Teen Pregnancy Surges

Study: 10-Year Decline in Teen Pregnancy Ends

From the WebMD Archives

Jan. 26, 2010 - U.S. teen pregnancies went up 3% in 2006 after declining in the 1990s and leveling off in the early 2000s.

In state rankings based on figures from 2005 -- a year before the increase -- New Mexico had the highest and New Hampshire the lowest teen pregnancy rates.

The figures come from a study by the Guttmacher Institute, a think tank that advocates for sexual and reproductive health worldwide. The study calculates the pregnancy rate by adding births, legal abortions, and miscarriages. Estimates of illegal abortions are not included.

"This increase after a long decline means that there were 750,000 teen pregnancies in 2006 -- 7% of U.S. teens got pregnant," Lawrence Finer, PhD, Guttmacher director of domestic research, tells WebMD.

Sexual activity is not up. The increase, Finer says, is due to less effective use of contraceptives by sexually active teens.

"We have not seen too many changes in sexual activity. That is not driving the trends," he says. "In the '90s, most of the decline in teen pregnancy was due to improved contraceptive use, and some to decline in sexual activity. But that decline has plateaued -- teen pregnancy is up."

Data give some perspective on the problem. By age 19, 70% of unmarried teens have had sexual intercourse. Teens are waiting a bit longer to have sex than they have in the past. But they're also waiting longer -- until their mid- to late 20s -- to get married.

As a result, four out of five teen pregnancies are unplanned and unintended. This isn't good for teens, and it isn't good for the children of teen parents, says Susan Tortolero, PhD, director of the Center for Health Promotion and Prevention Research at the University of Texas School of Public Health.

"It is a cycle, where the child of a teen is more likely to get pregnant, drop out of school, and live in poverty," Tortolero tells WebMD. Tortolero was not involved in the Guttmacher study.

Who's to blame? Neither Finer nor Tortolero downplays a teen's personal responsibility, but both blame adults for not giving teens the tools they need. Tortolero points to the huge differences between states in teen pregnancy rates.

Continued

"It really shows you we have the technology to decrease teen pregnancy, and we are really not doing what we need to do," she says. "The adults in the U.S. want to blame the kids, the media, when in fact we are not doing what is needed to prevent teen pregnancy."

What is needed? Tortolero says we have to get over the idea that having the "talk" just one time is enough.

"We have this idea that sexual health is just one conversation with a child, where in other countries with much lower teen pregnancy rates it is an ongoing conversation throughout their lives," she says. "We have effective programs that work but the schools aren't using them. And the other thing is access to contraception."

That latter point is reflected in the Guttmacher calculation that a sexually active teen who does not use contraceptives has a nine in 10 chance of becoming pregnant within a year.

Wouldn't abstinence education help? Tortolero and Finer agree that it does. But both say that sexual behavior is changed only by comprehensive sex education that includes abstinence education, and not by abstinence education alone.

Not so, says Valerie Huber, executive director of the National Abstinence Education Association, which advocates abstinence education.

"If you are looking at school-based programs, the primary mode of sex education, abstinence education has stronger results than any comprehensive education," Huber tells WebMD. "And our survey shows that in every topic area -- whether it is how contraception is discussed, discerning healthy and unhealthy relationships, receiving skills for setting future goals -- parents supported abstinence education and the way we present it over comprehensive education."

Huber says abstinence education includes education about contraception but emphasizes delaying initiation of sexual activity. And she says comprehensive education gives short shrift to abstinence -- the best way to prevent pregnancy and sexually transmitted disease.

Finer and Tortolero say comprehensive sex education is more effective at promoting abstinence than abstinence education. And Finer says abstinence education focuses on contraceptive failure rates but does not teach correct use of contraceptives.

Continued

Teen Pregnancy State Rankings

Teen pregnancy rates vary widely from state to state. The Guttmacher study did not have state-by-state data for 2006 but did calculate rates for 2005, the year before the increase.

Teen pregnancy rates in the table reflect the number of teen pregnancies per 1,000 teens.

State

Rank

2005 Teen Pregnancy Rate, Ages 15-19 (per 1,000)

U.S. total

na

70

District of Columbia

na

165

New Mexico

1

93

Nevada

2

90

Arizona

3

89

Texas

4

88

Mississippi

5

85

Delaware

6

83

Arkansas

7

80

Georgia

8

80

Tennessee

9

79

South Carolina

10

79

New York

11

77

Florida

12

77

Oklahoma

13

76

North Carolina

14

76

California

15

75

Alabama

16

73

Hawaii

17

71

Louisiana

18

70

Colorado

19

69

New Jersey

20

68

Illinois

21

67

Kentucky

22

66

Maryland

23

65

Wyoming**

24

65

Missouri

25

63

Indiana

26

62

Rhode Island

27

62

Ohio

28

62

West Virginia

29

62

Virginia

30

61

Alaska

31

61

Michigan

32

60

Kansas

33

60

Washington

34

59

Oregon

35

57

Connecticut

36

57

Montana

37

56

Idaho

38

55

Pennsylvania

39

53

South Dakota

40

51

Iowa

41

51

Nebraska

42

50

Massachusetts

43

49

Wisconsin

44

47

Utah

45

47

North Dakota

46

45

Minnesota

47

43

Maine

48

43

Vermont

49

40

New Hampshire

50

33

WebMD Health News Reviewed by Louise Chang, MD on January 26, 2010

Sources

SOURCES:

Guttmacher Institute: "U.S. Teenage Pregnancies, Births, and Abortions: National and State Trends and Trends by Race and Ethnicity," January 2010.

Lawrence Finer, PhD, director of domestic research, Guttmacher Institute, N.Y.

Susan Tortolero, PhD, director, Center for Health Promotion & Prevention Research, University of Texas School of Public Health, Houston.

Valerie Huber, executive director, National Abstinence Education Association.

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