Teen Births
In 2012, there were 29.4 births for every 1,000 adolescent females ages 15-19, or 305,420 babies born to females in this age group.[1] Nearly eighty-nine percent of these births occurred outside of marriage[1]. The 2012 teen birth rate indicates a decline of six percent from 2011 when the birth rate was 31.3 per 1,000[1]The teen birth rate has declined almost continuously over the past 20 years. In 1991, the U.S. teen birth rate was 61.8 births for every 1,000 adolescent females, compared with 29.4 births for every 1,000 adolescent females in 2012 (see Figure 1). Still, the U.S. teen birth rate is higher than that of many other developed countries, including Canada and the United Kingdom.[2]
Not all teen births are first births. In 2012, almost one in five (17 percent) births to 15- to 19-year-olds were to females who already had one or more babies.[1] Avoiding repeat teen births is one of the goals of OAH’s Pregnancy Assistance Fund (PAF) grant program to States and Tribes. Grantees may use PAF funds to help pregnant and parenting teens complete high school or earn postsecondary degrees, as well as to gain access to health care, child care, family housing, and other critical supports. The money can also be used to improve services for pregnant women who are victims of domestic violence and to increase public awareness and education efforts surrounding teen pregnancy prevention, among other activities. Through PAF grants, OAH also supports several public and private organizations working with adolescent males who become young fathers. For more information about The Pregnancy Assistance Fund, look here.
Variations in Teen Birth Rates Across Populations
Teen birth rates differ substantially by age, racial and ethnic group, and region of the country. Most adolescents who give birth are 18 or older; in 2012, 72 percent of all teen births occurred to 18- to 19-year-olds.[1] Birth rates are also higher among Hispanic and black adolescents than among their white counterparts. In 2012, Hispanic adolescent females ages 15-19 had the highest birth rate (46.3 births per 1,000 adolescent females), followed by black adolescent females (43.9 births per 1,000 adolescent females) and white adolescent females (20.5 births per 1,000 adolescent females) (see Figure 1).[1] Estimates from 2010 data show that one in seven adolescent females (14.4%) in the United States will give birth by her 20th birthday, with substantial differences by race/ethnicity: 10 percent of white adolescent females, 21 percent of black adolescent females, and 24 percent of Hispanic adolescent females.[3]
Although Hispanics currently have the highest teen birth rates, they have also the most dramatic recent decline in rates. Since 2007, the teen birth rate has declined by 39% for Hispanics, compared with declines of 29% for blacks and 25% for whites.[4]
Teen Pregnancies
The national teen pregnancy rate has declined almost continuously over the last two decades. The teen pregnancy rate includes pregnancies that end in a live birth, as well as those that end in abortion or miscarriage (fetal loss).* Between 1990 and 2008 (the most recent year for which data are available), the teen pregnancy rate declined by 42 percent—from 116.9 to 67.8 pregnancies per 1,000 teen girls.[5] According to recent national data, this decline is due to the combination of an increased percentage of adolescents who are waiting to have sexual intercourse and the increased use of contraceptives by teens.[5],[6]
About 82 percent of teen pregnancies are unplanned. In other words, they are unwanted or occurred “too soon,” according to a national survey of adolescents.[7] In 2008, the majority of pregnancies to adolescent females ages 15-19 in the United States—an estimated 59 percent—ended in a live birth; 14 percent ended in a miscarriage; and 26 percent ended in an abortion. The rate of abortions among adolescents is the lowest since abortion was legalized in 1973 and 59 percent lower than its peak in 1988.[5]
* The teen pregnancy rate is the sum all live births, abortions and miscarriages (or fetal losses) per 1,000 adolescent females ages 15-19 in a given year.
Characteristics Associated with Adolescent Childbearing
Numerous individual, family, and community characteristics have been linked to adolescent childbearing. For example, adolescents who are enrolled in school and engaged in learning (including participating in after-school activities, having positive attitudes toward school, and performing well educationally) are less likely than are other adolescents to have or to father a baby.[8] At the family level, adolescents with mothers who gave birth as teens and/or whose mothers have only a high school degree are more likely to have a baby before age 20 than are teens whose mothers were older at their birth or who attended at least some college. In addition, having lived with both biological parents at age 14 is associated with a lower risk of a teen birth.[9] At the community level, adolescents who live in wealthier neighborhoods with strong levels of employment are less likely to have or to father a baby than are adolescents in neighborhoods in which income and employment opportunities are more limited.[8]
Teen childbearing is associated with negative consequences for the adolescent parents, their children, and society.[1]
Children born to adolescents face particular challenges—they are more likely to have poorer educational, behavioral, and health outcomes throughout their lives, compared with children born to older parents.[1]
Moreover, teen childbearing costs U.S. taxpayers between $11 and $28 billion a year through public assistance payments, lost tax revenue, and greater expenditures for public health care, foster care, and criminal justice services.[1]
,[2]
Efforts are currently under way to explore strategies to reduce teen childbearing and its associated negative outcomes for parents, children, and society. Teen pregnancy is estimated to cost U.S. taxpayers between $11 and $28 billion a year.[1],[2] However, research suggests that implementing evidence-based teen pregnancy prevention programs, expanding access to Medicaid family planning services, and utilizing mass media campaigns to promote safe sex may reduce teen pregnancy and lighten the burden on taxpayers.[3]
Additionally, the Affordable Care Act, passed in 2010, aims to improve access to recommended health care services for the entire population, including adolescents. The law expands health insurance coverage for teens, and offers new support for preventive services, innovative models of care, and clinical training, all of which have implications for teen pregnancy in the United States.[4]
See below for specific strategies and approaches for:
Adolescents
The only certain way to avoid unwanted pregnancies is to abstain from sexual intercourse. For adolescents who are sexually active, using effective contraceptives (such as condoms, birth control pills, the patch, the vaginal ring, the intrauterine device [IUD], and/or injectable birth control methods) every time that they have sexual intercourse will reduce the risk of unwanted pregnancy.[5] In addition to using a contraceptive method that protects against pregnancy, using condoms correctly with every sex act from start to finish will reduce the risk of HIV and other STDs for males and females.[6]
Parents
Visit our Tips for Parents page to learn more about talking to your teen about pregnancy prevention. Healthfinder.gov also has helpful strategies and tips for parents on how they can start and maintain conversations with teens about relationships and sexual decisions.
Healthcare Providers
Healthcare providers should:
- Screen and counsel adolescents for sexual risk behaviors, HIV and sexually transmitted infections (STIs), and dating violence. Learn more about the preventive services covered under the Affordable Care Act.
- Provide teen-friendly sexual and reproductive health care services. The Provider’s Toolkit from www.itsyoursexlife.com and the Centers for Disease Control and Prevention (CDC) gives practical advice on communicating effectively with teens on important issues, such as how to take their sexual history.[7]
- Locate continuing education opportunities and find teaching tools/curricula, current clinical practice references, and other helpful resources from the National Network of STD and HIV Prevention Training Centers. Also check out the latest STD Treatment Guidelines from CDC, other pregnancy prevention and STD resources for providers, and information on the gaps in testing for Chlamydia, and information on implementing Chlamydia screening.
Providers can visit our Tips for Parents page to learn more about talking with teens about pregnancy prevention.
Communities
Where we live, work, and play affects our health. Whether or not a neighborhood has safe sidewalks and playgrounds, effective schools, access to consistent and high-quality health care, as well as to jobs and opportunities, can all influence adolescents’ choices and hopes for the future and their present and future health. Communities can undertake programs that include broad-based strategies to reach many of the youth in the community (e.g., through communication strategies and media campaigns) and through programs targeting youth most in need of prevention and other program services (e.g., through implementation of evidence-based programs and improved links to services).
What communities can do:
- Implement an evidence-based teen pregnancy prevention program in your area. Visit HHS’ searchable database to find a program that was shown effective in reducing teen pregnancy, sexually transmitted infections, and behavioral risks that fits the needs of your community.
- Find out if there is a HHS-funded teen pregnancy prevention program in your area. Check out OAH’s and ACF’s lists of grantees to find organizations working in your state and community.
- Consider creating a youth development behavioral intervention that emphasizes social and emotional competence, improved decision making and communication skills, self-determination, and positive bonding experiences with adult role models, with a goal of reducing sexual risks, as recommended by the Community Preventive Services Task Force.
- Encourage schools to use effective tools and resources that help to reduce sexual risk behaviors among adolescents.
Learn more about the reproductive health of adolescents in your state or about how the teen birth rate in your county compares to that other counties in your state and across the nation.
DID YOU KNOW?
In May 2012, in recognition of teen pregnancy prevention month, OAH held an event to elevate the importance of engaging adolescent males in preventing teen pregnancies. Read more about the event here.
An estimated nine percent — or 900,000 — of young men between the ages of 12 and 16 will become fathers before their twentieth birthday, based on a recent survey.[1]Research and data collection efforts have tended to focus on female adolescents. As a result, less is known about the strategies and approaches for effectively engaging males in preventing teen pregnancies or even about their attitudes toward being a father. Clearly, the behavior of adolescent males is also central to preventing teenage pregnancy and childbearing.[2]Research and programs are increasing the focus on the role of males in teenage pregnancy and childrearing. During May 2012, OAH held an event, “Let’s Hear about the Boys: Engaging Adolescent Males in Teen Pregnancy Prevention” to elevate the importance of engaging adolescent males in preventing teen pregnancies. Read more about the eventhere.
In addition, some experts suggest that efforts to promote responsible sexual behavior need to incorporate ways for adolescents, both males and females, to develop the vital emotional and interpersonal skills necessary for successful relationships, as well as reduce some of the gender stereotypes that shape expectations about behavior.[3]
There are some tips you can follow that may help in talking with your teen about relationships and pregnancy prevention. More tips can be found for parents here.
Start talking to your teen about changes to expect during puberty; your expectations for their dating and sexual behavior, abstinence and contraception; avoiding teen pregnancy, STDs, and HIV/AIDS; and having healthy relationships. Talk early and often, and be ready to listen to your teen and answer questions that might come up.[1] For general tips on how to get the conversation started and ideas of what to talk about, visit OAH’s Talking with Teens pages on these topics. Research shows that teens who talk with parents about these topics begin to have sex at later ages, use condoms and birth control more often if they do have sex, have better communication with romantic partners, have sex less often than other adolescents,[1]and have a lower risk of teen pregnancy.[2]
Children often begin asking questions about where babies come from at a young age. These are great opportunities to lay the foundations for later talks about your expectations and values about sexual behavior and relationships. Take advantage of opportunities to have these important conversations. And if you think you waited too long, you didn’t. It’s never too late to begin this dialogue.
Be clear and specific about family values and rules about when it’s okay to start dating and your expectations around dating and sexual behavior.[3] If you have strong beliefs and values around sex and marriage, communicate those plainly. For example, if you believe people should not have sex until they are married, say that. If you think teens in high school are too young to be involved in a serious relationship, say that, and why. Or, if you think the time to have a baby is after college, say that. Same goes for using condoms or other birth control methods. Whatever your beliefs, you need to say them out loud to your son or daughter. And explain why you believe what you do.[1]
Believe in your power to affect change. It might seem like son or daughter is ignoring you, as if your adolescents don’t want to hear what you say, or that they don’t care what you think. Despite how they act, some of what you say will sink in. In survey after survey, children report that they want to talk to their parents about their sex-related questions, that it would be easier to delay sexual activity and avoid teen pregnancy if they were able to have more open, honest conversations about these topics with their parents, and that parents influence their decisions about sex more than friends do.[4]
Be there: monitor and supervise. Establish rules, curfews, and expectations for behavior through family conversations. Get to know your children’s friends and their families. Also, be sure to monitor what your children are reading, watching and listening to, and encourage your children to think about consequences from behaviors they may be exposed to in the media.
Discourage early dating. Dating during adolescence is common and can be part of healthy development.[5]However, serious and exclusive dating relationships can lead adolescents to have sex earlier than they would have otherwise.[6] Adolescents who have sex at an early age are more likely to engage in risky sexual behaviors and in other unsafe activities, such as substance abuse.[5],[6]
Ensure your child has regular visits with a medical provider. Sometimes a young person will feel more comfortable asking a doctor or other medical professional specific questions about sex and reproductive health. The American Academy of Pediatrics recommends that adolescents have private time with doctors. Learn more about the services provided under the Affordable Care Act.
Talk about their future. Young people who believe they have bright futures, options, and opportunities are much less likely to engage in risky sexual behavior. Encourage your children’s aspirations to high levels of achievement and to participate in school and community activities (such as clubs, sports or music, etc.). Support their activities and dreams to the extent you can[5],[6]
Health care, family planning and STD services
- Find a health center for well-child checkups and exams.
- Understand family planning service options, and get more information on the types of birth control available and their effectiveness at preventing pregnancy at the Office of Population Affairs and the Office of Women’s health’s Web sites on contraception.
- Find family planning services. Federally funded Title X family planning clinics offer low-cost contraceptive services and pregnancy testing for qualifying patients. Adolescents and others can find a Title X -funded clinic near their homes.
- Find HIV or STD testing. Locate a clinic that offers low-cost testing and prevention counseling for HIV testing, STD testing, and vaccines to prevent sexually transmitted infections, such as the human papillomavirus (HPV) and hepatitis athttp://www.hivtest.org or call 1-800-CDC-INFO.
Resources for pregnant and parenting teens and their partners:
- Sign up for Text 4 Baby. A woman can get support throughout pregnancy and her baby’s first year with text messages on topics such as prenatal care, baby health, parenting, and more. Different texts go out to pregnant females, parenting mothers, partners, friends or relatives of an expecting or new mother, and health care providers or other stakeholders. Messages are also available in Spanish. Visit text4baby.org to sign up for this free service today.
- Find Title V health care services for pregnant women and their babies. The federally funded Title V program seeks to improve the health of all mothers and children (including children with special health care needs), by assessing needs, setting priorities, and providing programs and services. Visit the Title V Information System to learn more about Title V programs in your state or region, or the Title V site also has the local phone number to learn more about Title V services in your state.
- Access prenatal and pediatric health resources. Baby’s first test is a Web site that explains newborn screenings and describes and provides support for babies diagnosed with medical problems. Also, the Bright Futures Education Centerpartnered with the Virginia Department of Health to develop a series of one- to two-minute videos for parents covering a wide range of topics (from child development and Sudden Infant Death Syndrome [SIDS] to discipline and behavior) that may arise any time between the newborn visit and the four-year visit. Search their site using the age of an infant or toddler. Bright Futures for Families has more materials for households with children and adolescents. The National Center for Family/Professional Partnerships provides tools and resources for families of children and youth with special health care needs and disabilities.
- Find a Maternal, Infant, and Early Childhood Home Visiting Program. Home visiting programs provide health, child protection, early education, and social services based on the needs of a family. Nurses, social workers, and other professionals meet with at-risk families in their homes, evaluate the families’ circumstances, and connect families to the services that they need in areas such as health care, child development, early education, parenting skills, child abuse prevention, and nutrition education or assistance.
- Learn more about the Office of Minority Health’s A Healthy Baby Begins with You campaign. The goal of this national campaign is to raise awareness about infant mortality with an emphasis on the African-American community, because infant mortality rates among black babies are twice as high as babies of the general population. The program focuses on health and health care prior to conception, and works closely with college students at historically black colleges and universities (HBCUs).
- Investigate what resources are available for runaway and homeless youth who are pregnant and parenting. The National Clearinghouse on Families and Youthprovides information that can assist these particularly vulnerable young people.
It is important for a pregnant or parenting teen and her partner to continue their education. It is also critical for their children to develop the cognitive, social, and emotional skills necessary for kindergarten. Taking these steps can help improve the outlook for both generations:
- Explore programs for pregnant and parenting teens such as the GRADS or PPass program. The GRADS program (Graduation, Reality, and Dual-Role Skills curriculum) is an in-school instructional program for pregnant and parenting teens in grades 7-12, with the mission to promote personal growth, educational competence, and economic self-sufficiency. The PPass Program (Pregnant and Parenting Adolescent Support Services) targets services at pregnant and parenting teens with the goal of strengthening infrastructure; reducing subsequent pregnancies; and decreasing high school dropout rates. Learn more about these programs and others funded by the Office of Adolescent Health’s Pregnancy Assistance Fund program.
- Enroll your child in Head Start or Early Head Start. Head Start is a federal program that promotes the school readiness of children through age five who come from low-income families by enhancing these preschoolers cognitive, social, and emotional development. The Early Head Start Program, with a special focus on low-income pregnant women and their infants and toddlers, is also a valuable resource. To find a Head Start program near you, click here. Additionally, the Early Head Start National Resource Center has valuable tip sheets, professional development tools, research news, and other training and technical assistance opportunities for Early Head Start professionals or those looking to learn more about the program.
