The XX Factor

Thank Contraception, Not Abstinence, for the Drop in U.S. Teen Pregnancies

More teens are using more effective forms of birth control.

The United States’ teen pregnancy rate, the very highest among the world’s 20 nations with complete statistics, has been falling since the 1990s. Since 2007, it has dropped precipitously, but teens didn’t report a significant change in their sexual activity. What could possibly be behind this welcome decline in adolescent fertility?

The answer, as sexual health advocates have been saying for years, is contraception. A recent study published in the Journal of Adolescent Health found that the entire 36 percent drop in the teen pregnancy rate between 2007 and 2013 can be attributed to increased contraceptive use and increased popularity of more effective birth control methods among teens.

Researchers from the Guttmacher Institute and Columbia University analyzed data on sexual activity and use of contraception among women aged 15 to 19 collected in several National Surveys of Family Growth, a series of nationally representative surveys conducted by the Centers for Disease Control and Prevention. Using this data and established rates of failure for different contraceptive methods, researchers calculated the average pregnancy risk for the respective populations of teens surveyed in 2007, 2009, and 2012.

Pregnancy risk declined at an average annual rate of 5.6 percent over this five-year period because of considerable jumps in contraceptive use in general, use of multiple forms of birth control, and use of more reliable birth control. Previous research has shown that 86 percent of pregnancy-risk decrease between 1995 and 2002 came from contraceptive use, but teen sexual activity also increased during that period. The pregnancy-rate drop from 2007 to 2013 came just from increased contraceptive use and increased use of oral contraceptives or long-acting reversible contraception (LARC) like IUDs and implants instead of condoms or withdrawal.

The U.S. teen birth rate is also steadily falling, down 46 percent since 2007. In 2015, it fell 8 percent, marking the eighth consecutive year of decline. Even amid diminishing abortion rates, U.S. teens are having fewer babies. This is no coincidence: A recent study of abortion laws, contraception access, and abortion rates around the world found that anti-abortion regulations don’t lower abortion rates, but increased access to affordable, modern contraception does.

In other words, improved access to birth control has positive ramifications that impact several measures of public health. (It also saves U.S. taxpayers billions of dollars it would have been spending on public assistance for teen mothers and their babies, for those who care about that sort of thing.) Policymakers are finally starting to take note: Contraception access has gotten much easier since some states started letting teens get birth control without notifying their parents, since the Affordable Care Act made contraception free for insured people, and since programs in Colorado and Delaware proved that offering free LARCs to low-income women and teens can halve the teen birth rate. More importantly, giving young people easier access to reliable birth control methods gives them greater control over their own lives—a worthy end in itself.