After Years of Decline, Teen Pregnancy and Births Back on the Rise

Sarah Brown

Why are we seeing an uptick in teen pregnancy and teen births after years of decline? More sex and less contraception, the policy wars of the past 8 years and the failure to fund effective programs are among the reasons behind this reversal in trends.

There is
reason to be concerned on this 8th National Day to Prevent Teen
Pregnancy.  The extraordinary decline in
teen pregnancy and childbearing – one of the nation’s preeminent success stories
of the past two decades – is in danger of being reversed.  Cue sober music.

From the
early 1990s, until 2007, the teen pregnancy rate in the United States plummeted
38 percent and the teen birth rate declined by about one-third.  State and local level trends mirrored national
trends almost everywhere: Over the past decade, we’ve seen declining rates of
teen pregnancy in all 50 states and among all racial and ethnic groups-extraordinary
progress on an issue many once considered intractable.

However,
the most recent news on this front has not been as positive. After 14 straight
years of declines, the national teen birth rate increased 5 percent between
2005 and 2007 and many states are reporting statistically significant increases
in their respective rates of early childbearing as well. 

Given this,
it is not surprising that one of the questions we are most frequently asked at
the National Campaign is:  Why? Why has the encouraging progress on teen
childbearing begun drifting in the wrong direction?  Based on the limited data that are available,
the observations of those who work directly with teens nationwide, and
researchers who study the issue, there are several clues that help explain the
recent increase:

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More sex, less contraception.  Declines
in sexual activity and increases in contraceptive use among teens – the two
factors that drove the steep decreases in the teen pregnancy and birth rates
beginning in the early 1990s – have apparently stalled out.  In fact, although the changes have been small
and not statistically significant, sexual activity increased and contraceptive
use by sexually-active teens decreased among high school students between 2005
and 2007.

Less concern about HIV/AIDS.  Observers
have long believed that concern about HIV/AIDS has helped make young people – in
particular, young men – more cautious about sexual activity and more vigilant
about contraceptive use, and that these concerns contributed to the decline in
teen pregnancies and births over many years. 
Now, however, there is evidence to suggest that concern among young
people about HIV/AIDS is less pronounced. For example, a recent survey of those ages 18-29 who say they are
personally very concerned about becoming infected with HIV declined from 30
percent in 1997 to 17 percent now.  And
according to the CDC, the proportion of high school students who say they have
ever been taught about HIV/AIDS has decreased from a high of 92 percent in 1997
to 83 percent in 2007.

Reaching older teens.  Recent
National Campaign analyses suggest that nearly three quarters of the recent increase
in teen births can be attributed to older teens (age 18 to 19) rather than
younger teens (age 15 to 17).  Efforts to
prevent teen pregnancy have largely ignored older teens and recent increases in
the teen birth rate underscore the need for additional, more creative
interventions that reach older teens.  In
short, high school sex education may not "carry forward" into non-high school
years.

Changes in the Makeup of the Teen Population.  The overall increase in the national teen
birth rate is due, in large part, to increases in the birth rate among teens of
all racial and ethnic groups. Even so, a National Campaign analysis suggests
that about a quarter of the three percent increase in the teen birth rate
between 2005 and 2006 may be due to changes in the racial and ethnic makeup of
the teen population overall.

Limited information about contraception.  Abstinence should be stressed as the
first and best option for teens.  It is
developmentally appropriate, widely supported by parents and teens, and the
only certain way to prevent too-early pregnancy and parenthood.  But we also know that those teens who are having sex and are not using
contraception are the ones who get pregnant. 
The nation’s emphasis on abstinence-only education in recent years may
not have provided young people with adequate information about contraception or
enough encouragement for sexually active teens to use contraception
consistently and carefully.  Every time.

Complacency and prevention fatigue. 
The years of good news about
teen pregnancy may have led to complacency on the part of practitioners and
parents.  It may also have let policymakers
and other funders turn their attention to other issues and away from preventing
teen pregnancy.  An informal survey by the
National Campaign conducted in December 2008 found that in half of the 20
states that responded, teen pregnancy prevention programs received cuts in
funding from public and/or private sources. 
Others reported flat funding. This situation may worsen as the full
effects of the current economic downturn become apparent.

An "anything goes" culture.  What
about the role of prevailing social norms and popular culture?  At present four in ten births to U.S. women
are to unmarried women; for those in their early 20’s, it is six in ten.  One in five teens say they have
electronically sent or posted a nude or semi-nude image of themselves; and the
high-profile teen pregnancies of Bristol Palin and Jamie Lynn Spears were
largely greeted as the latest in a long line of celebrity baby bumps-mildly
interesting but, at the end of the day, no big deal.  Perhaps such trends and factors help shape
the social script for teens, suggesting that getting pregnant and starting a
family in the teen years when you are single and may not have even finished
high school is simply not that big a deal.

So what to
do?  Of course we need better sex
education for young people.  Of course we
need more on-the-case parents who are helping their children figure out
relationships, sex, family planning and more. 
Of course access to and affordability of contraceptive services remain
critically important.

In addition
to all of these things, my sense is that young people-in fact all of  us-would also profit from some good,
old-fashioned "straight talk."  For
example, when was the last time any of us heard any major public figure say
things like:

  • Babies need adult parents.
  • "If it happens, it happens" is no way to start a
    family. And "I just never really thought
    about it" isn’t either.
  • Babies don’t cement relationships; they often put great stress on
    them. Be sure you are in a solid
    relationship before you begin a family.
  • Sex has meaning, risks and consequences. It’s not a casual
    activity. Take it seriously.
  • Babies don’t give unconditional love; they demand it from the
    adults around them.
  • Children do best when they are raised by parents who are committed
    to each other and to years of devoted parenting.
  • To boys and men: Making babies doesn’t make you a man. Being
    a devoted partner and father may.
  • To girls: Sex won’t make him yours and a baby won’t make him stay.
  • Personal responsibility and parental
    responsibility mean it’s not just about "me" the adult – it’s also about what’s
    in the best interest of children, communities and future generations.

In short, getting pregnant or causing pregnancy, having
babies, and starting families are perhaps the most important things we ever do,
with generational effects.  These major
steps need to be thought about carefully, not stumbled into.  We think and
talk about so many less important things all the time: what’s for dinner, March
Madness brackets, what movie to see this weekend… Surely the event of when
to become a parent, with whom and under what circumstances deserves at least
the same amount of time and attention.   

P.S.  On this day
focused on teen pregnancy, let’s not forget the unacceptably high rates of
unplanned pregnancy among women of all ages-particularly single
20-somethings.  At present, fully 7 in 10
pregnancies among single women in their 20s are unplanned.  We can and must do better.

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