Teen birth rates are declining, but the job is not done


Births to U.S. teenagers are at a historic low. In 2013, there were 26.5 births per 1,000 teenagers aged 15-19, compared to 29.4 in 2012 and 41.5 in 2007. This translates to an estimated 11 percent of all teen girls who would have a birth before age 20. This is good news, given the well-documented disadvantages associated with teen childbearing for both the teens and their children.

But the job is not done; the declines in teen births have not occurred among all teens equally, and some teens in the United States remain at higher risk than do other teens. Notably, there is large variation by place of residence and by race/ethnicity—although the extent of even these variations, and their implications, are not fully understood.

Despite declines in teen childbearing across the nation, teen birth rates have varied by state for decades, and still do. In 2013, the teen birth rate ranged from 12.6 in New Hampshire to 43.3 in New Mexico, per 1,000 teenagers aged 15-19. Even within a state or region, however, there can be substantial variation. For example, based on analyses of recent birth data, it is estimated that 17 percent of girls in Washington, D.C. will become teen mothers. Yet there are dramatic differences in the likelihood of being a teen parent, based on which ward in D.C. one lives; in the most disadvantaged wards of the city, over one-third of girls are estimated to become teen mothers, while less than 7 percent of girls in the most advantaged wards are predicted to have a birth before age 20.

Similarly, although there have been important declines in teen childbearing across all racial and ethnic groups, particularly among blacks and (more recently) Hispanics, there remain large differences. And while attention and policy in the past have often focused on the high rates of teen childbearing among blacks, Hispanic teens have the highest birth rates since the mid-1990s. Roughly 34 percent of all teen births in the country occur to Hispanics. Among Hispanics there is notable variation; Hispanic teens of Mexican origin have birth rates that are almost three times higher than teen women of Cuban origin, for example.

There are many programs and initiatives that are working to reduce teen pregnancy. Some include the HHS Office of Adolescent Heath’s Teen Pregnancy Prevention grant program, as well as The National Campaign to Prevent Teen and Unplanned Pregnancy, and stayteen.org, among many others.In our recent review of over 100 rigorously evaluated teen pregnancy prevention programs, approximately half were found to be effective at reducing teen pregnancy, STIs, or key behavioral determinants (delaying sexual activity and increasing contraceptive use). Among the range of most effective approaches, parent-teen relationship programs and clinic-based programs were more frequently effective than were some other types of programs. This knowledge is critical and can be used to shape future teenage pregnancy prevention efforts.

Continuing to build the number of evidence-based teen pregnancy prevention programs through rigorous evaluations is one way we can continue to see declines in teen pregnancy.  Additionally, some evidence-based programs may need to be updated to make sure they are most relevant to populations most in need. For example, the number of rigorously evaluated teen pregnancy prevention programs that focus on Latinos remains small, and a review of program evaluations found little evidence that any particular approach consistently changes behavior. Moving forward, teen pregnancy prevention programs are likely to be more effective if they reflect the culture and values of the people they are serving.