Book excerpt: Why Knocked Up? The Paradox of Sex, Magical Thinking, and Accidental Pregnancy in This Age of Contraception. The United States birth rates are at record lows, yet our rates of accidental pregnancy are still sky high1 out of 2-- is unplanned, unwanted. Peeling back the layers of conflict, denial, hope, dreams, and myths about pregnancy, this provocative book unravels the paradox of why we have so much Knocked Up pregnancy even though contraceptives are readily available. Dr. Cassell illustrates how magical thinking about sex and our cultures quirky sexual norms--combined with the far-rights efforts to block contraception, abortion, and sex education escalates the crisis. She uniquely describes the Knocked Up Paradox as a Black Elephant--a cross between a black swan (an unexpected event with huge complications) and the elephant in the room (a problem no one wants to admit is there). She delivers a powerful argument as to why unwanted pregnancy merits our concern even if we arent directly involved: we all pay a high price dealing with the complex tangle of personal dilemmas and the domino effect on families it creates. Cassell assures us that reducing Knocked Up pregnancies isnt a hopeless challenge and endorses a range of effective and edgy resolutions.