Teen births decline, but more work left to be done
Executive Summary
While progress has been made in reducing teen pregnancy rates, many adolescents still are having babies, according to new data from the Centers for Disease Control and Prevention. While births to younger teens ages 15-17 have declined, they still represent over one-quarter of births to teens ages 15-19, which is nearly 1,700 births a week.
• The birth rate to younger adolescents is higher for Hispanic, non-Hispanic black, and American Indian/Alaska Native teens, the new data show.
• In 2012, the birth rate per 1,000 adolescents ages 15-17 was 25.5 for Hispanic teens, 21.9 for non-Hispanic black adolescents, 17 for American Indian/Alaska Native teens, 8.4 for non-Hispanic white adolescents and 4.1 for Asian/Pacific Islander teens.
Although births to younger teens ages 15-17 have declined, they still represent more than a quarter of births to teens ages 15-19, which is nearly 1,700 births a week, according to new data from the Centers for Disease Control and Prevention (CDC).1
While progress has been made in reducing teen pregnancy rates, far too many adolescents still are having babies, said Tom Frieden, MD, MPH, CDC Director, in a statement accompanying the publication of the data.
"Births to younger teens pose the greatest risk of poor medical, social, and economic outcomes," noted Frieden. "Efforts to prevent teen childbearing need to focus on evidence-based approaches to delaying sexual activity and increasing use of the most effective methods of contraception for those teens who are sexually active."
Important points from data
To perform the current analysis, CDC researchers looked at birth data from the National Vital Statistics System, drawn from vital registration systems throughout the United States, and adolescent health behavior data gathered from the National Survey of Family Growth, a national compilation of information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and men’s and women’s health. The analysis yielded several points of interest, including:
• The rate of births per 1,000 teens ages 15-17 declined 63%, from 38.6 in 1991 to 14.1 in 2012.
• The birth rate to younger adolescents is higher for Hispanic, non-Hispanic black, and American Indian/Alaska Native teens. In 2012, the birth rate per 1,000 adolescents ages 15-17 was 25.5 for Hispanic teens, 21.9 for non-Hispanic black adolescents, 17 for American Indian/Alaska Native teens, 8.4 for non-Hispanic white adolescents, and 4.1 for Asian/Pacific Islander teens.
• Most teens (73%) ages 15-17 had not had sex yet.
• Nearly one in four adolescents in this age group never spoke with their parents or guardians about sex.1
Talk about LARC methods
According to the new findings, among those teens who were sexually active, while more than 90% used some form of contraception the last time they had sex, most of them relied on methods that are among the least effective. Just 1% used long-acting reversible contraceptive (LARC) methods; the most common methods used were condoms and birth control pills.1
The U.S. Selected Practice Recommendations for Contraceptive Use and an American College of Obstetricians and Gynecologists (ACOG) committee opinion state that LARC methods such as intrauterine contraception and the contraceptive implant are safe, effective, and appropriate options for adolescents.2,3 (To read more on the guidance, see the Contraceptive Technology Update articles, "What does the US SPR mean for adolescents?" September 2013, p. 99, and "Long-acting methods safe for teens: Include options in your counseling," December 2012, p. 133.)
With the current analysis indicating that more than half (58%) of sexually active younger teens made a reproductive health visit for birth control services in the past year, such visits give clinicians the opportunity to discuss advantages and disadvantages of different contraceptive methods and the importance of condom use during every sexual encounter, CDC officials note.
Take steps with teens
What are some steps that providers can take to help prevent younger teens from becoming pregnant? Shanna Cox, MSPH, a health scientist in the CDC’s Division of Reproductive Health, says that providers can work to provide a teen-friendly setting that offers convenient, confidential, respectful, and culturally appropriate services to meet the needs of teen clients. (To obtain resources for creating a teen-friendly clinic, visit the healthcare providers’ section of the CDC’s Teen Pregnancy website, http://1.usa.gov/1mHi8bC. Also see the CTU article, "How to get into heads of teens in initial visit," January 2014, p. 8.)
Discuss normal physical, emotional, and sexual development with teens and parents, says Cox, who served as lead author of the current analysis. Encourage teens to delay sexual activity. If teens are sexually active, offer them a broad range of contraceptive methods, and encourage them to use the most effective methods, notes Cox.
Visit the CDC’s web page on contraceptive guidance for healthcare providers (http://1.usa.gov/1nlOKvj) to access links to the "U.S. Medical Eligibility Criteria for Contraceptive Use, 2010" and the "U.S. Selected Practice Recommendations for Contraceptive Use, 2013."
"Talk about using condoms correctly every time during sex to prevent sexually transmitted diseases, including HIV/AIDS, even if another birth control method is used," says Cox.
- Cox S, Pazol K, Warner L, et al. Vital signs: Births to teens aged 15-17 years — United States, 1991-2012. MMWR 2014; 63(14):312-318.
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. U.S. Selected Practice Recommendations for Contraceptive Use, 2013: Adapted from the World Health Organization Selected Practice Recommendations for Contraceptive Use, second edition. MMWR Recomm Rep 2013; 62(RR-05):1-60.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 539. Adolescents and long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol 2012; 120(4):983-988.
