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It is common to encounter young girls who are very uncertain about choosing a method of contraception. They attend and request advice on methods, but are disinclined to choose one; nothing seems quite right. Suggestions that they should postpone sexual activity may be met with verbal agreement, often apparent relief, only for the doctor to discover later that intercourse is still continuing. They are encouraged to use a reliable method by their advisers but seem unable to comprehend the need to use it sensibly, often missing their contraceptive pills, or complaining that it does not suit them or that the condom or diaphragm makes them sore. It is as though by not using contraception they are saying, ‘I am not really active sexually, you see, I’m not even managing to use contraception. This sexual activity is not my responsibility; the onus is on my partner to make the running.’ They often seem surprised if a pregnancy occurs as though their sexual activity is divorced from real life.

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