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Since the early 1970s, adolescent pregnancy rates in the United States, the United Kingdom and other western European countries have dropped significantly, partly because of the availability of more effective contraceptive methods and increases in condom use. I Despite this progress, U.S. youth continue to be at greater risk for pregnancy and sexually transmitted diseases (STDs) than their British and other western European peers. Given these disparities, can experiences in other developed countries inform U.S. prevention efforts? We believe that they can, and the results of Stone and Ingham's investigation of when and why British youth seek sexual health services, on page 114 of this issue, provide an instructive starting point. A country's approaches to prevention are rooted in an interplay of socioeconomic, political and cultural forces. Consequently, to examine the relevance of Stone and Ingham's findings and recommendations in the context of the United States, it is necessary first to review the ways in which these forces impact access to reproductive health care.

This article focuses on contraceptive cycling or recurring episodes of method uptake discontinuation and switching over the course of a womans reproductive life span as an important implication for the prevention of unintended pregnancy. It describes the dynamics of contraceptive use the need for new family planning service models and implications for research and practice for the delivery of family planning care.