THERE are 55 million American women of childbearing age (15 to 44 years), of whom about 30 million use some form of contraception, including sterilization. Approximately 10% have the opposite problem—difficulty in conceiving—and annually about 1 million couples seek medical advice or treatment for infertility. Each year approximately 6 million women learn that they are pregnant. One fourth of the pregnancies end with an induced abortion, and another 15% of these confirmed conceptions end in miscarriage or stillbirth. Over 3.6 million infants are delivered, of whom about 40,000 die within a year of birth. Nearly all of the infants receive some medical care and a small percentage receive a great deal.
Currently there is considerable controversy about "high-tech" obstetrical methods, costly neonatal intensive care, and other reproduction-related expenditures, but there is little solid information available about these health services from an economic perspective. What fraction of total health care spending