After more than a decade in decline, the United States teen pregnancy rate has been rising in recent years.
According to momlogic.com, the estimated public cost for teen pregnancy in the United States is between $6 and $9 billion a year. Eighty percent of teen moms are on some form of public assistance. Seven out of 10 teen mothers are unlikely to receive prenatal care, which of course has great negative health impacts for their children.
Aside from the health risks, kids born to teen mothers are at greater risk for emotional and physical abuse, especially if there is no family support.
“It really is a public health issue,” said Bill Albert, chief program officer at the National Campaign to Prevent Teen and Unplanned Pregnancy. “This administration and this Congress have made a historic investment in preventing teen pregnancy. In our view, this investment could not be more timely… given the fact that the teen pregnancy rate in the U.S. is on the rise.”
Teenage mothers are also at higher risk of having emotional and academic problems later in life. Another startling statistic: baby boys of teen mothers are at an increased risk for incarceration later in their lives, while girls born to teens are more likely to become teen moms themselves.
In the beginning of 2009, President Obama signed an appropriations bill that ended federal funding for existing abstinence-only-until-marriage programs and put a new teenage pregnancy prevention initiative in the newly funded Office of Adolescent Health within the U.S. Department of Health and Human Services that was supported with more than $114 million in federal funds.
The prevention initiative was being hailed by health advocates for its focus on the evidence. Of the $114 million, $75 million will go toward replicating pregnancy prevention programs that had been thoroughly evaluated and provided the strongest evidence of success, while $25 million went to programs that show promise and innovation. There are roughly 400,000 teen births every year in the U.S., with about $9 billion in associated public costs.
While the nation’s teen pregnancy rate declined about 40 percent between 1990 and 2005, data released by the Guttmacher Institute in January 2010 showed that the rate rose three percent in 2006. According to the institute, the new data are “especially noteworthy because they provide the first documentation of what experts have suspected for several years, based on trends in teens’ contraceptive use – that the overall teen pregnancy rate would increase in the mid-2000s following steep declines in the 1990s and a subsequent plateau in the early 2000s.”
And like many other health issues, the U.S. teen pregnancy rate is checkered with disparities. In 2006, among Black and Hispanic teens ages 15 to 19, there were about 126 pregnancies per 1,000 women, while among white teens, it was 44 per 1,000. Such statistics mean the U.S. has the highest teen birth rate among Western, industrialized nations.
First there was a study from the Guttmacher Institute, a nonpartisan think tank that concluded the teen pregnancy rate is on the rise after more than a decade of decline. Then there was a federally-funded report that said the cure to the problem might just be those abstinence-only sex education classes – despite experts’ opinions that those classes are the cause of the rise.
The report’s rankings of states by teen pregnancy rates look eerily similar to the U.S. Census rankings of states by poverty rates.
Mississippi, for example, has the nation’s highest rate of poverty and the third highest rate of teen pregnancies. New Mexico is third in poverty and second in teen pregnancies. Texas leads in teen pregnancies and comes in ninth in the poverty rankings. Other “risk factors” for teenage pregnancy – being a person of color, being disinterested in school, etc. – similarly dovetail with living in poverty.
According to the National Campaign to Prevent Teen Pregnancy, a child born to an unmarried teen mother has a 27 percent chance of growing up in poverty. If the mother has not earned a high school diploma or equivalency degree, the child will grow up in poverty 64 percent of the time. If those numbers are correct, the steep decline in teen pregnancy rates between 1991 and 2002 kept an additional 460,000 children from being born into poverty.
“As a society, we have to continually redouble our efforts to sustain these kinds of (downward) trends over time,” said Heather Boonstra, a senior public policy associate at the Guttmacher Institute, which conducts research on a range of sexual and reproductive health issues. “We can’t just sit back, because new teens are constantly coming into the field. We have to remain vigilant.”
Factors shaping the recent rise in teen pregnancy are varied and complex, prevention advocates say, ranging from years of federal support for rigid abstinence-only programs to tempered fears of contracting HIV, to less teen contraceptive use.
“We have the tools we need (to prevent teen pregnancy and disease) – and we can always improve on them – but we need to better apply them,” said Lorrie Gavin, a health scientist with the Center for Disease Control’s Division of Reproductive Health. “In addition to disseminating evidence-based sexuality education and youth development programs, it is critically important that we make sure that sexually active youth have access to contraceptive services and that there is a supportive social and policy environment.”
The debate over the effectiveness of abstinence vs. contraception made headlines after a study published in the February 2009 issue of Archives of Pediatrics and Adolescent Medicine found that one specific abstinence-based intervention was successful at delaying sexual initiation. However, the study authors noted that the intervention studied “would not meet federal criteria for abstinence programs… (and) was not moralistic and did not criticize the use of condoms.”
For the Obama administration, the sticking point will be evidence, not content, Albert said.
“It used to be, to get this federal pot of money, you had to stick to a certain curriculum — the variable was content, not evidence,” Albert told The Nation’s Health. “Now, our ‘sort variable’ is going to be evidence, and for geeks like us, that’s music to our ears.”
The American Public Health Association contributed to this report.
Zach Burgess is a writer for The Philadelphia Tribune.
