Issues in Brief

Teenage Pregnancy and
The Welfare Reform Debate

Teenage pregnancy and out-of-wedlock childbearing have become central issues in the debate over welfare reform. Paradoxically, they are frequently seen as both the cause of increased welfare costs and caseloads over the last 25 years, and the result of the welfare system itself.

Out-of-wedlock births among teenagers have increased dramatically in the last several decades and now account for almost 70% of all teenage births. Yet, trends in teenage sexual activity and childbearing reflect broader trends in sexual and reproductive behavior among women of all ages and income levels. Women age 20 and older, for example, account for more than three-quarters of the unintended pregnancies and abortions that occur each year in the United States. Moreover, despite the sharp increase in teenage out-of-wedlock births, the increase has been even greater among older women. As a result, teenagers account for a much smaller proportion of out-of-wedlock births today than they did in the 1970s.

Contrary to popular belief, only 5% of mothers on welfare are teenagers, and just 1%, or about 32,000, are under age 18. However, a large proportion of women who begin childbearing as teenagers eventually end up on welfare, and those who do tend to need assistance for a long period of time.

Clearly, therefore, ensuring teenagers access to services that can enable them to avoid unplanned pregnancies and unwanted births is essential to helping them avoid or escape poverty and welfare. Making voluntary family planning services and, as a backup, abortion easily accessible to adolescents has been demonstrated to be a cost-effective way to reduce unplanned childbearing and its consequences.

For the most part, however, current welfare reform proposals take a different approach. They rely on disincentives-the threat of punitive measures down the line-to discourage teenage childbearing.

These proposals appear to rest on two basic assumptions: that poor, unmarried teenagers deliberately get pregnant and have babies in order to collect welfare and set up their own households; and that a prohibition on benefits will, in and of itself, discourage out-of-wedlock births. Undoubtedly, some teenagers want to get pregnant and have a child. Research indicates, however, that the great majority of poor teenagers use contraceptives to prevent pregnancy, and that most births to poor adolescents are unintended. It also suggests that most women, including teenagers, would prefer to give birth within marriage. The reality is, however, that marriage is not a realistic or even desirable option for most poor adolescent women.

This Issues in Brief examines teenage sexual and reproductive behavior, with special attention to key behavior differences among adolescents of varying income levels. It explores the extent to which teenage mothers depend on welfare and whether welfare recipients who gave birth as teenagers differ significantly on certain socioeconomic indicators from those who were not teenage mothers. It also considers whether current proposals to reduce teenage pregnancies and out-of-wedlock births among young women on or at risk of welfare are likely to achieve their stated goals.

Teenagers and Sex

Initiation of sexual intercourse during the teenage years has become the norm in the United States. While intercourse among very young teenagers is still relatively rare (and many of the youngest teenagers who have had sex report that they were forced to do so), more than 8 in 10 adolescents have had intercourse by the time they turn 20. Because marriage in the teenage years is now so uncommon, most adolescent sexual activity occurs outside marriage.

As sex has become more common at younger ages, historic differences in sexual activity among teenagers of different races, income levels and religions have narrowed considerably. For example, while 60% of poor women aged 15-19 are sexually experienced, so are 53% of low-income adolescents and 50% of higher income teenagers.

[Poor refers to those whose family income is at or below the federal poverty level; low-income, to those with incomes between 100% and 199% of the poverty level; and higher income, to those with incomes of 200% of poverty and above. In 1994, the poverty level was $7,360 for a single person and $12,320 for a family of three.]

Contraceptive Use and Pregnancy. Most teenagers can and do use contraception to avoid sexually transmitted diseases (STDs) and unintended pregnancies-even the first time they have intercourse. Nearly 60% of poor and low-income teenage women and about three-quarters of higher income adolescent women use some method of contraception-usually the condom-the first time they have sex. Even higher proportions use a method on an ongoing basis: 78% of poor teenage women, 71% of low-income teenagers and 83% of higher income adolescent women.

Although their contraceptive use is by no means perfect, teenagers use contraceptives as effectively as young, unmarried adults. Adolescent women, in fact, are less likely to experience a contraceptive failure than unmarried method users in their early 20s. At all ages, however, higher income women use contraceptives more successfully than lower income women. Poor and low-income teenagers, for example, are twice as likely as higher income adolescents to have an unplanned pregnancy while using the pill or the condom.

Because poor and low-income teenagers are somewhat more likely than higher income adolescents to be sexually active and somewhat less likely to use contraceptives or to use them successfully, pregnancy is much more common among lower income teenagers. Poor and low-income adolescents, for example, account for 73% of women aged 15-19 who get pregnant, even though they make up only 38% of all women in that age group.

[Overall, one million U.S. teenagers become pregnant every year-85% of them unintentionally and two-thirds of them 18-19-year-old women. Yet, despite a significant increase in levels of sexual activity in the last two decades, the rate of unintended pregnancy among sexually active teenagers has declined 19%-an encouraging indication that teenagers use contraceptives more effectively than in the past.]

Teenagers who become pregnant rarely place a child for adoption; instead, they have an abortion or give birth and raise the child themselves. About half of pregnancies to adolescent women end in birth, slightly over a third in abortion and the rest in miscarriage. Since the late 1980s, the proportion of teenage pregnancies ending in birth rather than abortion has risen. The increase may reflect, in part, the greater acceptance of out-of-wedlock births as well as the federal government's policy of extending Medicaid coverage to prenatal care and delivery services but not abortion.

Adolescent Childbearing. While sexual activity among teenagers of all income levels is now common, having a baby is not. Adolescent childbearing is heavily concentrated among poor and low-income teenagers, most of whom are unmarried.

Almost three-quarters (70%) of higher income teenagers who become pregnant have abortions; they choose to postpone childbearing so they can complete their education, get a good job, establish their financial independence and get married before they start a family. Poor and low-income teenagers, whose prospects for a good education, a decent job and marriage are dim or nonexistent, often have little incentive to delay childbearing. As a consequence, disadvantaged young women often continue unplanned pregnancies to term and raise the children themselves; still, 39% of poor teenagers and 54% of low-income adolescents terminate unplanned pregnancies.

As a result of differences in pregnancy and abortion rates, poor and low-income teenagers account for 83% of adolescents who have a baby and become a parent and 85% of those who become an unwed parent. By contrast, higher income teenagers, who make up 62% of all women aged 15-19, represent only 17% of those who give birth.

Many teenagers who become mothers would have been poor later in life even if they had not had a baby. Nevertheless, having a baby often compounds the disadvantaged circumstances in which young mothers live, causing them to fall further behind their better-off peers in terms of income, education and the likelihood of a stable marriage. Thus, early childbearing has a profound impact on the lives of these young mothers and their children.

Teenage Mothers and Welfare

AFDC, or Aid to Families with Dependent Children, is the nation's principal welfare program. It provides cash assistance for needy families. Between 1970-1993, the number of families on AFDC increased 163%, from 2 million to about 5 million, while benefit expenditures rose only 44%, from $15.5 billion to $22.3 billion, when inflation is accounted for. During that period, the average monthly AFDC benefit per family declined 45%, from $676 to $373, when inflation is taken into account.

In 1993, 3.8 million mothers aged 15-44 were AFDC recipients. Fifty-five percent of these women became mothers when they were teenagers. However, only 191,000, or 5%, were current teenage mothers, and most of these-159,000-were aged 18-19; young teenagers, those aged 15-17, accounted for just 32,000 of all mothers on AFDC. The remaining 50% were women aged 20-44 who had their first child as a teenager: 26% of these women were under age 18 when they first gave birth, and 24% were age 18-19 when their first child was born.*

* Other data sources produce similar, but somewhat different proportions of current and former teenage mothers than these data from the 1993 Survey of Income and Program Participation. Based on the AFDC's National Integrated Quality Control System, Kristin Moore at Child Trends, Inc. has estimated that 8% of all women on welfare in 1992 were teenage mothers and another 44% were older women who had their first child as a teenager. The General Accounting Office, relying on data from the 1992 Current Population Survey, calculated that 42% of all single women on AFDC were current or former teenage mothers: 5.3% were current teenage mothers and 36.3% were older women who were teenagers when their first child was born.

Never-Married Recipients. Since the mid-1970s, the proportion of women on AFDC who have never been married more than doubled, increasing from one-fifth to one-half. Those who had a baby as a teenager are more likely than other recipients never to have married; almost two-thirds in 1992 had never been married, compared with 45% who were not current or former teenage mothers.

Even so, never-married women receiving AFDC are less likely to be current or former teenage mothers than they were in the mid-1970s. Furthermore, the growth in never-married women who are mothers has been more pronounced among women who are not welfare recipients: Between 1976-1992, the proportion of all unmarried mothers who had never been married tripled, increasing from 12% to 36%.

Longterm Dependency. Nonetheless, unmarried women who begin child-bearing in their teenage years very often end up on welfare. According to data collected between the late 1970s and mid-1980s, for example, three-quarters of unmarried adolescent mothers began receiving welfare within five years of the birth of their first child. Marriage is no guarantee against welfare, however: 25% of teenage mothers who were married when they gave birth also went on welfare within five years.

Women who gave birth as teenagers are among the poorest AFDC recipients: 53% of current and former teenage mothers on AFDC in 1992 had incomes below 50% of the poverty line, compared with 41% of women who did not give birth as teenagers. In part, their poverty reflects the fact that current and former teenage mothers are less likely than others to receive any financial support from their child's father because they were never married. In addition, although current and former teenage mothers on AFDC are as likely to work as women who did not have a baby as a teenager (about 35% of each group), they earn less-an average of $1,600 less in 1992. Their lower earnings, in turn, result from a lack of education; in 1992, 47% of current and former teenage mothers on AFDC had graduated from high school, compared with 62% of those who were older when they gave birth.

Women on AFDC who began childbearing as teenagers are more likely to have large families than women who waited until they were at least age 20 to have a baby. Eighteen percent of women who had their first child as a teenager have four or more children-twice the proportion among women who did not give birth as a teenager. It is important to note, however, that the majority of AFDC families, including those headed by a current or former teenage mother, have 1-2 children.

Because they tend to have less education and larger families, teenage mothers often have a harder time working their way off of welfare and becoming self-sufficient. As a consequence, they are disproportionately represented among those recipients who remain on AFDC for long periods of time.

Welfare Reform

Welfare reform is likely to be the top policy issue in 1995. Enactment of legislation at some point during the year is considered likely. During the welfare reform process, these proposals are virtually certain to be given serious consideration:

¥ a denial of AFDC benefits to unmarried teenage mothers under age 18, perhaps with a state option to extend the ban to even older unwed mothers;

¥ a ban on additional benefits for women who have a child while on welfare; and

¥ a revival of the "gag rule" through a prohibition on the use of welfare funds to provide abortion information and counseling as well as services.

Missing Elements. The ability to make decisions about whether and when to have a child is an essential prerequisite to taking charge of one's life. Yet, largely missing from the public debate on welfare reform is an acknowledgment of this fact and of the importance of ensuring that poor teenagers and adult women on or at risk of welfare have easy access to comprehensive family planning and abortion services that would enable them to avoid unintended pregnancies and unwanted births.

No one would argue that family planning and abortion services, by themselves, are the key to reforming welfare. Nevertheless, their provision on a purely voluntary basis is a simple, cost-effective strategy that would "empower" poor women and, at the same time, have a positive impact on unplanned childbearing.

Family Planning Services. Despite the fact that not all women use contraceptives, or use them effectively, contraception does work, for teenagers as well as adult women. Publicly funded family planning services, for example, prevent an average of 1.2 million unintended pregnancies, including 509,000 unintended births and 516,000 additional abortions, each year. Every dollar spent on publicly subsidized family planning services saves more than $4 that would otherwise be spent to provide medical care, welfare benefits and other social services to women who by law would be eligible for such services if they became pregnant and gave birth. (Over $3 would be saved in medical costs alone.)

Despite the undeniable benefits of subsidized family planning services, Congress has not reauthorized Title X of the Public Health Service Act, which supports the network of family planning clinics that is the primary source of contraceptive services for poor and low-income women, particularly teenagers, since 1985. Moreover, Congress allowed the program's funding for contraceptive services to decline 72% between 1980 and 1992, when inflation is taken into account.

Abortion Services. Meanwhile, public funding of abortion services for Medicaid-eligible women has been severely restricted since the mid-1970s. Studies show that 20-35% of Medicaid-eligible women (most of whom are AFDC recipients) who would have abortions if coverage were available continue their pregnancies to term in the absence of coverage-at a cost of millions of dollars annually to the federal government and the states.

Conclusion

Sexual activity is now common among teenagers in the United States, and there is little difference in levels of sexual activity among adolescents of different income levels. However, poor and low-income teenagers are less likely to use contraceptives when they have intercourse (although a large majority do), and thus are more likely to experience an unplanned pregnancy. When they do get pregnant, teenagers from disadvantaged families are also less likely than their more affluent peers to have an abortion; about 60% of poor teenagers and nearly half of low-income adolescents continue their pregnancy and give birth. All too often, the poorest of these young women have-and perceive that they have-futures that are bleak. They see little reason why having a baby now will make their lives "worse," or, conversely, why waiting until later will make their lives "better."

A major challenge for policymakers is to provide these young women with realistic incentives to wait. That means guaranteeing them-and their partners-access to the education and training that will enable them to get good jobs, which, in turn, will give these young people reason to hope that their lives will improve. It also means assuring that family planning and abortion services are widely available on a voluntary basis to all poor and low-income teenagers who want to delay having a baby.

Efforts to prevent adolescent pregnancies and births must be targeted not just at those already poor or currently living in welfare families, but at all women at risk of poverty and welfare, since research shows that most young women who give birth as a teenager do not immediately go on welfare. Eventually, however, many fall into poverty, and very often, welfare dependency.

The currently proposed disincentives to teenage pregnancies and out-of-wedlock births are misguided in this regard, if for no other reason than because they are targeted largely at the very small proportion of young women who are likely to go on public assistance immediately upon the birth of their baby. Yet, very often there is a lag-sometimes of several years-between the time most teenagers who eventually become welfare-dependent give birth and when they actually begin to receive AFDC benefits. These women, presumably, are not expecting to go on welfare when they have a child and therefore are unlikely to change their behavior as a result of restrictions on welfare eligibility related to childbearing.

Major Sources

The Alan Guttmacher Institute (AGI), The Politics of Blame: Family Planning, Abortion and the Poor, New York, 1995.

AGI, Sex and America's Teenagers, New York, 1994.

General Accounting Office (GAO), "Families on Welfare: Sharp Rise in Never-Married Women Reflects Societal Trend," GAO/HERS-94-92, Washington, D.C., May 1994.

GAO, "Families on Welfare: Teenage Mothers Least Likely to Become Self-Sufficient," GAO/HERS-94-115, Washington, D.C., May 1994.

U.S. House of Representatives, Overview of Entitlement Programs: 1994 Green Book, Washington, D.C., July 15, 1994.

The preparation of this Issues in Brief has been made possible by grants from the Glen Eagles Foundation and The Marion Cohen Memorial Foundation.

For more information about the data presented in this Issues in Brief or about other AGI publications and materials, contact the Washington Office at (202) 296-4012. Multiple copies of this Issues in Brief can be purchased for a small charge.

© 1995 by The Alan Guttmacher Institute.