More than 1 million teenage girls in the United States become pregnant each year; nearly half give birth. Why do these young people, who are hardly more than children themselves, become parents? This volume reviews in detail the trends in and consequences of teenage sexual behavior and offers thoughtful insights on the issues of sexual initiation, contraception, pregnancy, abortion, adoption, and the well-being of adolescent families. It provides a systematic assessment of the impact of various programmatic approaches, both preventive and ameliorative, in light of the growing scientific understanding of the topic.

This issue will provide an update on contraception for adolescents. The content will include an overview of contraceptive practices among adolescents with specific articles on hormonal and nonhormonal methods including barrier contraceptives, emergency contraception and the IUD. One article will address contraceptive issues for teens in the developing world. The issue will also include a review of the noncontraceptive benefits of hormonal methods and potential interactions with other medications including herbal products. Specific concerns for teens with chronic illnesses and disabilities will be discussed along with new contraceptive methods under development.

Experts estimate that nearly 60 percent of all U.S. pregnancies--and 81 percent of pregnancies among adolescents--are unintended. Yet the topic of preventing these unintended pregnancies has long been treated gingerly because of personal sensitivities and public controversies, especially the angry debate over abortion. Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are wanted. Now, current issues--health care and welfare reform, and the new international focus on population--are drawing attention to the consequences of unintended pregnancy. In this climate The Best Intentions offers a timely exploration of family planning issues from a distinguished panel of experts. This committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the United States on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention programs. The Best Intentions explores problematic definitions--"unintended" versus "unwanted" versus "mistimed"--and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they bear. Why does unintended pregnancy occur? In discussions of "reasons behind the rates," the book examines Americans' ambivalence about sexuality and the many other social, cultural, religious, and economic factors that affect our approach to contraception. The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. And the book looks at such practical issues as the attitudes of doctors toward birth control and the place of contraception in both health insurance and "managed care." The Best Intentions offers frank discussion, synthesis of data, and policy recommendations on one of today's most sensitive social topics. This book will be important to policymakers, health and social service personnel, foundation executives, opinion leaders, researchers, and concerned individuals. May

By all indicators, the reproductive health of Americans has been deteriorating since 1980. Our nation is troubled by rates of teen pregnancies and newborn deaths that are worse than almost all others in the Western world. Science and Babies is a straightforward presentation of the major reproductive issues we face that suggests answers for the public. The book discusses how the clash of opinions on sex and family planning prevents us from making a national commitment to reproductive health; why people in the United States have fewer contraceptive choices than those in many other countries; what we need to do to improve social and medical services for teens and people living in poverty; how couples should "shop" for a fertility service and make consumer-wise decisions; and what we can expect in the futureâ€"featuring interesting accounts of potential scientific advances.

This document is one of two evidence-based cornerstones of the World Health Organization's (WHO) new initiative to develop and implement evidence-based guidelines for family planning. The first cornerstone, the Medical eligibility criteria for contraceptive use (third edition) published in 2004, provides guidance for who can use contraceptive methods safely. This document, the Selected practice recommendations for contraceptive use (second edition), provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. The recommendations contained in this document are the product of a process that culminated in an expert Working Group meeting held at the World Health Organization, Geneva, 13-16 April 2004.

Epilepsy requires careful management and monitoring through a woman’s life Epilepsy is a complex disease. The hormonal changes women experience, both day-to-day menstrual fluctuations and the longer waxes and wanings of a reproductive lifetime, make the management of epilepsy even more complicated. At some point, the well-being of a second person, a fetus, might also have to be taken into account. Epilepsy in Women provides a detailed guide to this challenge. The wide-ranging approach encompasses all aspects of a woman’s life including: Social and psychological impacts The impact in reproductive life Contraception Pregnancy Fetal health and long term developmental outcomes Lactation Menopause Each practical chapter begins and ends with a case study that demonstrates the more general challenge. The authors develop themes to provide clinical guidance based on evidence and experience. Written and edited by an international cast of experts, Epilepsy in Women provides crucial tips and recommendations for neurologists and gynecologists who need to be aware of the subtle effects of epilepsy on woman’s life.

Adolescence is a time of major transition, however, health care services in the United States today are not designed to help young people develop healthy routines, behaviors, and relationships that they can carry into their adult lives. While most adolescents at this stage of life are thriving, many of them have difficulty gaining access to necessary services; other engage in risky behaviors that can jeopardize their health during these formative years and also contribute to poor health outcomes in adulthood. Missed opportunities for disease prevention and health promotion are two major problematic features of our nation's health services system for adolescents. Recognizing that health care providers play an important role in fostering healthy behaviors among adolescents, Adolescent Health Services examines the health status of adolescents and reviews the separate and uncoordinated programs and services delivered in multiple public and private health care settings. The book provides guidance to administrators in public and private health care agencies, health care workers, guidance counselors, parents, school administrators, and policy makers on investing in, strengthening, and improving an integrated health system for adolescents.

Adolescents undergo rapid physical, psychological and social developmental changes that result in management challenges, communication issues, patterns of disease and symptom presentations that are different from children or adults. This can be challenging for health professionals, who rarely have had specific training in dealing with the young people they meet in their clinical work. This ABC covers topics surrounding adolescent development, sexual behaviour and substance misuse, along with education and preventative strategies. It also features other adolescent health problems such as self-harm, eating disorders and psychosomatic presentations. This book is a valuable resource for all those who deal with adolescent patients in primary care, emergency departments, and hospital and outpatient settings.