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January 2007 Most of the decline in U.S. teen pregnancy rates is the result of improved contraceptive use, and a small percentage is attributed to teenagers prolonging the start of sexual activity, according to a report published in the American Journal of Public Health. John Santelli, MD, MPH, department chair and professor of Clinical Population and Family Health at the Mailman School of Public Health, and colleagues believe that these findings indicate that abstinence promotion, in itself, is insufficient to help teens prevent unintended pregnancies. A CDC National Center for Health Statistics report on the latest birth statistics showed that last year, the U.S. teenage birth rate fell to its lowest level in 65 years. A total of 421,123 women younger than age 20 gave birth. Data from Santelli’s report, “Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use,” suggest that the United States seems to be following patterns seen in other developed countries where increased availability and use of modern contraceptives have been primarily responsible for declines in pregnancy. “If most of the progress in reducing teen pregnancy rates is due to improved contraceptive use, national policy needs to catch up with those realities,” he said. The researchers examined the National Survey of Family Growth, a nationally representative household survey that provides comprehensive coverage of female adolescents, to determine the relative contributions of abstinence and contraceptive use to the 14% decline in U.S. teen pregnancy rates between 1995 and 2002. According to the analysis, 86% of the decline was due to more sexually active teens using contraceptives, using more effective methods such as condoms and birth control pills, and using multiple birth control methods in 2002 than in 1995. Delays in sexual activity played a greater role for younger teens aged 15 to 17 (23% of the decline). Among 18- to 19-year-olds, the decline was entirely attributable to improved contraceptive use. This study raises questions about the value of the government’s funding of abstinence-only education programs, Santelli and colleagues concluded. They suggested that U.S. public policies and programs should vigorously promote provision of accurate information on contraception and on sexual behavior and relationships, support increased availability of contraceptive services and supplies for adolescents, and promote the value of responsible and protective behaviors, including condom and contraceptive use and pregnancy planning. For more information: |
