Teen pregnancy rates are dropping, but not for the reasons you might think

Aug 2, 2012

Health And Human Services Dept. Approves Free Birth Control For Women

The declining teen pregnancy rate can be partly attributed to the use of birth control pills, but IUDs have proven to be even more effective. Credit: Kevork Djansezian/Getty Images

Though the popularity of shows like Teen Mom might suggest otherwise, teen pregnancy rates have dropped nationwide. In fact, they’re down by 40% since 1990. So what accounts for the three-decade low?

Better sex education can be ruled out. The drops were found across the country, even in states without comprehensive sex education programs, like Texas and New Mexico. Part of the reason could be that teens are waiting to have sex. The number of teenage girls who are virgins has risen markedly in the last ten years.

However the bulk of the drop can be attributed to contraception use, but not the numbers – teen birth control use has remained at the same level for the last 20 years. It’s the type of birth control that has changed. More and more teens are moving away from condoms and towards the pill. However, the pill still poses a problem – many teens and adult women forget to take it every day, increasing the risk of pregnancy.

A recent study found an even more effective method: long-acting reversible contraceptives (LARCs) like intrauterine devices (IUDs) and implants. For the study, women were given their choice of free contraception. Those who chose the pill had a much higher risk of contraceptive failure than those who picked IUDs.

The problem is that IUDs aren’t readily available to most women. Though Medicaid covers them, it may not cover later checkups often needed for use of IUDs. Vermont, the state with the lowest teen pregnancy rate, teamed up with Planned Parenthood to create federal payment schemes that makes IUDs, and subsequent checkups, easier to obtain.

Should other states follow Vermont’s lead? Will wider access to LARCs really make that big of a difference?


Bill Albert, Chief Program Officer, The National Campaign to Prevent Teen and Unplanned Pregnancy

Gina Secura Ph.D., Senior Scientist, Washington University School of Medicine; Project Director

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