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?

This piece is cross-posted from SexReally.com, where it was posted on Friday, October 9th.

Even before it hits the newsstands, November's Teen Vogue has people talking.

Why? Because the cover displays two 19-year-old supermodels, one of whom, Jourdan Dunn, is pregnant.

Critics say Dunn shouldn't be there because she is a role model for teen girls. She makes pregnancy look cool - and there are way too many pregnant teens already.

I'm going to raise a different issue. Why is either model - Dunn or Chanel Iman - on the cover? Vogue, I could see, but Teen Vogue? Though technically teenagers, Dunn and Iman have a lot more in common with 20- and 30-something women than girls who just got their braces removed.

Last Friday the New York Times published an article focusing on the potential health concerns of using two popular oral contraceptives, Yaz and Yasmin. While this information is certainly important and the risks of serious side effects including blood clots and stroke should absolutely be considered when thinking about what type of contraception to use, the article failed to discuss the risk of health issues during pregnancy. Studies have found that 4 to 5 per 100,000 reproductive age women who are not taking birth control pills will develop thrombosis. Among women taking low-dose birth control pills that risk increases to 12 to 20 per 100,000. Among pregnant women the risk is even higher--48 to 60 per 100,000. So when we hear about the increased risks of serious side effects such as blood clots and strokes we need to ask ourselves: "Compared to what?"

In addition to providing us with the scary news, I wish there were more articles about the women, men and families who are thankful for reliable birth control methods such as the pill. A recent report from the Guttmacher Institute found that nearly half of women reported that they wanted to reduce or delay their childbearing because of economic concerns--clearly family planning is as important as ever.

There are lots of other great methods of birth control available, but like anything in life there are trade-offs for each one, and we all have to find the one that fits us best (check out our Birth Control 101 page for more information). While most methods have side effects (and these should be discussed with your doctor), consider the potential alternative--an unplanned pregnancy.

Why do we expect so much more from our birth control pills than from other medications we take?