U.S. Teen Pregnancy Rates Are Down Primarily Because Teens Are Using Contraceptives Better

Eighty-six percent of the recent decline in U.S. teen pregnancy rates is the result of improved contraceptive use, while a small proportion of the decline (14%) can be attributed to teens waiting longer to start having sex, according to "Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use" by John Santelli et al., published in the January issue of the American Journal of Public Health. This study raises serious questions about the value of the federal government’s funding of abstinence-only-until-marriage programs that prohibit information about the benefits of condoms and contraception.

Between 1995 and 2002, U.S. teen pregnancy rates declined by almost one-quarter (24%). The new study, from Columbia University and Guttmacher Institute investigators, examines data from the federal National Survey of Family Growth to determine the relative contributions of abstinence and contraceptive use to this decline. According to the analysis, most of the decline (86%) was due to more sexually active teens using contraceptives, using more effective methods (e.g., condoms and birth control pills) and using multiple methods (e.g., the pill together with condoms) in 2002 than in 1995. When broken down by age, delays in sexual activity played a greater role for younger teens aged 15–17 (23% of the decline). Among 18–19-year-olds, the decline in the risk of teen pregnancy was entirely attributable to improved contraceptive use.

"The United States seems to be following the recent patterns in other developed countries where increased availability and use of modern contraceptives and condoms have led to remarkable declines in teen pregnancy," said lead author John Santelli. "If most of the progress in reducing teen pregnancy rates is due to improved contraceptive use, national policy needs to catch up with those realities."

These study findings cast doubt upon current U.S. government policies that promote abstinence-only-until-marriage as the primary pregnancy prevention message for teens. The authors recommend that public policies and programs should vigorously promote the provision of medically accurate information on condoms and contraception, and support increased availability and accessibility of contraceptive services and supplies for teens, since these activities have the greatest impact on teen pregnancy declines.

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