Contraception in crisis.

J Fam Plann Reprod Health Care 2006: 32(4) Background At least 50% of pregnancies in the UK are unplanned and approximately one-fifth of conceptions end in legal abortion despite over 70% of women in the age range 16–49 years using some form of contraception.1 Despite free availability of family planning services in the UK, unplanned and unwanted pregnancies remain a public policy issue. It is therefore necessary that current contraceptive service provision be examined in terms of access, choice and quality. The public health benefits and cost effectiveness of family planning provision are long established.2 Policy Studies Institute studies3 have confirmed the economic value of family planning provision as early as 1982. In the UK, contraceptive advice and supplies have been provided free since the mid-1970s through multiple outlets including general practice, specialist community clinics, the voluntary sector and, more recently, pharmacies. The National Health Service (NHS) is committed to the concept of client choice and empowerment, which is particularly relevant in contraception where informed decision-making is paramount in achieving effective contraceptive practice. The Teenage Pregnancy Strategy,4 the National Strategies for Sexual Health and HIV in England and Wales,5,6 Respect and Responsibility in Scotland,7 the National Standards for Sexual Health Services8 and the Public Health White Paper Choosing Health9 have clearly acknowledged the importance of contraception in addressing sexual health with a holistic approach. However, despite the stated aims of these national strategies, currently it appears that even the existing contraceptive service provision within the NHS is being compromised.