1. Teen Pregnancy William P. Adelman M.D., FAAP
Assistant Professor of Pediatrics
Uniformed Services University of the Health Sciences
National Campaign to Prevent Teen Pregnancy

2. Teen Pregnancy Why do we care? U.S. Data and current trends
Should we care in the military?
What military data is available?
What works and where is the evidence?
Office Based Approach
We know lots about sex, what about sexuality?
Adult and teen perceptions

3. Four in Ten Girls Get Pregnant at Least Once Before Age 20.
Source: National Campaign to Prevent Teen Pregnancy analysis of Henshaw, S.K., U.S.. Teenage Pregnancy Statistics, New York: Alan Guttmacher Institute, May, 1996; and Forrest, J.D., Proportion of U.S. Women Ever Pregnant Before Age 20, New York: Alan Guttmacher Institute, 1986, unpublished.

4. 100 Teen Girls Get Pregnant Each Hour
Total: 905,000
542,640
337,530
24,830
The Alan Guttmacher Institute. (1999). Special report: U.S. teenage pregnancy statistics with comparative statistics for women aged New York: Author.

5. We’re Number One
The United States has much higher pregnancy and birth rates than other fully industrialized countries. US pregnancy rates are nearly twice as high as rates in Canada and England and seven to eight times as high as rates in Japan and the Netherlands.
Singh, S., & Darroch, J.E. (2000). Adolescent pregnancy and childbearing: Levels and trends in developed countries. Family Planning Perspectives 32(1), Pregnancy rates calculated as the sum of births, abortions, and estimated miscarriages (20 percent of births plus 10 percent of miscarriages).

6. Each Year, Half a Million Teens Give Birth
In 1996, just over one-half of teen pregnancies to girls aged ended in birth, about one-third ended in abortion, and 14 percent ended in miscarriage.
124,700
491,577
263,890
The Alan Guttmacher Institute. (1999). Special report: U.S. teenage pregnancy statistics with comparative statistics for women aged New York: Author.

7. 55 Teen Girls Give Birth Each Hour
Nearly one-half million teen births occurred in 1999.
Total: 484,794
312,186
9,049
163,559
* Data for 1999 are preliminary. Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14).

8. Proportion of Teen Births to Unmarried Teens, 1999
Proportion of Teen Births to Unmarried Teens, 1999* (Births to Teens Aged 15-19)
101,814
373,931
* Data for 1999 are preliminary. Ventura, S.J., & Bachrach, C.A. (2000). Nonmarital childbearing in the United States, National Vital Statistics Reports 48(16). Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14).

9. The Consequences of Teen Motherhood
Less likely to complete high school
Dependence on welfare
Single parenthood
More likely to have more children sooner on a limited income
More likely to abuse or neglect the child
National Campaign to Prevent Teen Pregnancy. (1997). Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States. Washington, DC: Author.

10. Teen Mothers and High School Diploma by Age 30
68%
32%
National Campaign to Prevent Teen Pregnancy. (1997). Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States. Washington, DC: Author.

11. Risks to Children of Teen Mothers
Growing up without a father
Low birth weight and prematurity
School failure
Mental retardation
Insufficient health care
Abuse and neglect
Poverty and welfare dependence
Females more likely to be teen moms themselves
Males more likely to be incarcerated
Source: Maynard, R.A., (ed.), Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing, New York: Robin Hood Foundation, 1996.

12. The Children of Teen Mothers Are at Greater Risk of Abuse and Neglect
110 51 29 18
National Campaign to Prevent Teen Pregnancy. (1997). Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States. Washington, DC: Author.

13. Taxpayers Spent $6.9 Billion ($2,831 Per Teen Parent) on Teen Childbearing in 1996
$1.0
$1.4
$2.7
$1.7
$0.1
National Campaign to Prevent Teen Pregnancy. (1997). Whatever Happened to Childhood? The Problem of Teen Pregnancy in the United States. Washington, DC: Author.

14. Teen Pregnancy Rates, Girls Aged 15-19 (Pregnancies Per 1,000 Girls)
The Alan Guttmacher Institute. (1999). Special report: U.S. teenage pregnancy statistics with comparative statistics for women aged New York: Author.

15. Teen Pregnancy Rates, Racial/Ethnic Subgroups (Number of Pregnancies Per 1,000 Girls Aged 15-19)
Non-Hispanic Black
Hispanic
(any race)
Non-Hispanic White
Darroch, J.E., & Singh, S. (1999). Why is teenage pregnancy declining? The roles of abstinence, sexual activity and contraceptive use. Occasional Report 1. New York: The Alan Guttmacher Institute.

16. Teen Birth Rates, Girls Aged 15-19 (number of births per 1,000 girls)
The teen birth rate declined steadily from 1960 through the mid-1970s, stayed fairly constant for the next decade, then increased 24 percent between 1986 and Between 1991 and 1999, the teen birth rate decreased 20 percent to a record low.
Note: data for 1999 are preliminary. Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14). Ventura, S.J., Mathews, T.J., & Curtin, S.C. (1998). Declines in teenage birth rates, : National and state patterns. National Vital Statistics Reports 47(12).

17. Teen Birth Rates by Race/ethnicity, Girls 15-19 (number of births per 1,000 girls)
Teen birth rates vary substantially among the largest racial/ethnic subgroups. Between 1991 and 1999, the rate for African-American teens declined 30 percent, the rate for all White teens declined 16 percent and the rate for non-Hispanic White teens declined 21 percent, the rate for Hispanics decreased 13 percent, the rate for Native Americans declined 20 percent, and the rate for Asian/Pacific Islanders declined 17 percent.
Hispanic (any race)
African American
Native American
TOTAL
White (total)
Non-Hispanic White
Asian/Pacific Islander
Note: data for 1999 are preliminary. Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14). Ventura, S.J., Martin, J.A., Curtin, S.C., Mathews, T.J., & Park, M.M. (2000). Birth: Final data for National Vital Statistics Reports 48(3).

18. Number of Teen Births, 1999*
* Data for 1999 are preliminary. Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14).

19. State Teen Birth Rates, 1998 (births per 1,000 girls aged 15-19)
Teen birth rates vary widely by state, ranging from 24.4 per 1,000 in Vermont to 73.0 per 1,000 in Mississippi.
per 1,000
per 1,000
per 1,000
per 1,000
per 1,000
Ventura, S.J., Curtin, S.C., & Mathews, T.J. (2000). Variations in teenage birth rates, : National and state trends. National Vital Statistics Reports 48(6).

20. Changes in Teen Birth Rates, 1991-98 (births per 1,000 girls aged 15-19)
Teen birth rates declined in all 50 state between 1991 and 1998; declines ranged from 9.7 percent in Rhode Island to 37.8 percent in Vermont.
% decline
% decline
% decline
% decline
% decline
Ventura, S.J., Curtin, S.C., & Mathews, T.J. (2000). Variations in teenage birth rates, : National and state trends. National Vital Statistics Reports 48(6).

21. Teen Births by Birth Order, 1999* (births to girls aged 15-19)
Total: 475,745
(85,455)
(14,643)
(370,749)
(2,148)
(2,750)
* Data for 1999 are preliminary. Curtin, S.C., & Martin, J.A. (2000). Births: Preliminary data for National Vital Statistics Reports 48(14).

22. Teen Pregnancy in the Military
Yes
Little data available for general consumption
Small projects within the military
Mostly anonymous to location
No intervention studies

23. Large Army Community Hospital
40,000 troops
38,000 dependents age 0-18
55,000+ retirees

24. Dependent of Dependent Deliveries July 2000-June 2001
134 of total 2911deliveries
4.6 % of ALL deliveries (1 in every 21)
46/1000 live births are dependents of dependents
Teen birth rate 48-67/ year olds (very conservative estimate)
Military teen birth rate same or higher than civilian rate

25. What Works to Prevent Teen Pregnancy?
“No Simple Answer”
State programs with data:
Promoting Abstinence
Providing comprehensive sexuality education
Advocating youth development
Increasing access to health service
Public awareness
Male responsibility and involvement
Economic stimulus

26. Sexual Intercourse in Teen Girls
25% Age 15
40% Age 16
55% Age 17
70% Age 18
The average sexually active teenager has had 4 partners by age 18

27. Why DO Girls have Intercourse?
Girls use sex to find love; Boys use love to get sex (All men are pigs)
3of 4 girls and over ½ of boys report that girls who have sex do so because their boyfriends want them to have sex.
8 of 10 girls wish they had waited until they were older to have sex

28. Why Do Girls NOT have intercourse?
#1 “Against my religious or moral values”
#2 “To avoid pregnancy”
#3 “Fear of contracting a sexual infection”
#4 “Have not met the right partner”

29. What Protects Against Teen Sexual Debut and Teen Pregnancy?
Two parent families (22% vs 44% of 16 yr olds are sexually active)
Strong emotional attachment to parents
School connectedness
Lack of free time
Access to contraception

30. A sexually active teen who does not use contraception has a 90 percent chance of pregnancy within one year

31. The Paradox of Teen Sex
Half of all teenage pregnancies occur within 6 months of the onset of sexual activity
Most Teenagers look to the physician for protection against pregnancy
Average time from onset of sexual activity to presentation to the physician for contraception is months

32. Office Techniques to Reduce Teen Pregnancy
Normalize history to include sexuality by the 6th grade—Teaches OK to discuss with the doctor before onset of activity
Promote Abstinence—congratulate smart decisions
Offer a safe environment for comprehensive discussion of sexuality and contraception BEFORE onset of sexual activity

33. Office Techniques to Reduce Teen Pregnancy
Promote communication about sexuality issues between parent and child
All Men Are Pigs (optional)

34. What Do Teens and Parents Think?
Some survey results
The majority of slides in this presentation are from the National Campaign publication, With One Voice: America’s Adults and Teens Sound Off About Teen Pregnancy. The publication has results from a nationally-representative survey of over 1,000 adults over age 20 and 1,000 young people aged conducted in January and February The other results are from various nationally polling of young people aged conducted in For complete results, please visit the National Campaign’s website —

35. “How important do you think it is for teens to be given a strong message from society that they should abstain from sex until they are at least out of high school?”
Adults
Teens
93.3%
6.6%
94.5%
4.7%
Important
Not important

36. Question for adults:
Please react to the following statement:
“Kids in your community are getting a clear message from the adults in their lives that teen pregnancy is wrong.” Would you say you agree strongly, agree somewhat, disagree somewhat, or disagree strongly with that statement?

37. Disagree net Agree net Adults Agree net 63.0% Agree strongly 36.0%
32.8%
63.0%
Agree net
Adults
Agree net
Agree strongly
Agree somewhat
Disagree net
Disagree somewhat
Disagree strongly
63.0%
36.0%
27.0%
32.8%
18.6%
14.2%

38. Question for teens:
Please react to the following statement:
“I’m getting a clear message from the adults in my life that teen pregnancy is wrong.” Would you say you agree strongly, agree somewhat, disagree somewhat, or disagree strongly with this statement?

39. Disagree net Agree net Teens Agree net 85.1% Agree strongly 57.2%
14.6%
85.1%
Agree net
Teens
Agree net
Agree strongly
Agree somewhat
Disagree net
Disagree somewhat
Disagree strongly
85.1%
57.2%
27.9%
14.6%
10.7%
3.9%

40. “Which of the following comes closest to your view?”
Adults
Teens
Teens should not be sexually active, but teens who are should have access to birth control (or “protection.”) Teens should not be sexually active and should not have access to birth control (or “protection”) It’s okay for teens to be sexually active, as long as they have access to birth control (or “protection.”)
73.0%
15.0%
11.6%
56.3%
18.4%
25.0%

41. Suppose a parent or other adult tells a teenager the following:
“I feel very strongly that not having sex at all during your middle and high school years is your best option and the right thing to do. I also think it is important for you to receive information about birth control or protection. But, again, I think not having sex is your best option.”

42. “Do you think this is a clear and specific message or do you think this is a confusing or mixed message?”
Confusing or mixed message
24.3%
28.3%
74.7%
70.6%
Clear and specific message
Clear and specific message
Adults
Teens

43. “When it comes to teens’/your sexual decision-making, which of the following is most influential? Would you say…”
Adults
Teens
Parents
Friends
The media
Teachers and sex educators
Brothers and sisters
Religious organizations
38.3%
31.7%
3.6%
6.8%
7.4%
9.1%
31.7%
50.0%
7.5%
3.5%
3.0%
2.9%

44. “Other than teens themselves, who do you think is most responsible for fixing the problem of teen pregnancy? Would you say…”
Adults
Teens
Parents and adults
The media
Schools
The government
Religious organizations
85.0%
6.8%
3.7%
1.8%
1.2%
63.3%
14.5%
13.5%
5.4%
2.1%

45. “Have you had a helpful conversation with your parents about sex?”
More than one-third of teens say they have not had even a single helpful conversation with their parents about sex.