Contraception
Contraception is an inherent part of good health care for women. Fertility is not a disease, and therefore contraception is not a purely medical concern but an area for collaborative care in which the woman and clinician, as well as frequently her partner(s), exchange knowledge, values and options in planning and/or preventing her pregnancies. Introduction: The “modern” birth control era began in the USA in 1912 with Margaret Sanger's efforts. These were perhaps initiated by her own mother's experience of 18 pregnancies and 11 live births.Table 7.1 provides a historical timeline of contraception in the USA. The proportion of reproductive age women using contraception and the percentage of women using contraception at “first intercourse” continues to increase. Also, the percentage of sexually active women not using contraception has declined among most major US ethnic groups including African-Americans, Hispanics, and whites. Despite these successes, 49% of the over six million pregnancies in the USA each year are “unintended”. Five percent of US women of reproductive age report an unintended pregnancy yearly: Nearly half (48%) end in abortion. Unintended pregnancy rates are substantially higher among younger women (aged 18-24), unmarried, low-income, those who did not complete high school and minority women. While the unintended pregnancy rate rose among women without a high school diploma, it fell among college graduates between 1994 and 2001. Women who do not use contraception and have unintended pregnancies are equally as likely to have a therapeutic abortion as to continue the pregnancy and have a live birth.
