Division of Reproductive Health

National Center for Chronic Disease Prevention & Health Promotion

Teen Pregnancy in America

Zsakeba Henderson, MD Medical Officer, Maternal and Infant Health Branch

Division of Reproductive Health National Center for Chronic Disease Prevention and

Health Promotion Centers for Disease Control and Prevention

Teen pregnancy, induced abortion, and birth rates: United States, 2000–2011*

*Pregnancy and abortion rates available through 2008. Ventura SJ, et al. NVSR, 2012; 60(7). Hamilton, et al. NSVR, 2011; 60(2). Hamilton, et al. NVSR, 2012;61(5)

Teen pregnancy rate

Teen birth rate

Teen abortion rate

69.8

Teen Pregnancy Outcomes, 2008

Guttmacher Institute. Facts on American Teens’ Sexual and Reproductive Health. June 2013

Birth rates for women aged 15-19: United States, 1940-2010, and by age, 1960-2010

NCHS Data Brief , No. 89, April 2012

International Comparisons of Teen Birth Rates, 2009

Pregnancy rate for women aged 15-19, by state, 2008

Guttmacher Institute. U.S. Teenage Pregnancies, Births and Abortions, 2008: State Trends by Age, Race and

Ethnicity.

Birth rate for women aged 15-19, by state, 2010

NCHS Data Brief , No. 89, April 2012

0

20

40

60

80

100

120

140

160

180

2000 2001 2002 2003 2004 2005 2006 2007 2008

Rat

e p

er 1

,000

wo

men

ag

ed 1

5-19

yea

rs

Year

Teen pregnancy rates* by race and Hispanic ethnicity: United States, 2000–2008

*Total pregnancy rate include live births, spontaneous fetal losses and induced abortions

White non-Hispanic

Black non-Hispanic

Hispanic

Birth rates for teenages aged 15-19 years, by race and Hispanic origin: United States, 1991, 2007, 2011

NCHS Data Brief , No. 123, May 2013

0

10

20

30

40

50

60

70

2000 2001 2002 2003 2004 2005 2006 2007 2008

Rat

e p

er 1

,000

wo

men

ag

ed 1

5-19

yea

rs

Year

Induced abortion rate among teens by race and Hispanic

ethnicity: United States, 2000–2008

12

Black non-Hispanic

Hispanic

White non-Hispanic

Ventura SJ, et al. National Vital Statistics Reports, 2012;60(7)

What are the possible reasons for the recent decline in teen pregnancy?

Fewer teens are initiating sex (or delaying sexual

activity)

More sexually active teens are using effective

contraceptive methods

Females aged 15–19 years who had never had sex*, by

race/ethnicity and age group — National Survey of Family

Growth, United States, 1995, 2002, and 2006–2010

Characteristic 1995 2006–2010 Change

(1995 to

2006–2010)

% (95% CI) % (95% CI) % Total 48.9 (46.1–51.8) 56.7 (46.8–66.6) 16*

Race/Ethnicity

White, non-Hispanic 50.0 (46.4–53.5) 57.6 (46.0–69.2) 15*

Black, non-Hispanic 40.0 (34.0–46.1) 53.6 (48.0–59.2) 34*

Hispanic 43.5 (35.5–51.4) 56.2 (47.2–65.3) 29*

Age group (yrs)

15–17 61.4 (57.9–64.9) 72.9 (63.6–82.2) 19*

18–19 28.9 (25.1–32.6) 36.5 (24.3–48.7) 26

* Defined as vaginal intercourse; Trend is statistically significant at p<0.05.

MMWR. 61(17);297-301

U.S. Teen Contraceptive Use

Martinez G et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006–2010

National Survey of Family Growth, Vital and Health Statistics, 2011, Series 23, No. 31

Teen Birth Control Use Postpartum

91% of sexually active teen mothers used some form of

birth control, but only about 22% used the most

effective types of birth control.

White (25%) and Hispanic (28%) teen mothers were

almost twice as likely as black teen mothers (14%) to

use the most effective types of birth control.

Long-acting reversible birth control (LARC) can be a

good option for a teen mother.

Source: CDC's Pregnancy Risk Assessment Monitoring System. http://www.cdc.gov/Features/vitalsigns/teenpregnancy/

Prevention Strategies

Evidence-based sexual health education

Support for parents

Access to effective and affordable contraception

http://www.cdc.gov/Features/TeenPregnancy/

CDC’s Teen Pregnancy Prevention Initiative Program Goals

Reduce the rates of pregnancies and births to youth in

the target areas.

Increase youth access to evidence-based and evidence-

informed programs to prevent teen pregnancy.

Increase linkages between teen pregnancy prevention

programs and community-based clinical services.

Educate stakeholders about relevant evidence-based

and evidence-informed strategies to reduce teen

pregnancy and data on needs and resources in target

communities.

http://www.cdc.gov/TeenPregnancy/PreventTeenPreg.htm

19 http://www.cdc.gov/vitalsigns/TeenPregnancy/

Socioeconomic and Other Factors as Determinants of Teen Childbearing

Individual-level factors

School dropout

Educational expectations

Attitudes toward childbearing (ambivalence, reaction to peer influences)

Family-level influences

Lower family SES (family receipt of public assistance)

Lower parental education

Penman-Aguilar A, et al. Public Health Rep. 2013;128 Suppl 1:5-22, Kearney MS, et al. J Econ Perspect. 2012;26(2):141-66.

Socioeconomic and Other Factors as Determinants of Teen Childbearing

Family-level influences

(continued)

Intergenerational teen childbearing

Lack of father figure

Foster care

Community-level influences

Lower county-level per capita income

Greater income inequality

Neighborhood “physical disorder”

Penman-Aguilar A, et al. Public Health Rep. 2013;128 Suppl 1:5-22, Kearney MS, et al. J Econ Perspect. 2012;26(2):141-66.

Why does all this matter?

The U.S. still has the highest rates of teen childbearing among other developed countries

Teen pregnancy costs taxpayers more than $11 billion/year and perpetuates the cycle of poverty

The high rate of teen pregnancy in the U.S. is a marker of a social problem

22

Take home points

Teen pregnancy and teen birth rates are decreasing for

all racial/ethnic groups

Racial/ethnic disparities still exist, but the gaps are

narrowing

Teen pregnancy prevention efforts include evidence-

based sexual health education, support for parents,

and increased access to and use of the most effective

contraceptives (LARC)

Addressing difficult social problems is a key

component of prevention

For more information please contact Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

National Center for Chronic Disease Prevention and Health Promotion

Division of Reproductive Health

http://www.cdc.gov/TeenPregnancy/

zhenderson@cdc.gov