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Iris F. Litt, MD

JAMA. 2005;293:98-99.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

Women without access to effective contraception were enthusiastic about the discovery that certain formulations of contraceptive hormones or hormone receptor inhibitors could prevent implantation of a fertilized ovum. "Morning after" or "emergency contraception" (EC) provided these women . . . [Full Text of this Article]

Author Affiliation: Division of Adolescent Medicine, Stanford University School of Medicine, Palo Alto, Calif.

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