After Years of Decline, Teen Pregnancy and Births Back on the Rise

There is
reason to be concerned on this 8th National Day to Prevent Teen
Pregnancy.  The extraordinary decline in
teen pregnancy and childbearing – one of the nation’s preeminent success stories
of the past two decades – is in danger of being reversed.  Cue sober music.

From the
early 1990s, until 2007, the teen pregnancy rate in the United States plummeted
38 percent and the teen birth rate declined by about one-third.  State and local level trends mirrored national
trends almost everywhere: Over the past decade, we’ve seen declining rates of
teen pregnancy in all 50 states and among all racial and ethnic groups-extraordinary
progress on an issue many once considered intractable.

the most recent news on this front has not been as positive. After 14 straight
years of declines, the national teen birth rate increased 5 percent between
2005 and 2007 and many states are reporting statistically significant increases
in their respective rates of early childbearing as well. 

Given this,
it is not surprising that one of the questions we are most frequently asked at
the National Campaign is:  Why? Why has the encouraging progress on teen
childbearing begun drifting in the wrong direction?  Based on the limited data that are available,
the observations of those who work directly with teens nationwide, and
researchers who study the issue, there are several clues that help explain the
recent increase:

More sex, less contraception.  Declines
in sexual activity and increases in contraceptive use among teens – the two
factors that drove the steep decreases in the teen pregnancy and birth rates
beginning in the early 1990s – have apparently stalled out.  In fact, although the changes have been small
and not statistically significant, sexual activity increased and contraceptive
use by sexually-active teens decreased among high school students between 2005
and 2007.

Less concern about HIV/AIDS.  Observers
have long believed that concern about HIV/AIDS has helped make young people – in
particular, young men – more cautious about sexual activity and more vigilant
about contraceptive use, and that these concerns contributed to the decline in
teen pregnancies and births over many years. 
Now, however, there is evidence to suggest that concern among young
people about HIV/AIDS is less pronounced. For example, a recent survey of those ages 18-29 who say they are
personally very concerned about becoming infected with HIV declined from 30
percent in 1997 to 17 percent now.  And
according to the CDC, the proportion of high school students who say they have
ever been taught about HIV/AIDS has decreased from a high of 92 percent in 1997
to 83 percent in 2007.

Reaching older teens.  Recent
National Campaign analyses suggest that nearly three quarters of the recent increase
in teen births can be attributed to older teens (age 18 to 19) rather than
younger teens (age 15 to 17).  Efforts to
prevent teen pregnancy have largely ignored older teens and recent increases in
the teen birth rate underscore the need for additional, more creative
interventions that reach older teens.  In
short, high school sex education may not "carry forward" into non-high school

Changes in the Makeup of the Teen Population.  The overall increase in the national teen
birth rate is due, in large part, to increases in the birth rate among teens of
all racial and ethnic groups. Even so, a National Campaign analysis suggests
that about a quarter of the three percent increase in the teen birth rate
between 2005 and 2006 may be due to changes in the racial and ethnic makeup of
the teen population overall.

Limited information about contraception.  Abstinence should be stressed as the
first and best option for teens.  It is
developmentally appropriate, widely supported by parents and teens, and the
only certain way to prevent too-early pregnancy and parenthood.  But we also know that those teens who are having sex and are not using
contraception are the ones who get pregnant. 
The nation’s emphasis on abstinence-only education in recent years may
not have provided young people with adequate information about contraception or
enough encouragement for sexually active teens to use contraception
consistently and carefully.  Every time.

Complacency and prevention fatigue. 
The years of good news about
teen pregnancy may have led to complacency on the part of practitioners and
parents.  It may also have let policymakers
and other funders turn their attention to other issues and away from preventing
teen pregnancy.  An informal survey by the
National Campaign conducted in December 2008 found that in half of the 20
states that responded, teen pregnancy prevention programs received cuts in
funding from public and/or private sources. 
Others reported flat funding. This situation may worsen as the full
effects of the current economic downturn become apparent.

An "anything goes" culture.  What
about the role of prevailing social norms and popular culture?  At present four in ten births to U.S. women
are to unmarried women; for those in their early 20’s, it is six in ten.  One in five teens say they have
electronically sent or posted a nude or semi-nude image of themselves; and the
high-profile teen pregnancies of Bristol Palin and Jamie Lynn Spears were
largely greeted as the latest in a long line of celebrity baby bumps-mildly
interesting but, at the end of the day, no big deal.  Perhaps such trends and factors help shape
the social script for teens, suggesting that getting pregnant and starting a
family in the teen years when you are single and may not have even finished
high school is simply not that big a deal.

So what to
do?  Of course we need better sex
education for young people.  Of course we
need more on-the-case parents who are helping their children figure out
relationships, sex, family planning and more. 
Of course access to and affordability of contraceptive services remain
critically important.

In addition
to all of these things, my sense is that young people-in fact all of  us-would also profit from some good,
old-fashioned "straight talk."  For
example, when was the last time any of us heard any major public figure say
things like:

  • Babies need adult parents.
  • "If it happens, it happens" is no way to start a
    family. And "I just never really thought
    about it" isn’t either.
  • Babies don’t cement relationships; they often put great stress on
    them. Be sure you are in a solid
    relationship before you begin a family.
  • Sex has meaning, risks and consequences. It’s not a casual
    activity. Take it seriously.
  • Babies don’t give unconditional love; they demand it from the
    adults around them.
  • Children do best when they are raised by parents who are committed
    to each other and to years of devoted parenting.
  • To boys and men: Making babies doesn’t make you a man. Being
    a devoted partner and father may.
  • To girls: Sex won’t make him yours and a baby won’t make him stay.
  • Personal responsibility and parental
    responsibility mean it’s not just about "me" the adult – it’s also about what’s
    in the best interest of children, communities and future generations.

In short, getting pregnant or causing pregnancy, having
babies, and starting families are perhaps the most important things we ever do,
with generational effects.  These major
steps need to be thought about carefully, not stumbled into.  We think and
talk about so many less important things all the time: what’s for dinner, March
Madness brackets, what movie to see this weekend… Surely the event of when
to become a parent, with whom and under what circumstances deserves at least
the same amount of time and attention.   

P.S.  On this day
focused on teen pregnancy, let’s not forget the unacceptably high rates of
unplanned pregnancy among women of all ages-particularly single
20-somethings.  At present, fully 7 in 10
pregnancies among single women in their 20s are unplanned.  We can and must do better.

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  • progo35

    I want to see teen pregnancy go down, not the rate of births resulting from those pregnancies.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • jodi-jacobson

    among teens will naturally decline with a decline in rates of unintended pregnancies among teens. It is somewhat contradictory to want to reduce unintended pregnancy among teens and not be concerned about the birth rate among teens given the data on the negative effects of early childbearing on educational attainment, health, income, poverty and other indicators.


    Jodi Jacobson

  • amanda-marcotte

    I’d like to separate the glorifying of teen motherhood emanating from social conservatives from the "sexting" panic.  Kids who experiment sexually in non-furitive ways are exactly the audience we can reach with messages about how contraception enhances sexual pleasure by taking the worry out of it.  They aren’t ashamed of being sexual, so we can talk to them about it.


    On the flip side, we have an evangelical subculture that is all too willing to push the idea that getting pregnant in your adolescence, while they’ll reluctantly agree isn’t the best idea, has the potential to be the best choice you ever made.  If you watch some of the speakers for Feminists For Life talk, you’ll see what I mean—they have women who got pregnant in college, and they’re outright selling it to the crowd as the ticket to respect and love.  You hear all these stories about how that accidental pregnancy caused your parents to glow, that trifling boyfriend to shape up and marry you, and you to get that wedding that you’ve secretly fantasized about while watching bridal shows on TLC.  You’re also assured it won’t hurt your chances of finishing college.


    I suspect high school girls are getting similar messages, especially the way that the Christian right propped up Bristol Palin as an example of how awesome it is to be pregnant at 17, because look!  You’ll get some hunky boy to marry you and act like you’re the queen of the universe.  


    I don’t know how much young women are compelled by the "and some boy will finally admit that he likes you" narrative, but abstinence-only materials do put a lot of emphasis on the idea that young men can’t be counted on to offer their love freely to women on the basis of attraction and compatibility.  No, boys have to be persuaded to overcome the natural repulsion to all things female—so you’re encouraged to be silent and submissive, and withhold sex in hopes that he’ll commit to you to get it out of you.  Or, apparently, get pregnant.

  • invalid-0

    You say “of course we need better sex education” but the feds don’t invest any money for sex education besides abstinence-only and those programs don’t work. So why is the Campaign advancing language with the White House and Congress that would keep the door open to abstinence-only programs? Why doesn’t the Campaign actually work with other groups and politicians to get Congress FINALLY invested in sex education that works?

    • invalid-0

      If you understand sexual education as lessons Kama-Sutry and appeals to fuck as it is possible is more often – at you one-sided representation.
      As the basic means of mastering by the child historical mankind experience dialogue serves. And at early school age “importance” of dialogue with adults prevails – and so lasts up to teenage crisis in 11-12 years when on the foreground “importance” of dialogue with contemporaries starts to act. By the end of younger school age the child already “has learnt to study” – it actively learns the world, basically by means of adults. Naturally, it has a set of questions. On the other hand, at it the logic thinking is already enough developed not to be satisfied with “simple” or “fantastic” answers of adults as it was at preschool age (the same storks in cabbage). The child not simply asks a question, it already and estimates the answer – correlates it to knowledge already received earlier of the world. In my native Tokyo bring up children from early school age instead of when it to become 30…

  • invalid-0

    My name is Roger D. Casterline and my book is entitled, “The IKE Disease.” Teenagers experimenting with drugs, sex, and in many cases even crime, are not the problem but rather symthoms of the real problem which is disobedience to parents. Every young person I have known that made it their business to disobey their parents suffered great hardship. It might seen too simple to be a solution; however, if one ignores the root cause (disobedience)there is no hope for recovery. People are all looking for a magic word for teen pregnancy instead of a healing act, “obey your parents.” For additional information on IKE please visit my website at:
    God Bless!!!

  • progo35

    The article makes a distinction, and that is what I’m responding to. I’m saying that I’m all for measures to prevent teenagers from getting pregnant in the first place, and thereby reducing the birth rate, but I am not upset about the birth rate going up becaue that would indicate that less teeens are choosing abortion after efforts to prevent pregnancy failed.  So, I’m all for free contraception and education, but when it fails, we need to focus on providing the resources women and girls need so that education, health and income do not suffer as a result of early childbearing, not encourage her to have an abortion.



    Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35


    No one on the "Christian right" or in the Palin family, or in the adoption field, etc, is suggesting that it is a good idea to get pregnant when you are a teenager. That is an outright lie. Christians and the Palins and those who promote adoption have said that if it does happen, carrying the baby to term is a good decision and is not the end of the world. It is not fair to adolescents to tell them that if they don’t have an abortion, their lives will end or that anyone who does tell them that is just trying to exploit them. Sheesh. I am almost surprised that you would make such an outrageous claim about a group that you also say demonizes teens who have sex. Then, in your second breath, you allege that Christians and social conservatives are running around encouraging teenagers to get pregnant. 



    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • invalid-0

    ooh wow it’s so very simple.
    Come back when you have something more substantial to contribute than a self published screed on how everything bad hinges on ONE thing.
    What is a teen’s parents are drug abusers or alcoholics? What if they force the teen to go out and buy drugs or watch them get high or tell them to start turning tricks for drug money so they can get high?
    It’s NOT all about obeying parents dummy.

  • invalid-0

    First off, thanks for the bit at the end about this happening to adult women as well, to keep this from looking like yet another full on bit about a teen problem that is actually a problem among adults as well, but the latter often gets little to no mention. Too many people forget to do that.

    That said, I think this article is forgetting something very important. It’s easy to blame teens for making poor sexual choices, but what about the VERY many instances that, well, the sex wasn’t their idea? It’s easy to talk about how misconceptions among teens are making them want to have babies, when not only do extremely few teens actually want to get pregnant, but many of their pregnancies are a product of sexual assault, a crime that is notoriously underreported, especially when it comes to youth. Which of course, sort of makes this like blaming rape victims.

    Also, involving the few who do intend to get pregnant, it helps to have a look at their actual lives (knowing someone is 16 doesn’t tell you everything there is to know about them, who knew!). They might be in a living situation where getting pregnant is a good idea or just about their only option in life. It’s complicated.

    As for Jamie Lynn Spears and Bristol Palin, I think the idea that most people hated them for their pregnancies just because of their age was absolutely deplorable. Both those girls were with supportive families and rather wealthy, so they’re quite alright.

    On a fun note, today, this national day for preventing teen pregnancy, also happens to be my birthday. I was born to a 19-year-old mother. So, yay, my birthday is a national day all about wishing I didn’t exist! I mean, I’m college-educated, support myself, have a good job and am fairly happy with my life, yet because of my mother’s age, my existence is a blemish on society. Oh boy, I feel so loved!

    But, yeah, I don’t mean to be like totally nasty or anything. I very much agree that better, realistic, respectful education of contraceptives and consequences and options is definitely a huge way to solve the issue of unplanned pregnancies, there are so many other complicated things generally going on, so many variations to everyone’s situation, many horrifying, that often are ignored or forgotten in this issue.

  • jodi-jacobson

    I think you raise an extremely important point regarding sexual violence and coercion, an issue we intend to cover here. You are correct that violence, abuse, and coercion play a role in adverse sexual and reproductive health outcomes and in the violations of children, teens and adults everywhere. Good comprehensive programs address this issue.


    I do not think, however, that anything about the discussion of teen pregnancy is meant to suggest that anyone whose mother gave birth as a teen is supposed to be stigmatized or to feel that the national conversation is meant to suggest that someone should not exist. In fact, my own mother was married at 16, gave birth me at age 20 and then quickly had 3 more kids. The only reason my parents did not have children earlier was that she simply just did not get pregnant right away.


    I understand you might feel that way, but I don’t believe that is inherent in any of these efforts.  The issue is first and foremost to prevent unintended/unplanned pregnancies (but also much more broadly though often forgotten to enable people to exercise their rights and have healthy, safe, and consensual sexual and reproductive lives throug responsible choices and behavior); to provide options to pregnant teens— *all* options in a manner that is non-coercive toward *any* end; and to ensure that support is put in place for teens who do become parents much earlier than they had planned.


    It is not about shaming or vilifying either teens who get pregnant nor their children.


    Thanks for writing.


    Jodi Jacobson

  • invalid-0

    There is no way your birth can be construed as a blemish. Every baby is a gift.

    That said, some 19-year-old women are not ready for a child and to do what is best for that new life, yet they are having sex. At 19, I think we should expect women to be having sex–responsibly. Having sex responsibly means to understand the implications. Understand your options for contraception and use it. Understand that you can and should say no when the timing or person is not right. Understand that you need to respect the other person and their needs and health. Use protection against STIs. Get tested.

    The National Day is simply a time to give these things some extra thought–even though they should be on our minds every day.

  • invalid-0

    What has made Amanda into the person we seem to see today–bitter, manipulative, dishonest?

    Amanda, tell us, do, how to get an obese three-year-old to enjoy her six chocolate shakes per day with enhanced pleasure and without shame? Or, on the other hand, maybe we can tell her that one shake per week will serve her far better over the long term.

    And, Amanda, if you are content to be sexually easy prey, you will certainly be kept very busy with boys that have had no reason to subordinate their erectile tissue to more noble priorities. The other kind of boy will be engaging in the struggle to be exemplary, so he can be worthy of a girl who sees that she has value in a wide spectrum of life experiences and goals, and hasn’t seen and done every sex-hormone-driven thing before she is out of her teens. When a girl is blithely enhancing her pleasure, she doesn’t notice all of the nice boys who have the deliberation to recognize that, while tempting, the pleasure-seeking girl is a minefield–and he is heading in the other direction.

  • on-the-issues-magazine

    Great discussion here. Check out a "sexual future that is violence-free, pleasure-present and children-chosen" in Rev. Dr. Donna Schaper’s story at On The Issues Magazine.

  • invalid-0

    Yes, Lucille, we know. “Women who enjoy sex are sluts and deserve all the shame and scorn they get.” (Of course, if the boys decide to get around, then, well, that’s not such a big deal—boys will be boys, after all!) We’ve only been hearing it from you right-wingers for decades now. Don’t forget the part about how being a stay-at-home mom is a higher calling than having a professional career, and the whole “submitting to your husband” business.

  • invalid-0

    The author stated,
    “In short, getting pregnant or causing pregnancy, having babies, and starting families are perhaps the most important things we ever do, with generational effects. These major steps need to be thought about carefully, not stumbled into. We think and talk about so many less important things all the time: what’s for dinner, March Madness brackets, what movie to see this weekend…”

    In today’s society, young women are extremely conscious of their bodies. Just as the author has noted, they tend to stumble into things. However, most spend an inordinate amount of time fretting over their hair, make-up, weight, etc. Let’s appeal to their vanity. I’m a registered nurse and I know for a fact pregnancy in young girls more often than not causes terrible stretchmarks. I’ve worked with women and pregnancy for 25 years. After the age of 20, this is dramatically decreased. I have no stretchmarks on my abdomen or my breasts. They are just as beautiful today (at 55 years of age) as they were when I got pregnant at 23. The female body undergoes a wonderful transformation after 20 with additional hormones that provide greater elasticity via collagen stimulation. Teenager girls do not do this!! Let’s get photos of women (in their 40’s to 50’s)who had babies as teenagers in their skivvies with their abdomens and breasts visable. And let’s also get photos of women (of the same age)who had their first children in their 20’s. Then, let’s blow these photos up into poster-sized wall hangings and hang them in the class prior to the young women coming in. The visible difference is just shocking. I know this well. My mother had my older sister at 18 and her abdomen still looks so painful and stretched. Growing up I thought this happened regardless. It doesn’t. Many, many women undergo abdominoplasty in order to have the stretchmarks removed. Have we ever educated these young women about the need for these hormones in order to have a nice recovery from pregnancy? Don’t we know these girls are quite self-centered at that age and would certainly take notice of this difference in a pregnancy-prepared body as opposed to one that has a very inadequate supply of elasticity? We’re at a point that anything that might help should be incorporated. For several years I taught nurse aide training. I alway directed the conversation to teenage pregnancy as many of the young women were just 18. They were shocked to learn their abdomen and breasts would weather pregnancy much better if they waited until their 20s. It’s all about being informed.
    I have to give kudos to the author and Ms. Fonda for being outspoken on this issue. Ms. Fonda is right. We need to pull out all the stops. Remember the poster of the beautiful young woman with the partially-blackened face (1980s)? Those posters were placed everywhere by the American Cancer Society with the caption, “If smoking did on the outside what it does on the inside, you wouldn’t smoke.” I quit then. We need to get together and brainstorm about ideas. While this one is a little far-fetched, it’s one that might work. Or at least augment other efforts. Anything at this point..
    Thank you, Gayle Clark

  • jodi-jacobson

    That we need to do less glorification of perfect bodies and appeals to vanity and build more self-esteem, more focus on the whole person and a far deeper platform for sexual and reproductive choices and health throughout the life-cycle.

    This strategy, to me, just feeds into the notion that women’s beauty and sexual appeal are only skin deep and i would guess that if right now teens are not "thinking future" enough in having unprotected sex to avoid having a baby, they are probably not "thinking future" enough to avoid sex because of sex marks.


    What I don’t get here is this: We know what works. We don’t need lots of shaming strategies. Comprehensive sex ed, straight talk, engagement of adolescents in efforts to break down gender stereotypes, answer their questions, get them facts and non-judgmental care and services….these are the things that work. We don’t need to make older mothers feel ugly.


    With all due respect. Jodi Jacobson