One of the great public health success stories of the past 30 years is the sharp decline in teen pregnancy rates.
While significant racial disparities remain, the overall drop in teen pregnancy – which is linked to a host of negative outcomes for women and society as a whole — has been nothing short of phenomenal.
In 1990, there were an estimated 61.8 teen births out of 1000, for girls aged 15-19, according to the Pew Research Center.
By 2008, the teen birth rate had fallen to 41.5. Last year, it was just 17.4, a 60% decline in the space of a single decade.
How could teen pregnancy rates fall so fast?
Arguably, the Great Recession of 2007 could be one factor. With greater fear for their economic future, jobless young women might have refrained from having babies knowing they couldn’t take care of them, analysts say.
But, in fact, teen pregnancy rates began falling during the boom period of the 1990s, and the same trend persists even as the economy continues to recover.
More likely, researchers say, is that pregnancy prevention and more effective contraception is changing teen behavior and paying big social dividends.
Another factor is that teen girls are simply having sex often. According to the National Survey of Family Growth, just 42% of women ages 12-19 reported having sex in 2015, down from 51% in 1988. And female contraception use is up, from 74% in 2002 to 81% in 2015.
Overall, women are having less sex and protecting themselves from pregnancy when they do.
Why is teen pregnancy prevention working so well compared to other prevention programs?
Some people believe it’s partly due to Reality TV. For example, a 2014 report by the prestigious Brookings Institution report claims that MTV programs like 16 and Pregnant and Teen Mom contributed up to a third of the decline in teen births over an 18 month period (June 20009-December 2010).
In addition, the federal government has made an unprecedented investment in programs to reduce teen pregnancy. Since 2010, the Centers for Disease Control CDC and the HHS Office of Adolescent Health (OAH) have implemented dozens of evidence-based teen pregnancy prevention interventions in communities nationwide that include the latest moderately or highly effective contraceptive methods.
Studies have shown that taxpayers can suffer a huge burden from teen pregnancies, mainly because the children born to teen parents are expensive to care for. In Texas, for example, those costs, which included Medicaid and CHIP, reached $1.1 billion in 2010, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.
“Children of teen parents are more likely to suffer poor health, underachieve in school, be incarcerated or placed in foster care, live in poverty and become teen parents themselves,” notes the National Conference of State Legislatures. “Lower levels of education among teen parents and their children often result in reduced earnings and spending. For states, this translates to less tax revenue.”
The costs of teen pregnancies can vary sharply by state. So, too, do the savings realized from reducing their rate. In 2010, a less populous state like North Dakota reported saving $6 million in a single year. By contrast, larger states like California have reported saving almost $2 billion over several years from reduced teen pregnancies – a huge boost to the state’s treasury.
Despite these enormous successes, challenges remain. Ethnic and racial disparities are still sharp. In 2018, the birth rate for Hispanic and black teens ages 15 to 19 was almost double the rate among white teens and more than five times as high as the rate among Asians and Pacific Islanders.
In addition, among all teens, nearly 30% still become pregnant by the time they turn 20. Moreover, 20% of teen births are to teens that already have a child.
With expected cutbacks to federal funding to reduce teen pregnancy, private philanthropies across the country are beginning to fill the void.
In Baltimore, MD, the city lost most of its annual $3.5 million budget for teen pregnancy prevention. In response, the Abell Foundation, the Aaron and Lillie Straus Foundation, the Henry and Ruth Blaustein Rosenberg Foundation, and the David and Barbara B. Hirschhorn Foundation have agreed to step up their funding.
Many foundations are focused on supporting the expanded use of Long-Acting Reproductive contraception, or LARC, which is widely viewed as the most advanced and effective contraceptive implant device available.
LARCS are the “first-line defense against teen pregnancy,” according to Planned Parenthood, which first endorsed their use in 2014.
LARC use has increased nearly fivefold since 2002, but thanks largely to the prohibitive start-up cost, the current utilization rate nationwide is below 10%, with even lower rates reported for women of color.