On Thursday, May 2^nd, in support of National Teen Pregnancy Prevention Month, the Office of Adolescent Health (OAH) will host a webcast that examines U.S. teen pregnancy and childbearing in a global context.  The presenter is adolescent health expert Dr. Robert Blum of Johns Hopkins University’s Bloomberg School of Public Health. Dr. Blum’s presentation will highlight the historic low rates of teen pregnancy in the U.S as well as some of the challenges researchers and policymakers face as they seek to continue to reduce teen pregnancy.

U.S. teen pregnancy and childbearing rates have fallen dramatically over the last two decades.  In fact, they are at the lowest levels ever recorded.

The National Center for Health Statistics reports that the teen birth rate was 31.3 in 2011––meaning roughly 31 of every 1,000 women ages 15-19 had a birth.¹  This is half what the rate was just twenty years ago.  Rates of abortion have declined as well.

Despite these truly impressive gains, however, the U.S. teen birth rate is still higher than it is in every other industrialized country in the world.²  Also humbling is the fact that teen birth rates in the U.S. vary widely by race/ethnicity and by region, and are highest among women of color and those living in the South.

There is no doubt that progress in the U.S. has been hampered by the polarizing nature of teenage pregnancy and childbearing in the public and private arenas.  Even among researchers, there has been ongoing debate as to why teenage childbearing is a problem.  For many years, concern about teen pregnancy was motivated by a focus on the negative consequences of teen childbearing for women and their children.  Many public health campaigns use this approach.  However, it is becoming increasingly clear that teenage pregnancy and childbearing are often markers of being born and growing up disadvantaged in the U.S., rather than the point at which disadvantage begins.²  This does not mean we should not be concerned about the high levels of teen pregnancy and childbearing.  The fact that nearly four in five (77 percent) of teen pregnancies are unintended, most often occurring much earlier than wanted, attests to the ongoing importance of this issue.

How to reduce teenage pregnancy and childbearing rates has also been subject to much debate, with some people emphasizing the importance of abstinence education and others the importance of comprehensive sex education.  The reality is that both components are probably important to an effective program approach.  However, many of these programs are insufficient on their own.  The fact is that U.S. teens use birth control, particularly highly effective methods such as the IUD, much less than do teens in countries with lower teen pregnancy rates²––so there are many gains still to be made in this arena, be it through education or access.

More fundamentally, regardless of why we are concerned about teen pregnancy or what type of sex education we support, teens need to be intrinsically motivated to avoid pregnancy.  In particular, they need to be motivated by the educational, employment, and social opportunities available to them.  As Dr. Blum will highlight in his webcast, however, many social factors can inhibit the availability and use of these opportunities––factors such as poverty, violence, and discrimination.  Thus, there’s a particularly important role here for the central people in teens’ lives––parents, teachers, partners, and peers—to promote opportunities and increase motivations to avoid pregnancy.

Efforts to reduce teen pregnancy need to be multifaceted in nature––focusing on successful youth development as well as specific reproductive health behaviors––and engage people from multiple domains. Promising examples include the Carrera Adolescent Pregnancy Prevention Program, a holistic program that works to develop individual goals and opportunity in addition to sexual literacy. The expansion of successful programs and the development of new evidence-based programs can help reduce teen pregnancy and childbearing.

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References

¹ Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2012). Births: Preliminary data for 2011. Hyattsville, MD: National Center for Health Statistics. Retrieved April 12, 2013, from http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_05.pdf

² Kearney, M. S., & Levine, P. B. (2012). Why is the Teen Birth Rates in the United States So High and Why Does It Matter? Journal of Economic Perspectives, 26(2), 141-166.