The most recent decline in teen births can be linked almost exclusively to improvements in teens’ contraceptive use, according to data from another CDC survey, the National Survey of Family Growth (NSFG). The NSFG interviewed a nationally representative sample of teens from June 2006 to June 2008, and again from July 2008 to July 2010. While there was no significant change over those years in the overall proportion of females aged 15–19 who were sexually experienced or engaging in sexual activity, there was a dramatic shift in teen contraceptive use.
Analyzing the NSFG data, Guttmacher researchers found an increase in teens’ use of any contraceptive method, in their use of the most effective methods and in their use of dual methods (condoms and hormonal methods simultaneously). Specifically, hormonal contraceptives were used by 37% of sexually active teens in 2006–2008 and by 47% in 2008–2010, while use of highly effective long-acting reversible contraceptive methods such as the IUD increased from 1.4% to 4.4%. Dual method use rose from 16% to 23%.
Anecdotal reports indicate that recent changes in medical recommendations that allow teens and young adults to access hormonal contraceptives without a pelvic exam or Pap test have made it easier for them to start—and continue—using these methods. There has also been a change in the medical community’s thinking around the use of IUDs, which is now seen as a “first-line” option for teens who are sexually active and want to delay childbearing for several years. Additionally, fewer teens reported that they were trying to become pregnant, and the economic recession may have increased teens’ motivation to protect themselves against unwanted childbearing.
In sum, teens are making the decision to be more effective contraceptive users, and their actions appear to be paying off in lower birthrates. However, despite the strong evidence of improved contraceptive use as a driver of these positive trends, attacks on contraception—including attacks on contraceptive coverage under private health plans and publicly subsidized family planning programs—are increasing in the political arena.
Even as the teen birthrate has declined dramatically, state variations and ethnic disparities have persisted. In 2010, 14 states and the District of Columbia had teen birthrates of 40 or more births per 1,000 teens aged 15–19, compared with the national rate of 34.3 per 1,000. Higher teen birthrates persist in the South and Southwest and among Hispanic and non-Hispanic black teens, with some of the regional variation reflecting the population composition by race and ethnicity.
Variations in state policies about sex education may also play a role. Methodologically rigorous studies have not found rigid abstinence-only-until-marriage programs to be effective, either in deterring teens from having sex or positively impacting their behavior when they do become sexually active. In contrast, a substantial number of comprehensive sex education programs were shown by such studies to be effective—in delaying the initiation of sex, reducing the frequency of sex, reducing the number of sexual partners and increasing condom or contraceptive use.
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