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Opponents of comprehensive sex education in schools and access to contraception for all individuals are a minority, and their viewpoints should not be allowed to paralyze public-health campaigns, says a report from a national medical-research group.

The Institute of Medicine report says Americans' polarized viewpoints on sexual activity have stymied progress toward the common goal of having all children be born into families that have planned for them and welcome their arrival.

The Washington-based institute advises the federal government on issues of medical care, research, and education. It is supported by the Carnegie Corporation of New York, the Robert Wood Johnson Foundation, and the U.S. Public Health Service.

The report outlines a strategy to reduce the incidence of unintended pregnancy, which it says bears heavily on three major social problems: teenage pregnancy, childbearing by unmarried women, and abortion.

The authors of the report urge first that the nation make intended pregnancies the social norm. They also advocate: improving education about contraception and reproductive health, making access to contraception easier, increasing research on unintended pregnancy, and launching demonstration programs at the community level.

About 44 percent of all births in 1990 in the United States were from unintended pregnancies, the study says.

The proportion of pregnancies that were unplanned was 60 percent among women in poverty, 62 percent among black women, 73 percent among never-married women, and 86 percent among unmarried teenagers.

Unintended pregnancies pose a wealth of risks beyond those that might already exist, the report says. In such instances, the mother is less likely to seek prenatal care and more likely to expose her fetus to drugs or alcohol.

The child is more likely to be a low-birthweight baby, die in the first year, and be abused or neglected. And the parents are less apt to pursue educational and career goals.

A limited quantity of summaries of the report, "The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families," is available from: Division of Health Promotion and Disease Prevention, Institute of Medicine, 2101 Constitution Ave., N.W., Washington, D.C. 20418. To purchase the complete volume, call (800) 624-6242.

--Laura Miller

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