Vinny Patti
May 31st 2012

Teen Pregnancy Prevention:  In Your Teenage Years Be A Teenager Not A Mom or Dad

Through the years of 2008-2011 have witnessed sustained declines in teen-age birthrates--a heartening development in view of the often negative effects of adolescent childbearing on young women and their children and the costs to society as a whole. Teenage births should not be the only concern, however. More than three-quarters of pregnancies among teenagers each year are unintended, and more than one-quarter end in abortion; therefore, helping young women avoid an unintended pregnancy is also an important public policy goal. Here, again, the news is encouraging: The teenage pregnancy rate also dropped in 2011 nevertheless, some 900,000 Americans younger than 20 become pregnant every year, and the U.S. teenage pregnancy rate is one of the highest in the developed world. Ensuring the continuation of the downward trend in teenage pregnancy is essential, and a key step is understanding the factors behind the progress already made. Declines in teenage pregnancies can be achieved through two mechanisms--changes in sexual behavior and changes in contraceptive use. Some observers have claimed that the declines are the result of increased abstinence. Others credit both greater abstinence and increased contraceptive use, especially condom use, among teenagers, but have not quantified their specific contributions to the falling rates.

Between 2008 and 2011, the proportion of teenage pregnancies ending in abortions decreased from 38% to 35% Therefore, teenagers' birthrate declines were attributable to reductions in their pregnancy rate. The question therefore becomes what explains the pregnancy rate decline. The pregnancy rate for all teenagers is mathematically the product of two factors: the proportion of young women who are potentially at risk of becoming pregnant because they have had intercourse and the rate at which those young women who have initiated sexual intercourse become pregnant. Therefore, examining changes in these factors over time is the key to understanding the extent to which each contributed to the decline in the overall teenage pregnancy rate.

An important question for further investigation is how sexually experienced teenagers have become more successful at avoiding pregnancy. Have they reduced their exposure to the chance of pregnancy by decreasing the frequency with which they have intercourse? They may have even lowered their risk of conceiving when they have sex by increasing their use of contraceptive methods or using more effective contraceptives. Any combination of these factors may come into play, and the focus here is on what behavioral changes contributed to declining pregnancy rates, not what caused the behavioral changes. Teenage contraceptive users have increasingly adopted long-acting hormonal methods (the inject able and the implant), which have the lowest failure rates of all reversible methods. These methods, which became available only in the early 2000s, accounted for 13% of current use by 2010 Some 10% of teenage users relied on the inject able and 3% on the implant. Condom use increased slightly, while reliance on oral contraceptives declined substantially.


Even so, these findings suggest that the best strategy for continuing the declines in teenage pregnancy levels is a multifaceted approach. Programs and policies should aim at encouraging teenagers--particularly those at the youngest ages--to postpone intercourse and at supporting sexually experienced youths who wish to refrain from further sexual activity. At the same time, it must be recognized that most young people become sexually active during their teens, and sexuality education and information should also prepare them to adequately prevent pregnancy and sexually transmitted infection if and when they do have sex. Services should be in place that will help them to behave responsibly--to ensure that they use contraceptives and to help them improve the effectiveness with which they practice contraception. That means providing adequate education and information about sexual behavior and its consequences, as well as confidential, affordable and accessible sources of contraceptive services and supplies, and support for research and development of new contraceptive methods that young people will find acceptable and easy to use effectively.