Teen births decline — What’s behind the drop?
Good news: Recent data from the Centers for Disease Control and Prevention (CDC) show that teen birth rates fell at least 15% for all but two states (North Dakota and West Virginia) during 2007-2011, with rates falling 30% or more in seven states: Arizona, Colorado, Florida, Idaho, Minnesota, Nevada, and Utah.1 (See box on p. 106 for overview.)
Declines were steepest for Hispanic teens (34%), followed by declines of 24% for non-Hispanic black teens and 20% for non-Hispanic white teenagers.
Public health emphasis has been placed on teen pregnancy prevention, because infants born to adolescents are at elevated risk of low birth weight, preterm birth, and dying in infancy, compared with infants born to women ages 20 and over.2-4 Teen births are associated with significant public costs, estimated at $10.9 billion annually.5
Teen birth rates dropped for all racial and ethnic groups, but fell the most among Hispanic teens: from 75.3 per 1,000 in 2007 to 49.4 per 1,000 in 2011. For Hispanic teens, analysts believe their behavior might be aligning more closely with their views of teen pregnancy. According to a 2009 national survey, three-quarters of Hispanic teens ages 16-19 called teen pregnancies "a bad thing for society," and seven in ten (69%) agreed that becoming a teen parent prevents people from reaching their goals in life. Among young adults, ages 18-25, 76% of Hispanics called teen pregnancies bad for society, versus 90% of all 18- to 25-year-olds.6
The new report reflects a resumption of a downward trend in teen births that began in 1991, but was briefly interrupted in 2006 and 2007. What might be some of the potential factors that led to this return to declining numbers?
One of the nation’s great success stories of the past two decades has been the "truly extraordinary" declines in teen pregnancy and childbearing, says Sarah Brown, chief executive officer of the Washington, DC-based National Campaign to Prevent Teen and Unplanned Pregnancy. She sees the slight uptick in the teen birth rate in 2006 and 2007 as perhaps an aberration in an otherwise uninterrupted period of progress.
Even taking into account the mid-2000s increase, teen childbearing has been cut nearly in half nationally, says Brown. There has been significant progress among all racial/ethnic groups, and all 50 states have posted impressive declines, she notes. "Simply put, the magic formula of less sex and more contraception has driven down the rates of too-early pregnancy and parenthood over the past 21 years," states Brown.
Although pinpointing the reasons why teens have become more careful is not easy, Brown outlines some possible explanations:
- Women in general are having fewer children and having them later in life. Teens might be mirroring older women’s overall shift toward lower birth rates.
- The declines in teen births might be explained in part by the power of positive peer influence. As more teens delay having sex, as more sexually active teens use contraception, as teen pregnancy and birth rates continue to plummet, teens’ behavior is probably being shaped in part by what is, or is not, happening around them, says Brown.
- Teens now have more birth control options than ever before and more effective methods as well. Methods such as the intrauterine device are nearly 100% effective and don’t require a game-time decision to use them, notes Brown.
"The declines in the past five years have been particularly steep — a time that coincides with a severe economic downturn," Brown points out. "As the recession kicked in, it may also be that more teens were somewhat sobered by the economic reality around them."
Ease of access to contraception is an important factor in driving down teen pregnancy, says Robert Hatcher, MD, MPH, professor emeritus of gynecology and obstetrics at Emory University School of Medicine in Atlanta. The success of the Contraceptive CHOICE Project proves this point, says Hatcher. The project was a prospective cohort study providing reversible contraception at no cost to 10,000 women ages 14-45 in the St. Louis area. It was designed to evaluate method satisfaction and continuation and to reduce unintended pregnancies in the region. Data from the project shows that the rate of teen birth within the CHOICE cohort was 6.3 per 1,000, compared with the U.S. rate of 34.3 per 1,000.7 This represents about an 82% drop, notes Hatcher. (To read more about the project, see the Contraceptive Technology Update articles "The Get It and Forget It’ methods are here: Remove obstacles to use," April 2012, p. 37; "Research proves LARC methods are best — What happens now in practice?" July 2012, p. 85; and "Abortion rates fall with free contraception," December 2012, p. 136.)
Whatever the underlying explanations for the current national decline in births, the bottom line is that teens get the credit for the progress, reflects Brown. Be sure to give adolescents the credit, says Brown.
"The next time you’re with a teen, how about saying a simple `thank you’?" she states.
- Hamilton BE, Mathews TJ, Ventura SJ. Declines in state teen birth rates by race and Hispanic origin. NCHS Data Brief, No. 123. Hyattsville, MD: National Center for Health Statistics. 2013.
- Martin JA, Hamilton BE, Ventura SJ, et al. Births: Final data for 2010. National Vital Statistics Reports 2012; 61(1). Hyattsville, MD: National Center for Health Statistics.
- Martin JA, Osterman MJK, Sutton PD. Are preterm births on the decline in the United States? Recent data from the National Vital Statistics System. NCHS Data Brief, No. 39. Hyattsville, MD: National Center for Health Statistics. 2010.
- Mathews TJ, MacDorman MF. Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Reports 2013; 61(8). Hyattsville, MD: National Center for Health Statistics.
- The National Campaign to Prevent Teen and Unplanned Pregnancy. Counting it up: the public costs of teen childbearing. Fact sheet. Accessed at http://bit.ly/184ld2v.
- Pew Hispanic Center. Between Two Worlds: How Young Latinos Come of Age in America. Washington, DC; 2009.
- Peipert JF, Madden T, Allsworth JE, et al. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol 2012; 120(6):1,291-1,297.