Teen births hit a 70-year low in 2010, probably due to a combination of increased abstinence and the use of more effective contraception.
The birth rate for U.S. teenage females in 2010 – the most recent year with full data – was 34 per 1,000, Crystal Pirtle Tyler, Ph.D., and her associates wrote in the May 4 issue of Morbidity and Mortality Report. That translates to a total of about 368,000 pregnancies that year – a 44% decline from 1990 (MMWR Morb. Mortal. Wkly. Rep. 2012;61:297-301).
A significant increase in sexual abstinence is a larger driver of that change, wrote Dr. Tyler and her associates at the National Center for Chronic Disease Prevention and Health Promotion. "During 2006-2010, more than half of female teens had never had sex, reflecting a 16% increase relative to the 1995 estimate."
Dr. Tyler and her colleagues extracted their data from three cycles of the National Survey of Family Growth (1995, 2002, and 2006-2010). The in-person survey addresses health issues in people aged 15-44 years.
The survey stratifies birth control methods into highly effective (long-acting reversible contraception); moderately effective (only condoms); and less effective (withdrawal, periodic abstinence, rhythm method, emergency contraception, diaphragm, female condom, foam, jelly, cervical cap, sponge, suppository, or insert).
Overall, 57% of teen females aged 15-19 years reported never having engaged in vaginal intercourse, a significant increase compared with 49% in 1995. There were intragroup differences in the proportion of abstinent teens in terms of race and ethnicity, with a 34% increase among black girls and a 29% increase among Hispanic girls, compared with a 15% increase among white girls.
Age also significantly impacted abstinence – 73% of teen girls aged 15-17 years compared with 36% aged 18-19 years reported never having had vaginal intercourse.
During the 2006-2010 era, 60% of teenage girls reported using highly effective contraception. This represented a 34% increase among whites, a 19% increase among Hispanics, and a 4% increase among blacks.
There were still disparities in the use of these methods, however. During 2006-2010, the highly effective methods were used by 66% of whites, 46% of Hispanics, and 54% of blacks.
There was also a 43% decrease in the use of moderately effective methods and a 27% decrease in less effective methods, compared with 1995.
There were changes in the proportion of teenage girls using no birth control. Compared with 1995, there was a 19% decrease among whites, but a 20% increase among blacks.
Again, Dr. Tyler noted, age was a factor. Teens aged 15-17 years had increased rates of highly effective methods compared with 1995 (56% vs. 46%). The rate for those aged 18-19 years increased from 48% in 1995 to 62% during 2006-2010.
Among the younger teens, rates of nonuse declined relative to 1995 (from 24% to 19%), but stayed steady for older teens at 16%-17%.
Parents, schools, communities, and health care providers all can contribute to furthering the decline in teen pregnancy, according to an accompanying editorial. "Ways to reduce barriers to decrease teen pregnancy include encouraging teens to delay sexual debut, offering teens convenient [health care provider practice] hours, culturally competent and confidential counseling and services, and low-cost or free services and methods."
Health care providers also should know that no contraceptive method is contraindicated for teens solely on the basis of age, according to the editorial.
As a federal employee, Dr. Tyler had no financial disclosures.