Declining Pregnancy Among U.S. Teens Partly Due to Contraceptive Changes
October 1, 2022 4 minutes read
Pregnancies and births in young people, ages 14 to 18 years, have declined dramatically in recent years when compared to decades past, new research shows.1
Researchers studied data from 2007 to 2017 and found that delays in first sexual intercourse contributed the most to the trend of declining births over this decade. But declines in the number of sexual partners and changes in contraceptive use — including use of long-acting reversible contraception (LARC) — also contributed to the trend.
“The goal of our study was to understand the contribution sexual behavior changes have had to these declines,” says Steven Goodreau, PhD, lead study author and a professor in the department of anthropology and adjunct professor in epidemiology at the University of Washington. “Our findings suggest that delays in the average age of first sexual intercourse among adolescents played the most significant role in declines in adolescent pregnancies over the decade, averting an estimated 496,200 pregnancies. Decline in the number of sexual partners among adolescents also had a considerable impact, preventing an estimated 78,500 pregnancies.” The use of LARC played a large role in the later years of the decade studied, preventing 40,700 pregnancies, he adds.
Goodreau and colleagues also tried to quantify the financial implications of the adolescents’ behavior changes. They found that preventing unintended pregnancies resulted in significant cost savings:
- Avoided pregnancies due to delays in first sexual intercourse saved $9.71 billion;
- Avoided pregnancies due to reduction in sexual partners saved $1.54 billion;
- Avoided pregnancies due to improved contraceptive saved $796 million.
“Our study only looks at data from 2007 to 2017, so the results only shed light on trends for that decade and are not forward-looking,” Goodreau notes. “Right now, we are not working on any studies that dig into these trends or behavior changes after 2017. However, we do know from the CDC’s National Vital Statistics System that birth rates for adolescents have continued to drop.”
Goodreau and colleagues did not explore why youth are delaying first intercourse, but they have some theories — based on books and articles published in recent years — about why this is occurring.
“Although we can’t say for sure how much of it is due to each cause, some of the main ideas are the rise in comprehensive sex education, the greater availability of information about sexual health on the internet, and the increase in the number of young people identifying as LGBT,” Goodreau says. “Our work does not speak specifically to the role of sex education in reducing adolescent pregnancy. We aimed to categorize the impact of specific sexual behaviors on trends in adolescent pregnancy but did not attempt to identify the driving forces behind those changes.”
Parenting style changes also might contribute. “There was a theory for a while about helicopter parenting and this generation being slower to adopt a number of different rites of passage,” Goodreau adds. “They are later in getting their driver’s license and first car and a lot of other activities.” There is some evidence for all those possible causes of delay in first intercourse, he notes.
With the new post-Roe political landscape of states adopting strict abortion bans — some that may affect certain contraceptive methods — the decline in adolescent pregnancies and births could slow or reverse.
“I think everyone in this area of research right now is concerned about seeing a reversal of some of these trends,” Goodreau says. “We need to study those trends to try to understand them as close to real time as we can.”
Another factor that may have affected youth pregnancy and birth trends involves sex education. “Numerous studies demonstrate that comprehensive sex education leads to a reduction in adolescent pregnancies, as we note in our paper,” Goodreau explains. “But there is a lot of debate among scholars about what exactly is driving the massive changes in behavior that we have seen for teens over this decade.”
Reproductive health providers could be on committees and boards that inform policies about sexual education for adolescents. “The findings from this work are focused on population-level behavior changes, offering insight into behavior changes among this population,” Goodreau says. “The research offers insight into behavior changes among this generation of adolescents and how those changes contributed to the decline in teen pregnancy rates. These results don’t dig into the role of clinicians or what can be done at the individual level.”
Researchers studied the overall trends of pregnancies and births but did not explore the different outcomes, such as miscarriages and elective abortions.
“It is important to note that this reduction in the number of unintended pregnancies results from population-wide behavior changes among this generation, regardless of what drove these changes,” Goodreau says. “I think we should also note what an achievement this is. This is a generation of adolescents that on the whole, and for varying reasons, made positive behavior changes, resulting in safer sex, fewer adolescent pregnancies, and significant societal and financial savings.”
REFERENCE
- Goodreau SM, Pollock ED, Wang LY, et al. Declines in pregnancies among US adolescents from 2007 to 2017: Behavioral contributors to the trend. J Pediatr Adolesc Gynecol 2022 Jul 10;S1083-3188(22)00254-6.
Pregnancies and births in young people, ages 14 to 18 years, have declined dramatically in recent years when compared to decades past, new research shows. Researchers studied data from 2007 to 2017 and found that delays in first sexual intercourse contributed the most to the trend of declining births over this decade. But declines in the number of sexual partners and changes in contraceptive use — including use of long-acting reversible contraception — also contributed to the trend.
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