Teenage Pregnancy Prevention: Statistics and Programs







Prepared for Members and Committees of Congress



In 2006, teen births accounted for 10.4% of all births and 22.7% of all nonmarital births. The
birth rate for U.S. teenagers increased in 2006 after a steady decline since 1991. This report
briefly examines some of the data collected by the National Center for Health Statistics on
teenage childbearing, offers potential reasons for high teen pregnancy and birth rates, and
provides synopses of select federal programs to prevent teen pregnancy and reduce teen births.
This report will be updated as legislative and statistical information warrant.






Introduc tion ..................................................................................................................................... 1
Teenage Births in the United States.................................................................................................1
National Trends.........................................................................................................................1
State Data/Trends......................................................................................................................2
Some Demographic Features and Trends..................................................................................2
Age of Fathers...........................................................................................................................3
Financial and Social Costs of Teen Births.................................................................................3
Reasons for High Pregnancy and Birth Rates Among Teens..........................................................4
Decline in Pregnancy/Birth Rates.............................................................................................4
Federal Programs and Strategies to Reduce Teen Pregnancy.........................................................5
Reproductive Health and Family Planning Services: Title X of the Public Health
Services Act...........................................................................................................................5
The Adolescent Family Life (AFL) Program: Title XX of the Public Health Services
Act .......................................................................................................................................... 5
Maternal and Child Health (MCH) Block Grant: Title V of the Social Security Act...............5
Medicaid: Title XIX of the Social Security Act........................................................................6
Social Services Block Grant: Title XX of the Social Security Act...........................................6
Temporary Assistance for Needy Families (TANF): Title IV-A of the Social Security
Act .......................................................................................................................................... 6
Abstinence Education Grants....................................................................................................6
The National Strategy to Prevent Out-of-Wedlock Teen Pregnancies......................................7
Figure 1. Teen Birth Rates (Aged 15-19), 1950-2006.....................................................................3
Author Contact Information............................................................................................................7






In 2002, an estimated 747,000 U.S. teenagers became pregnant, approximately 107,000 had
miscarriages, and 215,000 had legal abortions (latest available data). The result was that there 1
were 425,000 births to teenagers in 2002. In 2006, 10.4% of all U.S. births were to teens, and
22.7% of all nonmarital births were to teens. In recognition of the negative, long-term
consequences associated with teenage pregnancy and births, the prevention of teenage and out-of-
wedlock childbearing is a major goal of this nation. Although the birth rate for U.S. teens has
dropped in fourteen of the last fifteen years, it remains higher than the teenage birth rate of most
industrialized nations.

In 1950, the number of births to U.S. females under age 20 was 438,000; by 1960 births to teens
had increased nearly 36% to 593,746; and by 1970 they had increased another 11% to 656,460.
Since then, the number of births to teens has generally declined, with some upward fluctuations.
Births to teenagers declined 33% from 1970 to 2006; 21% from 1980 to 2006; 17% from 1990 to

2006, and 7% from 2000 to 2006. In 2006, the number of births to teens was 441,832 (of which 2


6,396 births were to girls under age 15).


The peak birth rate for U.S. teenagers occurred in 1957, with 96.3 births per 1,000 women aged
15-19. The 2006 teenage birth rate of 41.9 per 1,000 women aged 15-19 is 3.5% higher than the
2005 teenage birth rate (17% below the 1986 low of 50.2 births per 1,000 female teens). Teenage
birth rates increased during the late 1940s (i.e, the “baby boom” years after World War II) and
1950s, decreased during the 1960s and early 1970s, remained relatively stable between 1975 and
1988, increased sharply during the late 1980s, declined every year from 1991 through 2005, and
then increased in 2006. In 1950, teens (15-19) gave birth at the rate of 81.6 per 1,000 teens,
compared to 61.8 per 1,000 teens in 1991, 40.5 per 1,000 teens in 2005, and 41.9 per 1,000 teens
in 2006. Although the number of births to females under age 20 decreased nearly 17% from 1991
to 2006, the birth rate of teens aged 15 to 19 declined by 32% in the same period. The smaller
decline in the number of births to teens compared with the teen birth rate is due to an increase in
the number of teenage females in the 1990s.
In 2006 (first year of an increase in the teen birth rate after fourteen consecutive years of a
downward trend in the teen birth rate), the birth rate for teenagers aged 15-17 was down 43%
from 1991. For teens aged 18 and 19, the birth rate dropped by 22% from 1991 to 2006. In 2006,
of the 441,832 births to females under age 20, 84% (372,876 births) were to unmarried teenagers.

1 Guttmacher Institute, U.S. Teenage Pregnancy Statistics: National and State Trends and Trends by Race and
Ethnicity, updated September 2006, p. 5.
2Births: Final Data for 2006,” by , Joyce A. Martin , Brady E. Hamilton, Paul D. Sutton, Stephanie J. Ventura, Fay
Menacker, Sharon Kirmeyer, and T.J. Matthews, National Vital Statistics Reports, vol. 57, no. 7. January 7, 2009.
Hereafter referred to asBirths: Final Data.”





With fewer teens entering into marriage, the proportion of births to unmarried teens has increased
dramatically (84% in 2006 versus 29% in 1970).
Teen birth rates vary considerably from state to state. The birth rate of teens (aged 15-19)
increased in 26 states from 2005 to 2006; remained virtually unchanged in 21 states (and 3
jurisdictions); and decreased in 3 states (New York, North Dakota, and Rhode Island) and the
District of Columbia. Nonetheless, during the period 1991-2006, a reduction in the rate of births
among teens aged 15-19 was observed in all 50 states, the District of Columbia, Guam, Puerto
Rico, and the Virgin Islands. In 2006, the lowest reported rate was in New Hampshire, at 18.7
births per 1,000 women (aged 15-19), and the highest reported rate was in Mississippi, at 68.4 3
births per 1,000 women (aged 15-19).
After having declined for all racial and ethnic groups during the period 1991-2005, the teen birth
rate increased for white, black, American Indian, and Hispanic women aged 15 through 19 from 4
2005 to 2006. The greatest increase in the teen birth rate occurred among non-Hispanic black
teens, for whom the rate increased nearly 5%. Birth rates for black and Hispanic teenagers
continue to be much higher than that of other racial/ethnic groups. In 2006, Hispanic teens (15-
19) gave birth at a rate of 83.0 per 1,000 Hispanic teens. Non-Hispanic black teens gave birth at a
rate of 63.7 per 1,000 non-Hispanic black teens. In contrast, non-Hispanic white teens gave birth
at a rate of 26.6 per 1,000 non-Hispanic white teens, American Indian teenagers at a rate of 55.0
per 1,000 American Indian teens, and Asian or Pacific Islanders at the lowest rate, 17.0 per 1,000
Asian/Pacific Islanders teens. Also noteworthy is the decline in subsequent births among teens. In

1951, 28% of all teen births were second or higher-order births, compared to 20% in 2006.



3Births: Final Data.” p. 7.
4 Ibid. p. 6.





Figure 1. Teen Birth Rates (Aged 15-19), 1950-2006
12 09
5- 1 R a te P eak e d in19 57 at 9 6. 3
10 0e d 1
A g
80a l e s
e m
6000 F
1 , 0
40p e r
a t e
20r t h R R a te in 2 0 0 6:41. 9
B i
0
19 50 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
Year
Source: Chart prepared by the Congressional Research Service (CRS), based on data from the National Center
for Health Statistics, Department of Health and Human Services (HHS).
According to one study, about one in five births to unmarried, teenage girls is attributed to men at 5
least five years older than the mother. The information on fathers’ age has fueled legislative
action at the state and local level. Statutory rape laws are viewed by several states as a deterrent to
teen pregnancy and birth—the premise being that older men will avoid sexual relations with an
adolescent if criminal charges are likely to be brought. According to the 2002 National Survey of
Family Growth, among unmarried men aged 25-29, 8% had a female partner in the past 12 6
months who was 7 or more years younger than himself.
An October 2006 study by the National Campaign to Prevent Teen Pregnancy estimated that, in
2004, adolescent childbearing cost U.S. taxpayers about $9 billion per year: in child welfare
benefits, $2.3 billion; in health care expenses, $1.9 billion; in spending on incarceration (for the
sons of women who had children as adolescents), $2.1 billion; in lost tax revenue because of
lower earnings of the mothers, fathers, and children (when they were adults), $6.3 billion; and in
offsetting public assistance savings (younger teens receive less annually over a 15-year period
than those who give birth at age 20-21), $3.6 billion. Research indicates that teens who give birth
are less likely to complete high school and go on to college, thereby reducing their potential for
economic self-sufficiency. The research also indicates that the children of teens are more likely
than children of older parents to experience problems in school and drop out of high school, and

5How Old Are U.S. Fathers? by David J. Landry and Jacqueline D. Forrest, Family Planning Perspectives, vol. 27,
no. 4, 1995.
6 Centers for Disease Control and Prevention. Fertility, Contraception, and Fatherhood: Data on Men and Women from
Cycle 6 (2002) of the National Survey of Family Growth, by Gladys M. Martinez, Anjani Chandra, Joyce C. Abma, Jo
Jones, and William D. Mosher. National Center for Health Statistics, Series 23, No. 26. 2006.





as adults are more likely to repeat the cycle of teenage pregnancy and poverty. The 2006 report
contends that if the teen birth rate had not declined between 1991 and 2004, the annual costs 7
associated with teen childbearing would have been almost $16 billion (instead of $9 billion).


The high volume of pregnancies and birth rates among teenage and never-married women is often 8
attributed to a liberal view of sexual activity. Some analysts also contend that contraceptive
advancements have afforded women a false sense of security, thereby contributing to increased
sexual activity and more pregnancies. The academic and professional communities also maintain 9
that teen parenthood is one of the negative consequences of growing up without a father.
Moreover, policymakers suggest that, prior to reform, “welfare” was seen as a guaranteed source
of income for unmarried teenage mothers with grim marriage and job prospects. The president of
the Alan Guttmacher Institute, commenting on a study about adolescent pregnancy and
childbearing in “developed” countries, stated: “In the United States, poverty and inequity clearly
are behind much of our high rates of pregnancy, birth and abortion. But lack of sensitive,
confidential, low-cost contraceptive services and the denial of accurate and frank information 10
about sex, are equally to blame.”
One reason given for the historical decline (1991-2005) in teen pregnancies and births is that
sexually active female teenagers have significantly increased their use of contraceptives,
particularly condoms. The more effective and consistent use of contraception has been facilitated
by long-lasting injectable (Depo Provera) and implanted (Norplant) devices that are readily
available to female teens. Abstinence campaigns, aimed at younger teens, are also seen as having
a positive effect on pregnancy prevention. Moreover, casual sex, which may increase the risk of
sexually transmitted diseases (STDs) and may prove to be fatal given the presence of HIV/AIDS,
is viewed in an increasingly negative light by many teenagers.

7 The National Campaign to Prevent Teen Pregnancy, By the Numbers: The Public Cost of Teen Childbearing, by Saul
D. Hoffman. October 2006.
8 U.S. Congress, House Ways and Means, Subcommittee on Human Resources, Testimony of Dr. Isabel V. Sawhill on
Nonmarital Births and Child Poverty in the United States, June 29, 1999.
9 General Accounting Office, Teen Pregnancy: State and Federal Efforts to Implement Prevention Programs and
Measure Their Effectiveness, GAO/HEHS-99-4, November 1998.
10 Alan Guttmacher Institute, United States and the Russian Federation Lead the Developed World in Teenage
Pregnancy Rates, News Release, February 24, 2000, p. 2.







In recognition of the negative, long-term consequences of teen pregnancy and births, the
prevention of teenage and nonmarital childbearing is a major goal of this nation. Although the
pregnancy rate, birth rate, and abortion rate for teens have all dropped in recent years, the teen
birth rate is still far above that of most industrialized countries. The U.S. teen birth rate was two
and twelve times, respectively, that of the United Kingdom and Japan. Teen birth rates across
industrialized countries ranged from a low of 4 births per 1,000 teen aged 15-19 in Japan (1997
data) to 56 per 1,000 in Armenia (1995 data). In 1995, the U.S. teen birth rate was 54.4 births per 11

1,000 teens aged 15-19; the comparable figure for 1997 was 52.3 births per 1,000.


The National Family Planning Program, created in 1970 as Title X of the Public Health Services
Act, is administered through the Office of Population Affairs/Office of Public Health and Science,
Department of Health and Human Services (HHS). It provides grants to public and private non-
profit agencies to provide voluntary family planning services for individuals who are otherwise
ineligible for medical services. Family planning programs provide basic reproductive health
services: contraceptive and infertility services, gynecological care, screening for breast and
cervical cancers, STDs, reproductive health counseling/education and referrals.
The AFL Program was created in 1981 to support demonstration projects that provide
comprehensive and innovative health, education, and social services to pregnant and parenting
adolescents, their infants, male partners, and their families. One third of the projects currently
provide abstinence-focused educational services to prevent early, unintended pregnancies,
sexually transmitted diseases and the spread of HIV/AIDS. The AFL program also seeks to
prevent subsequent births among teens.
These funds support a variety of health services for women and children, including adolescent
pregnancy prevention activities. Activities include adolescent pregnancy prevention programs;
state adolescent health coordinators; state prenatal hotlines; family planning; technical assistance

11Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries, by Susheela Singh and
Jacqueline E. Darroch, Family Planning Perspectives [Alan Guttmacher Institute], vol. 3, no. 1, January/February
2000, pp. 14-23.





and other prevention services. Through the block grants, approximately 610 school-based and
school-linked centers are supported.
Medicaid is a jointly funded federal-state health insurance program for certain low-income
people. The federal government pays 90% of state expenditures for Medicaid family planning
services. The enhanced match encourages states to fund family planning programs which provide
patient counseling and education on pregnancy prevention and reproductive health.
The Social Services Block Grant is a flexible source of federal funds that states may use to
support a range of social services, which may include family planning services and pregnancy
prevention and parenting programs.
One of the four goals of the 1996 welfare reform law (P.L. 104-193) is to prevent and reduce out-12
of-wedlock pregnancies. To receive assistance under TANF, unmarried minor parents are
required to live at home or in an adult-supervised setting and to attend school if they lack a high
school diploma. HHS also awarded a bonus of $20 million for each of the years FY1999-FY2006
to up to five states that showed the largest decrease in nonmarital births, while simultaneously
maintaining abortion rates at or lower than FY1995 levels. P.L. 109-171 eliminated this bonus.
Also, pursuant to the 1996 welfare reform law (P.L. 104-193), $250 million in federal funds was
allocated for the abstinence-until-marriage program ($50 million per year for five years, FY1998-
FY2002; funded through June 30, 2008, by various legislative extensions). Funds must be
requested by states when they solicit MCH block grant funds, and must be used exclusively for
the teaching of abstinence (pursuant to P.L. 104-193) and may not be utilized in conjunction with,
or for any other purpose. In 2006, every state except California, Connecticut, Maine, and New
Mexico sponsored an abstinence education program. P.L. 106-246 appropriated an additional $20
million for abstinence education to HHS under the special projects of regional and national
significance (SPRANS) program for FY2001 to bolster the abstinence-only message for
adolescents aged 12 to 18. Various annual appropriations laws have provided funding for the
SPRANS abstinence education program in the amount of $40 million for FY2002, $55 million for
FY2003, $70.5 million for FY2004, $100 million for FY2005, and $109 million for each of the
fiscal years FY2006-FY2008 (the former SPRANS program is now called the Community-Based
Abstinence Education program).

12 Although P.L. 104-193 uses pregnancies as the policy variable, in practice, births have become the indicator because
birth data are more current and reliable than pregnancy data.





In January 1997, HHS announced the National Strategy to Prevent Out-of-Wedlock Teen
Pregnancies in January 1997. The purpose of the National Strategy is to ensure that at least 25%
of communities in the United States have pregnancy prevention programs. (Annual reports were
published for 1997-1999.) An alternative initiative, which is part of the Strategy, encourages
states to create Second Chance Homes with TANF and other funding. These homes are expected
to provide teen parents, who might be at risk of abuse if they stayed at home, with guidance in
parenting, child development, budgeting, health and nutrition; these skills are seen as a way to
prevent repeat pregnancies.
P.L. 104-193 contained some comprehensive child support enforcement measures. Because strict
child support enforcement is thought to deter nonmarital childbearing, the child support
provisions were seen by Congress as another method of attempting to reduce nonmarital
pregnancies. Child support enforcement measures include streamlined efforts to name the father
in every case; employer reporting of new hires (to locate noncustodial parents quicker); uniform
interstate child support laws; computerized statewide collections to expedite payment; and
stringent penalties, such as the revocation of a drivers’ license in cases in which noncustodial
parents owe past-due child support.
Carmen Solomon-Fears
Specialist in Social Policy
csolomonfears@crs.loc.gov, 7-7306