Dr. Marc J. Yacht: Teen pregnancy rates down – so far

Teen pregnancy rates for girls 15 to 19 years old have fallen in the United States in direct relation to extensive preventive efforts.

Those efforts include discussions about responsible sexual behavior, birth control pills, IUDs, the patch, abstention, vaginal rings, injectable birth control and the extensive network of family planning and women’s health services. Local health departments have played a large role in stemming teen pregnancy.

Although U.S. rates have dropped, we have a national rate of 57 teen pregnancies per 1,000 people. We have the highest rate among the industrialized nations. Switzerland, for example, has eight, France 25, and England and Wales have 47 teen pregnancies per 1,000. We still have a way to go to catch up to the success of other affluent nations. In Florida 59 percent of all 2010 pregnancies were unintended by adult or teen.

Blacks and Hispanics have significantly higher U.S. teen pregnancy rates that whites. Low-income families are more at risk of teen pregnancy than the affluent.  Intact families are at less risk for teen pregnancy than dysfunctional home environments. Abused girls are at far greater risk for pregnancy than girls living in safe environments.

About 47 percent of teens have sex before their 20th birthday. The vast majority (8 in 10) of all adolescent pregnancies are either unplanned or occurred before the teens were ready to become parents. Teens with babies are unlikely to finish high school, more likely to need welfare services, have poorer cognitive and educational outcomes, and are at risk for delinquency and mental health issues.

Teen moms face personal health risks as do the newborn. Younger teens have smaller wombs and fetal development can be compromised. Nine percent of teens have low-birth-weight babies. The young mother has a greater chance of premature labor, and complications during and after delivery. The young mother is more at risk for depression, shame, guilt and stress.

Adult or teen, two-thirds of U.S. child-bearing women are at risk each year for unintended pregnancy. Reasons may relate to improper use of contraceptives or lack of use. Those taking contraceptives are at 5 percent risk for conception.  Ninety-five percent of unwanted pregnancies are experienced by women not using contraception.The public programs funded by federal Title X resources provide millions of poor women with contraception and women’s health services.  Two million unintended pregnancies are prevented annually in the nation.

Absent family planning services would more than double the number of unwanted pregnancies and create astronomical government costs to provide pre-natal care and aftercare for both mother and infant. The welfare system would be further burdened by women unable to work or continue needed education for self sufficiency.

In 1970 President Richard Nixon signed into law federal Title X funding to guarantee every woman access to family planning and contraceptive services.  There are dangerous political conflicts that would undermine family planning, women’s health and contraceptive services.

Title X funding has been besieged by social and religious conservative groups alleging that the availability of family planning, sexual behavior education, and contraception promotes promiscuity and abortion. The result has been the current underfunding of this effort and puts us at risk for increased unintended teenage and adult pregnancy. Costs to provide such services have increased dramatically along with the explosion of health care costs.

In 2011 Florida had 17,125 teenage pregnancies. We rank 25th in the nation. Women’s health services work to reduce abortions and unwanted pregnancies. It would be tragic indeed to see family planning services fall victim to ideologies resulting in the reversal of teen pregnancy prevention and the increase in all unwanted pregnancies.

The adequate financial commitment to family planning clinics must not waiver.

Marc J. Yacht M.D., M.P.H. is a retired physician living in Hudson, Florida.  Column courtesy of Context Florida.

Marc Yacht


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