Teen pregnancy is probably the most studied aspect of adolescent sexual behavior because of its many impacts on the life of the teenager, the teenager’s family, and society as a whole. Although the number of sexually active adolescents is increasing, teenage pregnancy rates have declined over the last few years. The primary reason for this has been an increase in contraceptive use (Alan Guttmacher Institute, 2001b; J. G. Kahn et al., 1999).
However, as we pointed out earlier, the United States still has the highest rates of teenage pregnancy, abortion, and childbirth of any Western country. Studies have found that the likelihood of a child of 14 or younger becoming pregnant in the United States is 7 times higher than in the Netherlands, 9 times higher than in Europe as a whole, and 17 times higher than in Japan (Meschke et al., 2000; Society for Adolescent Medicine, 1991; see Figure 8.6).
Teen pregnancies do not preclude teen mothers from living healthy, fulfilling lives. In fact, there are many examples of teenagers who become pregnant and raise healthy babies while pursuing their own interests. However, the problems a teenage mother faces are many, especially if there is no partner participating in the child’s care. Babies born to teens tend to have lower birth weight, and the mothers have more difficult labors and are more likely to die in childbirth.
Teen mothers are more likely to drop out of school, have poorer physical and mental health, and be on welfare than their nonchildbearing peers, and their children tend have poorer health and cognitive abilities, more behavioral problems, and fewer educational opportunities (Meschke et al., 2000). Teen parenting also has an impact on others, such as the parents of the teens (who may end up having to take care of their children’s children), and on society in general, because these parents are more likely to need government assistance. Finally, children raised by a teenage mother are more likely to engage in earlier sexual intercourse and to face pregnancy than do children raised by older mothers (O’Connor et al., 1999; Woodward et al., 2001).
Pregnancy Rates Although there have been dramatic decreases in teenage pregnancy rates in the United States in the last decade, the United States still has higher levels of adolescent pregnancy than other Western industrialized countries (Bennett & Assefi, 2005). More than three-quarters of pregnancies to teens each year are unintended. Nationwide, the 1996 pregnancy rate was 97 pregnancies per 1,000 women aged 15 to 19, down from 107 per 1,000 in 1986 and a drop of 17% from its peak of 117 per 1,000 teens in 1990 (Alan Guttmacher Institute, 2001b). Among teenagers 14 and younger, the rate in 1996 was 13 pregnancies per 1,000 females, down from about 17 per 1,000 from the mid-1980s until 1993. U. S. teenagers are more likely than teenagers in other developed countries to become pregnant unintentionally (Alan Guttmacher Institute, 2001a).
Birth Rates Birth rates in the United States have been declining since about 1957, even as pregnancy rates have risen, because a high per-
centage of teen pregnancies end in abortion. Teen birth rates actually reached close to an all-time low in 1978! Then why all the concern over teen pregnancy? The problem is that, due to the post-World War II baby boom, there are many more teenagers. In 1970, there were 43% more teenagers in the United States than in the previous decade, so even though rates fell, the numbers of babies born to teenagers rose (C. W. Williams,
1991) . Recently, however, the numbers of births to teenagers have been declining. In 1986, there were 50 births per 1,000 women aged 15 to 19. The rate rose rapidly to 62 per 1,000 in 1991, an increase of 24%, before declining over the next 5 years until, in 1996, 54 births occurred per 1,000 teenage women (still a higher rate than that in 1986; Alan Guttmacher Institute, 2001a).
In studies of teen pregnancy, most of the focus has been on the mothers, who often bear the brunt of the emotional, personal, and financial costs of childbearing. Adolescent fathers are more difficult to study. Teenage fathers may run as soon as they learn of their mate’s pregnancy or become uninvolved soon after, and thus the problem of single mothers raising children can be traced in part to the lack of responsibility of teen fathers. Society asks little of the teenage male, and there are few social pressures on him to take responsibility for his offspring.
Yet many of these fathers also feel isolated or rejected or are treated punitively (Bolton & MacEachron, 1988). Today many adolescent fathers do accept their role in both pregnancy and parenthood and realistically assess their responsibilities toward the mother and child. Many feel both stress over the birth and guilt. Ideally, fathers should be reintegrated into the lives of their children and should be expected to take equal responsibility for the results of their sexual activities. However, if teen fathers neglect their partners and children, it is at least in part due to the fact that society does not demand or even encourage that they do otherwise.
Abortion The legalization of abortion in America in 1973 had the greatest impact on the ratio of teen pregnancies to births. Teenagers accounted for more than a quarter of all abortions in the United States in 1985 (Hudson, 1991). Yet although teenage abortion rates varied little during the 1980s, they began a steady decline in the 1990s. By 1996, the rate was 31% lower than the teenage abortion rate a decade earlier (Alan Guttmacher Institute, 1999a). In 2000, one-third of pregnancies among 15- to 18-year-olds was terminated through abortion (Alan Guttmacher Institute, 2004). However, there are state-bystate variations in these numbers. For example, 50-60% of teenage pregnancies in New Jersey, New York, Massachusetts, and the District of Columbia ended in abortion, whereas only 13% in Kentucky and Utah ended in abortion (Alan Guttmacher Institute, 2004). We will discuss the emotional and personal aspects of the abortion decision in Chapter 13.
The Effects of Race and Poverty Adolescent parenthood affects every race, every income group, and every part of American society; it is not just a problem of the inner – city poor. Historically, white teenagers have had lower birthrates than African American adolescents or Latino adolescents, a trend that continued in the 1990s. Though through much of the 1990s, African American teenagers had the highest rates of pregnancy, birth, and abortion, all three rates dropped by about 20% between 1990 and 1996. Because the birthrate declined more steeply among African American than among white teenagers, the gap between these two groups narrowed. By contrast, birthrates among Latino teenagers increased through the early 1990s, only taking a small dip after 1994, even though pregnancy and abortion rates declined slightly. As a result, Latino teenagers now have the highest birthrates of the three groups (Alan Guttmacher Institute, 1999a).
Unmarried mothers and their children of all races are more likely to live in poverty than any other segment of the population. Even though only about one-third of teen pregnancies happen to people officially listed as “poor,” many others are to people just above the official poverty line. For these mothers, pregnancy may carry with it the end of her educational history and decreased job opportunities. Society has become less willing to grant benefits to teenage and single mothers, believing (despite most data to the contrary ) that such aid simply perpetuates dependency on welfare and leads to the children of teenage mothers becoming teenage mothers themselves.
What Should Be Done About Teen Pregnancy? What is it about American society that seems to foster such high rates of teenage pregnancy? A complex series of factors is at work. American society is extremely conflicted about the issue of sexuality in general. Our teens are exposed to sexual scenes in movies and television, yet we hesitate to discuss sex frankly with them. We allow advertising to use blatantly sexual messages and half-dressed models, yet we will not permit advertising for birth control; and there is significant resistance to sex education in the schools.
Today, when teenagers do become pregnant, opportunities may be limited; it is difficult to have a baby and attend high school all day or work at a job. The United States is far behind most other Western countries in providing day care services that would help single or young parents care for their children. Better counseling, birth control, day care services, and hope for the future can help assure that the teenagers who are at risk for unwanted pregnancies and the children of those unwanted pregnancies are cared for by our society.
Sexually Transmitted Infections: Education and Prevention
Although we will discuss sexually transmitted infections in great detail in Chapter 15, here we will briefly talk about adolescent rates of STIs. In the United States, approximately 4 million teenagers are infected with an STI every year (Boonstra, 2002b). Adolescents between 15 and 19 years old account for one-third of all gonorrhea and chlamydia cases in the United States. It is estimated that in the United States, two teenagers are infected with an STI every hour of every day (Boonstra, 2002b). Preventing STIs and teenage pregnancy are both important goals of sex education programs. In the following section we will discuss the importance of sexuality education and what is being taught in schools today.