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Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use

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  • Santelli, J.S.
  • Lindberg, L.D.
  • Finer, L.B.
  • Singh, S.

Abstract

Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effectiveness of contraceptive use among sexually active adolescents (including nonuse), and the overall pregnancy risk index, calculated according to the contraceptive risk index score and the percentage of individuals reporting sexual activity. Results. The contraceptive risk index declined 34% overall and 46% among adolescents aged 15 to 17 years. Improvements in contraceptive use included increases in the use of condoms, birth control pills, withdrawal, and multiple methods and a decline in nonuse. The overall pregnancy risk index declined 38%, with 86% of the decline attributable to improved contraceptive use. Among adolescents aged 15 to 17 years, 77% of the decline in pregnancy risk was attributable to improved contraceptive use. Conclusions. The decline in US adolescent pregnancy rates appears to be following the patterns observed in other developed countries, where improved contraceptive use has been the primary determinant of declining rates.

Suggested Citation

  • Santelli, J.S. & Lindberg, L.D. & Finer, L.B. & Singh, S., 2007. "Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use," American Journal of Public Health, American Public Health Association, vol. 97(1), pages 150-156.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2006.089169_8
    DOI: 10.2105/AJPH.2006.089169
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    1. Hande Inanc & Alicia Meckstroth & Betsy Keating & Katie Adamek & Heather Zaveri & So O’Neil & Kim McDonald & Lindsay Ochoa, "undated". "Factors Influencing Youth Sexual Activity: Conceptual Models for Sexual Risk Avoidance and Cessation," Mathematica Policy Research Reports 50fc4ce6f652418495bb2ba7f, Mathematica Policy Research.
    2. Karen Benjamin Guzzo & Sarah R. Hayford & Vanessa Wanner Lang & Hsueh-Sheng Wu & Jennifer Barber & Yasamin Kusunoki, 2019. "Dimensions of Reproductive Attitudes and Knowledge Related to Unintended Childbearing Among U.S. Adolescents and Young Adults," Demography, Springer;Population Association of America (PAA), vol. 56(1), pages 201-228, February.
    3. Girma, Sourafel & Paton, David, 2015. "Is education the best contraception: The case of teenage pregnancy in England?," Social Science & Medicine, Elsevier, vol. 131(C), pages 1-9.
    4. Mariana Gerstenblüth & Zuleika Ferre & Máximo Rossi & Patricia Triunfo, 2009. "Impacto de la maternidad adolescente en los logros educativos," Documentos de Trabajo (working papers) 0509, Department of Economics - dECON.
    5. Frank Furstenberg, 2016. "Reconsidering Teenage Pregnancy and Parenthood," Societies, MDPI, vol. 6(4), pages 1-8, November.
    6. Ron Haskins, 2009. "Moynihan Was Right: Now What?," The ANNALS of the American Academy of Political and Social Science, , vol. 621(1), pages 281-314, January.
    7. Anne Martin & Jeanne Brooks-Gunn, 2015. "Has Adolescent Childbearing Been Eclipsed by Nonmarital Childbearing?," Societies, MDPI, vol. 5(4), pages 1-10, October.
    8. Melissa S. Kearney & Phillip B. Levine, 2012. "Why Is the Teen Birth Rate in the United States So High and Why Does It Matter?," Journal of Economic Perspectives, American Economic Association, vol. 26(2), pages 141-163, Spring.
    9. Sarah K. Cowan, 2013. "Cohort Abortion Measures for the United States," Population and Development Review, The Population Council, Inc., vol. 39(2), pages 289-307, June.
    10. Wolfe, Joseph D. & Thomeer, Mieke Beth & Reczek, Rin, 2023. "Age at first birth and women's midlife health: Cohort and race differences across the 20th century," Social Science & Medicine, Elsevier, vol. 331(C).
    11. Jennifer Manlove & Quentin Karpilow & Kate Welti & Adam Thomas, 2015. "Linking Changes in Contraceptive Use to Declines in Teen Pregnancy Rates," Societies, MDPI, vol. 6(1), pages 1-14, December.
    12. Lenhart, Otto, 2021. "The effects of minimum wages on teenage birth rates," Economics Letters, Elsevier, vol. 198(C).
    13. Zuleika Ferre & Mariana Gerstenblüth & Máximo Rossi & Patricia Triunfo, 2009. "Decisión sobre iniciación sexual: el caso de adolescentes uruguayas," Documentos de Trabajo (working papers) 0409, Department of Economics - dECON.
    14. Chien Liu, 2021. "A theory of sexual revolution: explaining the collapse of the norm of premarital abstinence," Mind & Society: Cognitive Studies in Economics and Social Sciences, Springer;Fondazione Rosselli, vol. 20(1), pages 41-58, June.
    15. Rosen, Brooke & Dauria, Emily & Shumway, Martha & Dumoit Smith, Jaime & Koinis-Mitchell, Daphne & Tolou-Shams, Marina, 2022. "Association of pregnancy attitudes and intentions with sexual activity and psychiatric symptoms in justice-involved youth," Children and Youth Services Review, Elsevier, vol. 138(C).
    16. Katie Adamek & Alicia Meckstroth & Hande Inanc & Lindsay Ochoa & So O'Neil & Kim McDonald & Heather Zaveri, "undated". "Conceptual Models to Depict the Factors that Influence the Avoidance and Cessation of Sexual Risk Behaviors Among Youth," Mathematica Policy Research Reports bbc3741c9fbe4963b6e053933, Mathematica Policy Research.
    17. Carla Shoff & Tse-Chuan Yang, 2012. "Spatially varying predictors of teenage birth rates among counties in the United States," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 27(14), pages 377-418.
    18. Colin Cannonier, 2012. "State abstinence education programs and teen birth rates in the US," Review of Economics of the Household, Springer, vol. 10(1), pages 53-75, March.
    19. Kearney, Melissa S. & Levine, Phillip B., 2015. "Investigating recent trends in the U.S. teen birth rate," Journal of Health Economics, Elsevier, vol. 41(C), pages 15-29.
    20. Edwin van Teijlingen & Sirpa Wrede & Cecilia Benoit & Jane Sandall & Raymond DeVries, 2009. "Born in the USA: Exceptionalism in Maternity Care Organisation among High-Income Countries," Sociological Research Online, , vol. 14(42), pages 52-11, January.
    21. Nathan Berg & Teresa D. Nelson, 2016. "Pregnancy and Dropout: Effects of Family, Neighborhood, and High School Characteristics on Girls’ Fertility and Dropout Status," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 35(6), pages 757-789, December.
    22. Stulhofer, Aleksandar & Bacak, Valerio & Ajdukovic, Dea & Graham, Cynthia, 2010. "Understanding the association between condom use at first and most recent sexual intercourse: An assessment of normative, calculative, and habitual explanations," Social Science & Medicine, Elsevier, vol. 70(12), pages 2080-2084, June.
    23. Chelsea Campbell & Kruti Lehenbauer, 2019. "Teenage Pregnancy: Time for Change and Action," Proceedings of the 12th International RAIS Conference, April 3-4, 2019 24CC, Research Association for Interdisciplinary Studies.
    24. Melissa Schettini Kearney & Phillip B. Levine, 2012. "Explaining Recent Trends in the U.S. Teen Birth Rate," NBER Working Papers 17964, National Bureau of Economic Research, Inc.

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