153
user skills and effectiveness of, 130-131, 153
See also Access to contraception
Cost:benefit analysis, 241, 339, 347-348
Cost-effectiveness, 240 n.9, 338-339, 347-363
Couples' interpersonal relationships
consequences of unintended pregnancy, 81-82
contraceptive use, 115, 120, 174-176, 207
disagreement on pregnancy planning, 23
in evaluated programs, 232
D
DALYS (disability-adjusted life-years saved) index, 339
Depo-Provera, 109-110
Depression, 75
Diaphragm, 111
as contraceptive method of choice, 103
failure rate, 101
insurance coverage, 140
proper use, 130-131
Diversity
cultural-ethnic, 184-185
religious and political, 185-188
Divorce
outcomes for children of single-parent families formed by, 63
as a result of an unintended birth, 61
prevalence, 203
E
Educational attainment
adolescent childbearing and, 55-56
of children from single-parent families, 61-63
father's, 75
proper contraceptive use and, 131
Elmira Nurse Home Visiting Program, 227, 313-314
Embarrassment, 169
Emergency contraception, 128 n.1, 146, 147, 258, 283-284
Employment issues, 195
Evaluation of programs
abstinence-based contraceptive strategies, 9, 233-236, 265
abstinence-only strategies, 9, 232-233, 265
access to contraceptive services, 9, 236-238, 265
adult interventions, 231-232
community level, 240
couples' interventions, 232
criteria, 225-226
cross-cutting themes, 231-240, 244
economic effects, methodology for measuring, 240-243, 244, 338-339, 347-363
effect on sexual behavior, 233-236
evaluated programs, 227-228, 228-240.
See also specific programs
family planning programs, federal, 219-222
methodological issues, 229-230
obstacles to, 229
outcomes, 225, 228, 244, 338, 340-347
recommendations, 4, 7, 9, 254, 264-266
reduction of rapid repeat pregnancies, 9, 238-239, 265
self-reported data in, 230
social context of, 230-231
socioeconomic/cultural factors in, 239-240
F
Facts and Feelings, 227, 233, 314-315
Family planning, 6
black perspective, 198-203
economic effects, 241-243, 244
effect on infant mortality, 72, 81
employment issues, 195
evaluation methodology, 338-339, 351-363
federally funded programs, 142-143, 218-222
funding issues, 240-242
male role in, 206-208, 256-257, 265
managed care systems and, 13
medical approach, 152-153
neonatal health and, 72
provider base, 146-147
public policy development, 12, 278-285
trends, 137
See also Medicaid;
Programs to reduce unintended pregnancy;
Title X
Family Support Act of 1988, 15
Fathers
impact of unintended pregnancy on, 75-76
preconception counseling, 79
socioeconomic consequences of absence of, 61-63
Fetal alcohol syndrome, 70
Fetal and neonatal health
abortion and subsequent pregnancy outcomes, 52
abortion for problems of, 25 n.2
adolescent childbearing risk, 58-59
childbearing by older women and, 60-61
effect of federally funded family planning programs, 221-222
family planning and, 72
low birthweight, pregnancy intendedness and, 70
maternal substance abuse, 68-70
outcome research, 296
preconception care, 77-78
sexually transmitted disease infection and, 120
spacing of pregnancies and, 70
in unintended pregnancy, 1, 81, 250-251
in unwanted pregnancy, 251
See also Child health and well-being;
Prenatal care
Foam, 103
Folic acid, 78
Food Stamp Program, 196
France, 43
G
Gender bias, 205-208
Genetic testing, 2, 78, 82, 251
Girls Incorporated Preventing Adolescent Pregnancy, 227, 315-316
Group Cognitive Behavior Curriculum, 227, 317
Guilt, 168-169
H
Head Start, 12
Health and Human Services, U.S. Department of, 3, 253
Health care professionals
abortion providers, 210-211
discussion of sexual topics in primary care, 147-148, 151-152
nursing profession, 148
training for contraceptive counseling, 7, 8, 145-148, 260, 261-262, 263
Health care system
accessibility to contraception through, 6, 136, 148-150, 154, 259
early intervention for contraceptive counseling, 150-152
modeling of, 349-350
reform, 12-13
See also Insurance System;
Managed care
Health maintenance organizations, 140
HIV/AIDS, 15, 115, 120, 268-269
I
Implants and injections, contraceptive, 267
insurance coverage, 140
pricing, 145
recommendations for, 258
removal, 145
welfare policy and, 200
Individual behavior and decision-making
among low-income adolescents, 163-165, 262
assessment of, in pregnancy surveys, 23-24
attitudes about contraceptive methods, 171-172, 267
attitudes about fertility, 169-170
attitudes about sexuality, 168-169, 176
benefit:burden models explaining contraceptive use, 161-162, 176
by child of single-parent family, 62
in contraceptive use, 4, 7-8, 18-19, 103, 120, 153, 160, 167, 176, 254, 262-264
couple and partner interactions, 174-176
determinants of proper contraceptive use, 131
locus of control perspective, 167
media influence, 192-193
modeling, 340-347
motivational perspective, 162-163
obstacles to research, 161
patterns of contraceptive use, 92-96
planning of sexual activity and, 170
preconception care, 77
prenatal care, 68-70
public welfare considerations in, 13-14
religious beliefs and, 187
risk of unintended pregnancy, 28-30
single-factor investigations, 166
strategic significance, 264
welfare considerations in, 196-198
Information gathering and processing, 17-18, 43 n.11
contraceptive use, 292-295
measures of pregnancy intendedness, 288-289, 290-292
methodological issues in outcomes research, 64-66
pregnancy prevention programs for evaluation, 226
recommendations, 266
See also Evaluation of programs;
Research needs
Insurance system
access to contraception and, 6, 139-140, 153, 259, 260
family planning programs and, 13
health care reform debate, 13
recommendations for, 6, 259, 260
Intended pregnancy
abortion for, 25 n.2
as focus of prevention efforts, 255
international comparisons, 42-43
measurement of, 43 n.11
number of pregnancies, 26
International comparisons, 19, 42-47
abortion policy and practice, 43-47
access to contraception, 136-137
nonmarital childbearing, 14 n.3
sexual attitudes, 193-194
teenage pregnancy, 42-43
International Conference on Population and Development (Cairo Conference), 19
Intrauterine devices, 129
access to, 147
insurance coverage, 140
patterns of use, 103, 109, 110
L
Legal issues
contraceptive use, 16, 279-280
discussion of sexual topics in medical practice and, 147
drug- and alcohol-exposed infants, 70
M
Marital status
adolescent pregnancy trends, 56
births from unwanted pregnancy and, 38-39, 41
contraceptive use and, 96, 110-111, 115
data sources, 24
effects of unintended pregnancy on, 74
impact of income transfer programs on, 196-197
likelihood of abortion and, 41-42
never-married women, 31, 38, 41, 250
pregnancy intendedness and, 31
unintended pregnancy demographics, 34, 38, 50, 55, 250
See also Nonmarital childbearing;
Single-parent families
Maternal and Child Health Bureau, 266
Maternal health
adolescent childbearing risk, 58-59
health risk for older women, 60-61
preconception care, 77-78
risks of unintended pregnancy, 74-75, 81
McCabe Center, 227, 238, 317-318
Media
contraceptive education, 127-128, 129
contraception use portrayed in, 189-190, 191
contraceptive advertising in, 191, 192
influence of, on sexual behavior, 192-193
sexual attitudes and behaviors expressed in, 189-191
sexuality as topic of discussion, 15
violence and, 193
Media Project, 239-240
Medicaid, 6, 7, 12, 13, 19, 153, 218
adolescent services, 142
contraceptive coverage, 141, 196, 219, 259, 260-261
effect on unintended pregnancy rate, 7, 219, 222, 261
eligibility, 141
family planning coverage, 139, 140-142, 282
male role in contraception and, 207-208
sterilization coverage, 149-150, 282
Miscarriage, 25 n.3
age-related risk, 60
Mistimed pregnancy
characteristics of women, 31
child development and, 72-74
effects of eliminating, 50-51, 309-310
low birthweight and, 70
marital status and, 34, 38, 310
maternal behavioral risks and, 68-70
maternal risk in, 81
percentage rates, 25-27
prenatal care and, 66-68
program effectiveness in preventing, economic evaluation of, 242-243
Mortality
adolescent childbearing risk, 58-59
childbearing risk for older women, 60
maternal, in unintended pregnancy, 74-75
N
National Institute of Child Health and Human Development, 219 n.1, 266, 267
National Longitudinal Survey of Youth, 133
National Maternal and Infant Health Survey, 18, 24 n.1
National Survey of Families and Households, 23, 34
National Survey of Family Growth, 11, 22-25, 33-34, 64, 92, 98, 103, 165-166, 286-295
Neural tube defects, 78
Nonmarital childbearing
effects of reducing unintended pregnancy, 80, 81, 309, 310
intentionality in, 38
international comparisons, 14 n.3
public policy issues, 13-14
social attitudes and, 33 n.8
See also Single-parent families
Nonmarital pregnancy
abortion outcomes, 41-42
assessing intentionality in, 38
research issues, 56
as unintended, risk of, 31, 50, 55, 250
See also Marital status
Norway, 47
Nursing profession, 148
O
Office of Population Affairs, 266
Oral contraceptives, 100, 101, 103, 108, 109, 110, 135-136
as emergency contraceptive, 147
insurance coverage, 139-140
over-the-counter availability, 144 n.2, 152
pelvic examination in prescription process, 153, 169
pricing, 144-145
proper use of, 131
public understanding of, 5, 128, 130, 256
Ortho Birth Control Studies, 98
Ounce of Prevention Fund's Parents Too Soon Program, 227, 320-321
P
Paternity establishment, 15
Political context
family planning concepts in, 278-285
religious beliefs and, 186, 187-188, 285
Postponing Sexual Involvement, 227, 234, 321-322
Posttraumatic stress disorder, 54
abortion utilization and, 42
adolescent childbearing attitudes, 163-165, 166
Medicaid eligibility, 141
risk for adolescent mothers, 56
Preconception care, 2, 50, 76-79, 81, 251
Pregnancy rate, 47
Pregnancy Risk Assessment Monitoring System (PRAMS), 75
adolescent childbearing, 59
effect of federally funded family planning programs, 221-222
obstacles to, 66
outcomes research, 296
pregnancy intendedness and, 66-68
social support network and, 68
See also Fetal and neonatal health
Private sector
funding for adolescent pregnancy interventions, 225
in public-private consortium for reducing unintended pregnancy, 4, 252-253
Programs to reduce unintended pregnancy
access to contraceptive services, 9, 236-238, 265
contraceptive use, strategies for encouraging, 96
development of, 223-225
economic impact of, 242-244, 245
effects of funding withdrawal, 242
financing of contraceptive methods in, 6-7, 12, 259-61
focus on financial consequences, 195
in health care reform, 12-13
intervention through existing systems, 150-153
leadership, 252-253, 258-259, 270-271
male participation, 14-15, 206-208, 219, 257, 265
national programs, 218-222
noncontraceptive interventions, 8
opposition to, 255
personal motivation as factor in, 264
potential effects of, 79-80, 81, 253, 256, 308-310
public policy, evolution of, 12
recommendations for national campaign, 3-10, 252-266
research needs, 266-270
risk identification in, 81-82
training of physicians for, 146, 261-262
See also Evaluation of programs;
Schools, sex education in
Project Redirection, 227, 238-239, 322-323
Project Taking Charge, 227, 233, 323-324
Psychological functioning
abortion and, 53-54
maternal depression risk in unintended pregnancy, 75
See also Individual behavior and decision-making
Public education and information
for males, 258
sexual behavior topics in, 5-6, 256-259
through health care system, 150-152
See also Schools, sex education in
Public health programs
abortion funding, 209
access to contraception, 137-138, 140-143, 148-149, 153-154
campaign to reduce unintended pregnancy as, 4, 254
federally funded clinics, 142-143
funding for contraceptive services, 141
health care reform debate, 12-13
national family planning programs, 218-219
perception of racism in, 202
sexually transmitted disease treatment in, 143
spending, 143
welfare reform debate, 13-14
See also Programs to reduce unintended pregnancy
R
Race/ethnicity
abortion utilization and, 47
adolescent childbearing outcomes, 56
condom use and, 116
low birthweight and, 70
nonmarital childbearing and, 14
outcomes for children of single-parent families and, 62-63
race-based perceptions of family planning policies, 198-203
risk of rape, 204
risk of unintended pregnancy and, 30, 33
sterilization patterns, 115
unwanted pregnancy resulting in birth and, 38-39, 41
U.S. diversity, 184-185
Rape, 203-205
Reducing the Risk, 228, 234-235
Religion
in contraception policy-making, 279-282
in family planning policy, 279, 285
U.S. diversity, 185-188
Reproductive age range, 28
Reproductive Health Screening of Male Adolescents, 227, 325-326
Research needs
contraceptive use, 5, 9-10, 266-270
individual behavior and decision-making, 10, 269
male contraceptive behavior, 265
measures of intentionality, 23-24, 269-270, 288-289
predictors of unintended pregnancy, 81-82
program efficacy, 9
public financing programs, effectiveness of, 7, 261
on unintended pregnancy, 17
RU 486, 284
S
School/Community Program for Sexual Risk Reduction Among Teens, 228, 236-237, 326-327
Schools, sex education in, 5
abstinence as a strategy to prevent pregnancy, 15-16, 131, 134-135
adolescent sexual activity and, 133-135, 235-236, 257-258
anti-abortion movement and, 211
approaches, 131
contraceptive education and information, 131-135, 256-258
effectiveness of, 134-135
evaluation of, 224-225
federal involvement, 224
opportunities for improvement, 132-133, 152
public support for, 132
recommendations for, 5-6, 257-258
religious conflict over, 186
Self Center, 228, 237, 328-329
Self-esteem, 167
Sexual behavior
abstinence-focused interventions, 15, 232-233, 255
adolescent counseling, opportunities for, 151-152
attitudes about, and contraceptive use, 168-169, 176
influence of media on, 192-193
international comparison of attitudes on, 193-194
in mass media advertising, 192
mass media portrayals, 189-193, 259
parent-child interpersonal relations and, 173-174
patterns of contraceptive use, 92-96
planned vs. unplanned, 170
public policy messages about, 5-6, 255
public willingness to discuss, 15
religious beliefs and, 185, 281-282
risk of unintended pregnancy, 28, 33
as a topic in routine medical care, 147-148
sex education and, 133-135, 233-236, 257-258
socioeconomic/cultural influences, 28, 163-165, 239-240
substance abuse and, 172-173
U.S. attitudes, 188-189, 254-255
use of contraception at first intercourse, 96, 111-115, 116, 255
violence toward women, 203-205
See also Contraceptive use
Sexually transmitted diseases, 6, 8, 14, 77, 91, 119-120, 254-255, 258-259, 263, 268-269
adolescent mothers, 59
condom use and, 171-172
contraceptive counseling in treatment for, 150-151
dual-method contraception and, 118-119, 258, 259
public health program spending, 143
public understanding of, 129-130
in sexual content of mass media, 191
Single-parent families
adolescent pregnancy and, 56
child outcomes, 61-63
See also Nonmarital childbearing
Six School-Based Clinics, 228, 329-330
Smoking, 68-70
Social and cultural values, 91, 211-212
abortion and, 54
childbearing decisions among low-income adolescents, 163-164, 166, 262
contraceptive use and, 9, 16, 19, 174, 175, 183-184, 265-266, 268
in evaluated programs, 239-240
gender bias in, 205-208
international comparisons, 193-194
religious belief in, 185-188
research needs, 10
sexual content of mass media expression, 189-193
sexuality in U.S. culture, 188-189, 255
U.S. diversity, 184-188, 254-255
value attached to children, 194-195
willingness to discuss sexual subjects, 15
Socioeconomic consequences of births from unintended pregnancies, 1, 18, 50, 74, 251
adolescent childbearing outcomes, 55-58, 195
for child of single-parent family, 61-63
cost-effectiveness modeling, 338-339, 347-363
effect on fathers, 76
for older women, 60
Socioeconomic variables of unintended pregnancy, 31-33, 47, 250
abortion utilization, 42
access to contraception, 6-7, 259-262
contraceptive use, 117, 183-184
decision-making among poor adolescents, 163-165, 166, 262
economic influences on fertility, 194-195
in evaluated programs, 239-240
prenatal care, access and delivery, 66
strategic significance, 263
unwanted pregnancies resulting in birth, 39-40, 41
St. Paul School-based Health Clinics, 228, 237, 330-331
as contraceptive method of choice, 103, 108
gender differences, 115
insurance coverage, 139
obstacles to access, 149-150
sociodemographic variables, 282 n.1
Substance abuse, 33
contraceptive counseling in treatment for, 151
contraceptive use and, 172-173, 176
preconception care, 77
risks in pregnancy, 68-70
Success Express, 228, 232-233, 331-332
Sudden infant death syndrome, 59
Summer Training and Education Program, 228, 239, 332-333
Sweden, 43
T
Teenage Parent Demonstration, 228, 333-335
Teenage pregnancy
abortion outcomes, 53
abstinence-focused interventions and, 15-16
adolescent fathers, 75-76
age of father, 205
age at onset of menarche and, 31 n.6
child sexual abuse and, 205
contraceptive nonuse and, 96
decision-making among low-income adolescents, 163-165, 166, 262
development of prevention programs, 223-225
educational attainment and, 55-56
effect of federal family planning programs on, 221
family planning trends, 137
income transfer programs and, 197-198
intentionality in, 38, 288-289
international comparisons, 42-43
involuntary sexual activity in, 204
marital status trends, 56
medical issues, 58-59
percentage of unintended pregnancies, 31, 252
rapid repeat, 238-239
risk for child of single-parent family, 62
sex education and, 133-135
socioeconomic outcomes, 55-58, 195
socioeconomic risk factors, 28
understanding of reproductive biology and, 129
unintended, percentage rate, 250
Teen Outreach Project, 228, 335-336
Title X, 12, 19, 142, 207-208, 209, 218
access to contraception in, 6, 7, 259-262
effect on unintended pregnancy rate, 219, 222
funding, 278
in health care reform debate, 13
origins and development, 278, 279
prospects for, 278-279
spending, 219
utilization, 219
Title XX, 142
U
Unintended pregnancy
benefits of reducing, 4, 79-80, 81, 253, 254
demographic trends, 2, 11-12, 18, 33-34-41, 250
extent of, 1, 2, 11, 25, 26-27, 92, 250
interrelationship of factors in, 2-3, 8, 10, 19, 211-212, 253
methodological issues in outcomes research, 64-66
methodological issues in research on determinants, 268
number of abortions for, 2, 21, 41, 251
percentage rates, 25-27, 28-31, 45
trends in births from unintended pregnancies, 33-41, 47
types of, 22
Unwanted pregnancy
child development and, 72-74
effects of eliminating, 50-51, 70, 81, 308-309
likelihood of abortion for, 41-42
low birthweight and, 70
maternal behavioral risks and, 68-70
program effectiveness in preventing, economic evaluation of, 242-243
trends in births from unwanted pregnancies, 38-41, 47
V
unintended pregnancy and, 203-205
W
Welfare system
adolescent childbearing outcomes, 56
alcohol- and drug-exposed infants, 70
benefit: burden models in evaluation of, 162
child support payment and, 15
contraceptive services, perception of racism in, 198-203
marital status and, 196-197
pregnancy prevention programs and, evaluation of, 240-241, 242, 243 -244, 245
reform efforts, 13-14
unintended pregnancy trends and, 196-198
See also Title X
Withdrawal method, 103, 111, 115
Women over 40 years old, 1-2, 5, 250, 256-257
abortion utilization, 42
medical risk in childbearing, 60-61
percentage of unintended pregnancies, 31
program outreach for, 266
socioeconomic issues in childbearing, 60
child care, 74
gender bias, 205-208
violence against women, 203-205
Y
