Contraceptive revolution revisited: new arrivals, same old rivals.

: There has been little progress in contraceptive development, availability, and accessibility during the last 3 decades in the US. Between the 1960s and late 1990s, the only new contraceptive method to emerge was the contraceptive implant, Norplant. Government funding for contraceptive research has neither decreased nor increased and the number of US pharmaceutical manufacturers, which have done this research, has fallen from 9 to 1. The US has the distinction of having one of the highest unplanned pregnancy rates in the developed world. Current US birth and fertility rates are the highest in 20 years. The current US population of 257 million could double in 60 years at these higher rates. More than 50% of unplanned pregnancies happen to contraceptive users, indicating that available contraceptives are inadequate. Oral contraceptives (OCs) are rather effective, but can cause side effects and place women at risk of some diseases. Condoms protect against AIDS and other sexually transmitted diseases, but are not as effective as OCs at preventing pregnancy. Contraception research has brought about the female condom; new, improved male condoms; an injectable contraceptive, Depo-Provera; and Norplant. Medical personnel are required to administer Depo-Provera and Norplant while women will be in control of inserting the experimental, hormone-releasing vaginal ring. Some women are concerned about the possibility of medical personnel coercing women to accept Depo-Provera and Norplant. President Clinton has recently removed the ban on the abortifacient, RU-486. RU-486 would accord women control to terminate unplanned pregnancies rather than confront violent anti-abortion protesters. The leading obstacles to contraceptive progress are insufficient funding for contraception research, inaction by the private sector in this research, conservative politics, and anti-abortion groups.