A portrait in American fecundity: every day hundreds of young women, their bodies roundly pregnant, descend on the University of Southern California Women's Hospital. They overflow the available chairs and sprawl awkwardly on the floor. They come for prenatal checkups, gynecological care and, finally, to deliver their young. Last year more than 18,000 babies were born in this building, roughly 1 out of every 200 babies born in the U.S. "Sometimes they are lined up in the hallways and stacked up for C-sections like planes at LAX, six or seven deep," says obstetrician-gynecologist David Grimes.
But this busiest of U.S. obstetrics units also symbolizes an American failure: the extent to which the birth control revolution has not fulfilled its promise in the country where it began. Three decades after the Pill was introduced in the U.S., a shocking number of the 58 million American women of childbearing age still find it difficult to control their own reproduction, especially compared with women in other countries. Teenage pregnancy in the U.S. is more than double that of European countries, and the nation's abortion rate -- 1.6 million a year -- is one of the highest in the developed world. All told, more than half of all American pregnancies -- 3.4 million out of 6 million each year -- are accidents, the result of misusing contraceptives, using unreliable contraceptives or using no contraceptives at all.
The sorry state of birth control in America is underscored in a report prepared by the Population Crisis Committee, a nonprofit research group based in Washington. The committee found not only that Americans have fewer contraceptive options than their counterparts in most developed countries, but also that contraceptive devices are more expensive and more difficult to obtain in the U.S. than in some parts of the Third World.
While scientists around the globe are making rapid progress deciphering the dance of hormones that makes pregnancy possible -- work that raises new strategies for blocking conception -- the major American pharmaceutical companies have all but abandoned the field. Of the nine doing research in contraceptives 20 years ago, only one (Ortho Pharmaceutical) is still active. The others have been scared off by the fear of costly lawsuits like the one that drove the maker of the Dalkon Shield, an intrauterine device, into bankruptcy, and by public controversy such as that surrounding RU-486, the French "abortion pill."
Most of the world's governments encourage family planning and even subsidize the use of birth control devices. The U.S. stands out as the only major industrialized country that is moving in the opposite direction. Over the past decade, Washington has halted federal research on new reproductive technologies and declined to approve some of the most promising new methods of birth control.