For more than 50 years, since the successful synthesis of estrogens
and progestins, safe and effective pregnancy prevention has been possible.
Nonetheless, in the United States an estimated 3.5 million unwanted pregnancies
occur annually, one third of which involve teenagers.1 Among
the many possible explanations for this paradox, barriers to health care figure
prominently. For instance, lack of health insurance, an issue for more than
44 million Americans, creates a formidable barrier to access. Religious beliefs,
concerns about contraceptive safety, and psychological barriers also contribute.
Contraception may not be sought, especially by teens and other women for whom
a physician visit and discussion of sexual behavior may prove embarrassing.
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