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Teen pregnancy rates declining, but don’t take the good news for granted



For the Gazette
Monday, June 11, 2018

May, recognized as National Teen Pregnancy Prevention Month, may be over, but the steamy days, flowering trees and hormonal flourishing continue to remind us that fecundity is the theme of the season.

Information relating to the topic can be found in abundance on websites hosted by government and NGO agencies and other advocates of public health, including the U.S. Department of Health and Human Services; the Centers for Disease Control and Prevention; and Planned Parenthood (among many others).

Teen pregnancy, defined statistically as pregnancy among 15- to 19-year-olds, has, overall, seen declines in the U.S. over the last decade among all races and ethnicities. The declines, which vary from a 6 percent drop for American/Indian/Alaska natives to 10 percent for Asian/Pacific Islanders, are a positive overall trend, though many areas of concern remain where spikes in teen pregnancy exist.

Certain states and other regionally defined geographic areas demonstrate higher risk levels, and socioeconomic circumstances, including history in the child welfare systems and foster care, also can be determinants of elevated risk. Also, despite the overall improvement, teen pregnancy rates in the United States remain substantially higher than in many other western industrialized countries.

Being pregnant and giving birth as a teenager can dramatically affect the academic and professional futures of both men and women. Juggling child care with a professional life is challenging for even those parents who are comfortably into their adulthood, and teens often lack the resources and education that make this increasingly difficult balancing act workable.

“Pregnancy and birth are significant contributors to high school dropout rates among girls,” according to the Washington, D.C.-based nonprofit, nonpartisan research center Child Trends. “Only about 50 percent of teen mothers receive a high school diploma by 22 years of age, whereas approximately 90 percent of women who do not give birth during adolescence graduate from high school.” In addition, the children of teenage mothers are also more likely to drop out of high school, suffer more health problems, be incarcerated at some time during adolescence, give birth as a teenager, and face unemployment as a young adult, according to a 2008 publication by The Urban Institute Press.

The long-term impact of teen pregnancy and teen birth can be substantial not only to individuals, but to society as well. The CDC reports that “In 2010, teen pregnancy and childbirth accounted for at least $9.4 billion in costs to U.S. taxpayers for increased health care and foster care, increased incarceration rates among children of teen parents, and lost tax revenue because of lower educational attainment and income among teen mothers.” In addition, 80 percent of teen mothers are dependent on welfare/transitional assistance at some point in their lives.

Trusted individuals like parents, teachers and peers can all play a significant part in educating teenagers about birth control, and should not underestimate the importance of the roles they play in helping to teach young adults about the consequences of sexual choices and behaviors. Community and family planning services and clinics which provide youth-friendly contraceptive and reproductive health services are also critical to the prevention process. The CDC has labeled teen pregnancy prevention as one of its top seven priorities, which it calls a “winnable battle,” and supports evidence-based teen pregnancy prevention programs.

In general, Massachusetts parents, teachers and providers can pat themselves on the backs on this public health issue, as the state has the lowest teen pregnancy rate in the country at approximately 1 percent (the highest, Arkansas, stands at about 3.5 percent). Regardless, many might consider this number still too high, and our state also is not without its own pockets of elevated risk. Every teen’s personal situation is also a highly individual one, and some may involve circumstances of manipulation or abuse which need to be addressed on a social or even a legal level.

Teens or parents of teens, male or female, can find resources on family planning, birth control, sexual health/STD prevention and other topics locally through Cooley Dickinson Medical Group Women’s Health clinics, Tapestry Health or the Western Massachusetts Health Center.

Estevan Garcia, MD, is Cooley Dickinson’s chief medical officer and a pediatrician with special interest in public and preventive health. Cooley Dickinson Hospital health professionals contribute a column to this space monthly.