Teen Pregnancy Surges

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.

"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.

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.