This piece is cross-posted from SexReally.com.

Alma Powell, a well-known advocate for youth, opened a grand dinner at the Newseum this week, the U.S. Capitol illuminated behind her, by asking a simple question: "And how are the children?"

It was an appropriate salutation, delivered to reporters about to receive awards for writing and broadcasting about disadvantaged children and families.

Powell explained that the greeting is used by Masai warriors in Africa as they pass each other on the road. It is their version of "How are you?" --a reminder that an individual is only as good as her or his child, a community only as good as its children.

It occurred to me that night that those who counsel teens and 20-somethings about sex and contraception are trying to convey something similar. One argument they make for using contraception consistently goes something like this: "Think about the baby you might have if you don't. What kind of a life will she or he have?"

So, not how are the children, but how will they be?

Some scary things to consider this Halloween:

• The teen birth rate is on the rise after 15 straight years of decline.
• Fully seven in ten pregnancies among single 20-somethings are unplanned.
• More than half of pregnancies reported by unmarried men in their 20s are unplanned.
• Rosie O'Donnell is launching a new radio show.
• The magic less sex/more contraception formula that drove down the teen pregnancy rate over the past decade plus now seems to have morphed into a more sex/less contraception formula.
• 3 in ten girls in the United States get pregnant by age 20.
• Mariah Carey continues to record and release music.

What are some things that are scaring you? Let us know.

Sheldon J. Segal is no longer with us. Segal, 83, died October 17 at his home in Woods Hole, MA. Although his work helped millions of women all over the world, he labored and died in relative anonymity.

What gives?

Segal is credited with leading the team that developed the contraceptive implant Norplant. He was also instrumental in the development of the Mirena intrauterine device and copper-bearing IUDs. In other words, Segal played a critical role in what the Centers for Disease Control and Prevention calls one of the greatest public health achievements of the past 100 years---contraception.

You might have missed this news because the front page of several major newspapers featured other such absolutely essential fare as the fight for airplane overhead space (USA Today) and a new opus from Stephen King (Wall Street Journal).

What gives?

Rest in peace, Sheldon Segal, and thank you.

Women currently account for 51% of the overall U.S. population, according to the U.S. Census Bureau. To be precise, there were 154,135,120 women and 149,924,604 men in the United States in 2008. We also know that women, more often than not, are responsible for making decisions about their families' health care.

While I think it would be hard to make the leap that 51 percent of the programs and benefits of health reform should be directly targeted toward women, it's not a stretch to argue that health reform should address the health care needs of women and their families. That includes pregnancy planning and prevention.

Unplanned pregnancies are closely linked to a number of negative health, social, and economic consequences. Family planning services--counseling, gynecological care and screenings, prescription drugs and devices, and related outpatient services--are a cost-effective way to make progress on preventing unplanned pregnancy and improving health outcomes for women and families. As such, family planning should be classified as a preventive benefit with the same cost-sharing protections afforded to other designated preventive benefits in any essential benefit package that is created within the context of health reform.

For health reform to work, it has to be meaningful for everyone, including 51 percent of the U.S. population.

Watching the video above I am reminded of the challenge we face in the world of reproductive health—a world I am still getting to know—of trying to make adherence fun.  The piano stairs do a fabulous job of enticing people to walk and work off a few extra calories.  Fun can change behavior for the better.

The challenge for us is that contraception is not so fun.  Even the names of contraception methods—an opportunity for fun—are usually horrible.

Perhaps we can take some cues from toothpaste. Bill Smith, in his recent Social Marketing Quarterly article "The Power of the Product P, or Why Toothpaste Is So Important to Behavior Change," says that what we need to affect change is a product like toothpaste, not ideas. "An idea, like 'health is good,' 'exercise works,' or even 'environmentalism' is the affirmation of a belief, not a social marketing product," Smith wrote. And only a product can be effectively marketed. "Toothpaste," he went on to write, "is a product that helps us achieve our marketing goal of behavior change (bushing teeth)."

We don't try to get people to brush their teeth without toothpaste, but we do ask them to take HIV tests and obtain birth control without compensating them for the stigma they experience. "All we have to do is invent products and services that are as good as toothpaste, update them regularly to keep people interested, price them competitively, put them everywhere, and then tell people how cool they are," Smith challenged. Are we up for the challenge?

Where's the toothpaste?