The gist: A worthy population goal for the Northwest would be to ensure that every child is born wanted. The region can do this by curbing unintended pregnancies with programs such as access to Plan B, alleviating poverty, and preventing teen pregnancies.

The details: More than a third of all births in Washington, Oregon, and Idaho result from mistimed or unwanted pregnancies. Children conceived intentionally receive better prenatal care and have lower infant mortality rates and lower rates of abuse and neglect. Consequently, fewer wanted children end up in the child welfare system, including juvenile courts and foster care.

More than half of Cascadian women are fortunate to have unusual access to emergency contraception--higher doses of hormonal birth control pills that prevent ovulation and implantation of a fertilized egg.

Alaska, British Columbia, California, and Washington all have programs in place through which women can get emergency contraceptives, such as Plan B, from pharmacists without visiting a doctor first. And all Canadian pharmacies now offer emergency contraception without a prescription.

But elsewhere in Cascadia--in Oregon, Idaho, and Montana--as in much of the rest of the United States, pharmacy access to emergency contraception remains stalled.

Universalizing one-stop access to emergency contraception at pharmacies is one of the best public policy options toward reducing the number of unintended pregnancies--perhaps by as much as half. FDA approval, which is likely to come sooner or later, will expand the number of pharmacies in Northwest states from which Plan B is readily available. And it will expand that service to all other American states, including of course, the rest of Cascadia.

A recent study shows that BC's over-the-counter program has made a big difference. The number of BC women who used Plan B doubled to 18,000 a year after the province moved the medication off the prescription-only list in late 2000.

Ensuring that every Cascadian baby is born wanted would ease a variety of social problems. It would also help put the region on a more sustainable population trajectory. Increasing access to emergency contraception is one key step.