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A lifetime of work by a dedicated scientist who monitored the growing variety of methods for the control of human fertility and foresaw the need for information on the social, psychological, economic, and political aspects of fertility regulation and the prevention of unwanted pregnancies and births is reflected in the pages of this book. It also chronicles a series of related revolutions: (1) major changes in attitudes to the voluntary control of human fertility, (2) growing freedom of discussion outside the medical community relating to human reproduction, and (3) recognition that gov ernments have an appropriate role to play in programs involving these matters. As a result, official information systems have been established to guide the evaluation of programs and determine if and when changes in policy might be needed. Christopher Tietze, from whose writings the articles in this volume were selected, was a central figure in these developments. He was a physician whose major focus was social statistics. In effect, he became the scorekeeper of the world's efforts to avoid unwanted childbearing. He enlisted an ever-growing network of collaborators and prevailed on them to apply new tools to new issues.
Using Science to Improve the BLM Wild Horse and Burro Program: A Way Forward reviews the science that underpins the Bureau of Land Management's oversight of free-ranging horses and burros on federal public lands in the western United States, concluding that constructive changes could be implemented. The Wild Horse and Burro Program has not used scientifically rigorous methods to estimate the population sizes of horses and burros, to model the effects of management actions on the animals, or to assess the availability and use of forage on rangelands. Evidence suggests that horse populations are growing by 15 to 20 percent each year, a level that is unsustainable for maintaining healthy horse populations as well as healthy ecosystems. Promising fertility-control methods are available to help limit this population growth, however. In addition, science-based methods exist for improving population estimates, predicting the effects of management practices in order to maintain genetically diverse, healthy populations, and estimating the productivity of rangelands. Greater transparency in how science-based methods are used to inform management decisions may help increase public confidence in the Wild Horse and Burro Program.
The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.
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