U.S. Teen Pregnancy Rate Continues to Fall

WEDNESDAY, June 20 (HealthDay News) — The teen pregnancy rate in
the United States dipped to its lowest recorded level since 1976, a new
government report shows.

Teen pregnancy rates fell 40 percent from 1990 to 2008, the latest year
for which complete data are available, according to the U.S. National
Center for Health Statistics.

The report, which details pregnancy rates for 2006 to 2008 for U.S.
women aged 15 to 44, also found pregnancy rates were declining among
women in their 20s and increasing among women in their 30s and 40s.

Overall, there was a total of 4,248,000 live births, 1,212,000 induced
abortions and 1,118,000 fetal losses in 2008. The estimated pregnancy rate
for 2008 was 105.5 pregnancies per 1,000 women aged 15 to 44, which is
about 9 percent below the 1990 peak, the new report showed.

The U.S. teen pregnancy rate declined continuously during this time
period, except for a brief upturn from 2005 to 2006. This decline was more
pronounced in younger teens. The pregnancy rate for teens aged 15 to 17
declined by almost one-half from 1990 to 2008, while the rate for older
teenagers declined by about one-third over this time period.

Some racial and ethnic gaps in teen pregnancy rates exist. In 2008,
pregnancy rates for black and Hispanic teenagers aged 15 to 19 were two to
three times higher than the rates for white teenagers.

The overall decline in teen pregnancy seems to be continuing. The
researchers report that more recent birth data for teenagers show that the
birth rate has continued to fall from 2008 through 2010.

So what is driving these trends? “The overall fertility has dropped a
good bit in this country, and pregnancy rates are also going down,
presumably because people are more careful about contraception,” said Dr.
John Santelli, a pediatrician and adolescent medicine specialist who is
the chair of the Heilbrunn Department of Population and Family Health at
Columbia University’s College of Physicians and Surgeons, in New York
City.

“Women are increasingly delaying childbearing into their late 20s, 30s
and sometime even their 40s, which will lower the rates right there,” he
said. The reasons are twofold: Some women are pursuing careers and the
contraceptive use has also improved.

There have been pretty consistent declines in the teen birth rate and
teen pregnancy rates since 1990. “This is good news,” Santelli said.

Media coverage of pregnant teens such as Bristol Palin and the advent
of reality shows focusing on teen moms had left many public health experts
concerned about the glamorization of teen pregnancy and its potential
implications. But these events have had little bearing on the trends so
far, he said.

“Bristol Palin standing up for abstinence is not what is going on
here,” Santelli said. Instead, “this is probably related to better
contraceptive use, including some of these newer methods such as
long-acting reversible contraceptive methods and access to care.”

While 2008 data might already seem outdated in 2012, Santelli explained
that it takes a while for states to accrue the information needed to
analyze these trends. “Birth rates are pretty fast these days, but
abortion reporting can be sluggish, which is why this 2008 data just
became available.”

The decline in teen pregnancy rates overall is impressive, but gaps by
race remain, said Dr. Jill Maura Rabin, an obstetrician/gynecologist at
Long Island Jewish Medical Center-North Shore-LIJ Health System in
Manhasset, N.Y.

“We know that support is what works best for teens — especially when
they are pregnant,” she said. A support network made up of a nurse or
other health care provider and a social worker is the best way to prevent
a second pregnancy among teens. “It may be that certain teens need more
support. We still have a lot of work to do.”

Rabin said that pregnancy and birth rates are declining among women in
their 20s because of access to emergency contraception and more
contraceptive choices including long-acting reversible contraception. “We
have better education about these options,” she said. “Women are
postponing starting a family because of the economy, they want to get
their degrees and life expectancy is increasing.”

These same women may be more likely to consider getting pregnant in
their 30s and 40s due to advances in reproductive endocrinology. “Our
toolbox and skills have increased, and we are helping them get pregnant
into their 40s,” she said. While some older women may have a difficult
time getting pregnant, unplanned pregnancy can, and does, occur in this
age group, she said.

“Women in the 40s think they can’t get pregnant anymore and have
unprotected intercourse, but they can,” Rabin said. “If you are having
intercourse and don’t want to be pregnant, use contraception.”

There are risks associated with pregnancy at older ages, she added.
“Genetic issues increase as eggs age, but we have better testing for
genetic disorders today,” Rabin said. “Older women are also more likely to
develop pregnancy-related complications, but good prenatal care can help
identify these conditions early and monitor women so that they have a
healthy pregnancy.”

More information

Learn about
teen pregnancy, contraception and sexual health
at the Guttmacher
Institute.

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