Improvements in Contraceptive Use Continue to Drive Declines in Pregnancy Among U.S. Adolescents

Findings Come as Trump Administration Undermines Contraceptive Access and Boosts Abstinence-Only Programs

Improvements in contraceptive use were the key driving factor in the decline in pregnancy risk among adolescent women in the United States between 2007 and 2014, according to an updated analysis by Guttmacher researcher Laura Lindberg and colleagues. Levels of sexual activity among adolescents aged 15–19 did not change during this time period.

"Young people are using contraception, using the most effective methods and using methods more effectively," says lead author Laura Lindberg. "Echoing earlier findings, this new analysis shows that the recent pregnancy declines among adolescents are entirely driven by improved contraceptive use."

The authors used data from the National Survey of Family Growth to estimate U.S. adolescent women’s chances of becoming pregnant in a given year, as well as the relative influence of changes in contraceptive use and recent sexual activity. Between 2007 and 2014, the share of 15–19-year-olds who had used one or more contraceptive methods the last time they had sex increased from 78% to 88%, and use of long-acting reversible contraceptive (LARC) methods—particularly the contraceptive implant—increased from 1% to 7%. During the same period, the share of adolescents who had had sex in the last three months remained unchanged at 31%.

Despite clear evidence that contraceptive use helps young people prevent unintended pregnancies, the Trump administration and social conservatives in Congress continue to attack funding for evidence-based adolescent pregnancy prevention efforts, while also redirecting and increasing funding for harmful abstinence-only-until-marriage programs that are ineffective at achieving their stated goal. Abstinence-only programs not only withhold information about contraception from young people, but often spread misinformation about the effectiveness and safety of contraceptive methods. The administration also continues its ongoing efforts to fundamentally undermine the Title X program, which provides many young people with high-quality, confidential family planning services.

"The Trump administration is actively undermining young people’s ability to make informed decisions about their sexual health, or to act on those decisions," says Jesseca Boyer, Guttmacher policy expert. "Young people need and have the right to access high-quality information and services, including the full range of contraceptive methods."

Along with the overall increase in contraceptive use among young people between 2007 and 2014, there were also changes in the types of contraceptive methods being used. In addition to increases in LARC use, the share of young people who reported using withdrawal increased during this time period, from 15% to 26%, and nearly one in five adolescents (17% in 2014) reported using withdrawal in combination with other methods.

"Increases in contraceptive use, including use of multiple methods at the same time, demonstrates that young people are taking decisive action to determine when and if they get pregnant," says Lindberg. "It is important that they are supported with information and access to contraceptive methods to achieve their reproductive goals."

"Changing Patterns of Contraceptive Use and the Decline in Rates of Pregnancy and Birth Among U.S. Adolescents, 2007–2014," by Laura Lindberg, John Santelli and Sheila Desai, is currently available online and will appear in a forthcoming issue of the Journal of Adolescent Health.