Avoiding unintended pregnancies is critically important to allow women to make these choices, especially in cultures where unplanned pregnancy precipitates marriage or where premarital births have particularly disastrous social or economic consequences (74). In Latin America and the Caribbean, the Young Adult Reproductive Health Surveys (YARHS) document that many women are sexually active before marriage but are not consistently using contraception. For example, in a 1985 survey in Mexico City, 13% of women age 15 to 19 and 44% of men reported premarital intercourse. Only 22% of the women and 31% of the men used contraception at their first sexual experience, however. Among unmarried women ages 15 to 24, half of all first pregnancies were unintended. Among married women in this same age group, 11% of first births were conceived before marriage (216).

Nevertheless, offering contraceptives to unmarried adolescents and young adults remains controversial. Some parents and policy-makers assume that the availability of contraception will lead adolescents to have sexual relations before marriage. This assumption is one reason that, formally or informally, many family planning programs refuse to serve unmarried young people (333).

In fact, data do not suggest that the availability of contraceptives encourages early sex (130, 228). Most research on the subject comes from the US and other developed countries. For example, an international comparison found that sex education and contraceptive services were more available in Europe than in the US. Sexual activity among adolescents, however, was about as prevalent in the UK, France, and the Netherlands as in the US, while the US teenage pregnancy rate was much higher (154). Another US study found that teens who had a sexual education program in their school delayed intercourse and were less likely to become pregnant (379). Still other studies have found no link between the presence of contraceptive clinics in the schools and levels of sexual activity among students (176).