Improvements in contraceptive use have led to a drop in the risk of pregnancy among U.S. adolescents aged 15–19—and these changes also appear to be driving the recent declines in teen pregnancy rates, abortion rates and birthrates. A new analysis titled "Understanding the Decline in Adolescent Fertility in the United States, 2007–2012," by Dr. Laura Lindberg and colleagues, estimated that improved contraceptive use accounted for the entire 28% decline in teen pregnancy risk between 2007 and 2012. The authors found significant increases in teens’ use of any contraceptive method, use of multiple methods and use of highly effective methods, as well as a decline in contraceptive nonuse.

"There was no significant change in adolescent sexual activity during this time period," says lead author Dr. Lindberg. "Rather, our new data suggest that recent declines in teens’ risk of pregnancy—and in their pregnancy rates—are driven by increased contraceptive use."

The authors relied on U.S. government data from the National Survey of Family Growth to estimate a pregnancy risk index (PRI) for 2007, 2009 and 2012. The PRI summarizes the risk of pregnancy among all adolescent women, estimating the influence of both changes in the level of recent sexual activity and changes in the level of contraceptive risk. The study found that if sexual activity was the only factor taken into account, the risk of pregnancy among adolescents would have increased slightly, by 6%. Instead, improvements in contraceptive use improved to such an extent that it not only drove the entire decline in teen pregnancy risk, but it also compensated for the 6% increase in risk due to sexual activity from 2007–2012. Hence, improvements in contraceptive use accounted for 106% of the teen pregnancy risk decline.

Teen pregnancy rates have dropped along with teen pregnancy risk. The U.S. teen pregnancy rate declined 25% from 2007 to 2011 (the most recent year for which data are available), and declines are apparent across all 50 states and all racial and ethnic groups, although disparities remain. The new findings extend previous research analyses of the PRI, which found that improvements in contraceptive use drove the majority of the decline in teen pregnancy rates between 1991 and 2007.  

"Teens’ increased use of contraceptives indicates their increased commitment to protecting themselves from risk," says Guttmacher director of public policy, Heather Boonstra. "Policy discussions should focus on supporting teen contraceptive use generally, including ensuring access to a full range of contraceptive education, counseling and methods."