Teen Pregnancy Update

CDC Recommends Abstinence-Plus

The U.S. Centers for Disease Control and Prevention (CDC) Community Preventive Services Task Force has again recommended "Comprehensive Risk Reduction" programs to prevent teen pregnancy, HIV, and other sexually transmitted infections (STIs). These are the comprehensive, or abstinence-plus, programs that promote condoms and contraception, in addition to promoting abstinence.

The Community Guide recommendations are based on a careful review of 62 studies. The review found that these programs reduced sexual activity, number of partners, unprotected sex, and STIs.

The Task Force found insufficient evidence to recommend abstinence-only education programs. These are programs that promote abstinence from sexual activity and mention condoms or other birth control methods only to highlight their failure rates, if at all. 

Unfortunately, many people believe the myth that sex education encourages youth to have sex. As the CDC reviews demonstrate, programs that promote both abstinence and contraceptive use actually help reduce sexual activity among young people.

Record Low Teen Pregnancy Rates

The U.S. teen pregnancy rate fell to record lows in 2008, the latest year for which data are available. Since its peak in 1990, the rate has declined 42%, to 68 pregnancies per 1000 girls age 15 to 19.

A new Guttmacher Institute report details this progress, including decreasing rates among all racial and ethnic groups. However, stark disparities still persist: pregnancy rates among black and Hispanic teens remain 2 to 3 times that of non-Hispanic white teens.

The decline in pregnancy rate reflects reductions in both abortions and births. In fact, since 1988, the abortion rate among teens fell by 59%.

Even with this progress, however, we have a long way to go. The U.S. still has far higher rates of teen pregnancy than comparable industrialized nations. Nearly 3 in 10 girls in the U.S. will get pregnant at least once before they reach their 20th birthday. For Latinas and African American teen girls, 1 in 2  will experience a teen pregnancy.

Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy puts it well: "The declines in teen pregnancy have been nothing short of extraordinary."

Why Rates are Down

Teens themselves deserve the credit for the remarkable recent declines in teen pregnancy. Among U.S. teens, rates of pregnancy, abortion, and birth are all declining. Over the last 20 years, teens have become more cautious about sex, with fewer having sex, and more using contraception. Rates of sexual experience declined from 1991 to the early 2000's, but have stabilized since then. The more recent improvements (in the last 5-10 years) have been in the use of birth control.

Based on data from the CDC's National Survey of Family Growth, the Guttmacher Institute links recent progress in teen pregnancy rates to improvements in teens' use of contraception. Comparing reports from 2006-2008 and 2008-2010, the researchers point to similar rates of sexual activity over time, but a dramatic shift in teen contraception use. There was an increase in use of any contraceptive method among teens.  There was also an increase in use of highly effective methods, including the long-acting reversible contraceptives (LARCs) such as the intrauterine device (IUD) and the implant. In addition, more teens reported using dual methods, BOTH condoms and hormonal birth control, at the same time.

Teens have become more cautious with regard to other risk behaviors, as well. The University of Michigan Monitoring the Future survey found that adolescent use of alcohol, tobacco, and most illegal drugs is far less than 30 years ago. Teen marijuana use is up, but use of other illicit drugs has, in general, decreased.