Linking Changes in Contraceptive Use to Declines in Teen Pregnancy Rates

Jennifer Manlove,Kate Welti,Adam Thomas,Quentin Karpilow

doi:10.3390/soc6010001

Jennifer Manlove, Kate Welti + Show 2 more

Open Access

https://doi.org/10.3390/soc6010001

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Abstract

Using a unique microsimulation tool, Teen FamilyScape, the present study explores how changes in the mix of contraceptive methods used by teens contributed to the decline in the U.S. teen pregnancy rate between 2002 and 2010. Results indicate that changes in contraceptive use contributed to approximately half of the decline in the teen pregnancy rate during this time period (48%) and that a little more than half of this “contraceptive effect” was due to an increase in teen condom use (58%). The remaining share of the contraceptive effect can be attributed to an increase in the use of more effective hormonal (pill, patch, ring) and long-acting reversible contraceptive (LARC)/injectable methods (Intrauterine Devices (IUD), implant and injectable). Results from an additional counterfactual analysis suggest that the contraceptive effect was driven by the fact that the percentage of teens using no birth control fell during the study time period, rather than by the fact that some teens switched from less effective methods (condoms) to more effective hormonal and LARC/injectable methods. However, very high typical use failure rates for teen condom users suggest the need for a two-pronged approach for continuing reductions in teen pregnancy for sexually active teens: first, targeting the youth most at risk of not using contraception and helping them choose contraception, and second, increasing the effectiveness of method use among existing contraceptors.

Highlights

The teen pregnancy rate in the U.S has declined dramatically over the last two decades [1], declining by almost one-third (31%) between 2000 and 2010 from 83.4 pregnancies per 1000 teenaged women to 57.4 pregnancies per 1000 teenaged women
In the first stage of the simulation, we use the female respondent file of the 2006–2010 National Survey of Family Growth (NSFG)3 —a nationally representative survey that contains extensive information on sexual activity, contraceptive use, and fertility outcomes—to populate the model with a group of teenage women whose demographic characteristics are nationally representative with respect to marital status, age, race, educational attainment, and socioeconomic status [12]
We found that changes in contraceptive use produced a reduction of 8.1 pregnancies per 1000 teens in the teen pregnancy rate, which corresponds to a little less than half of the decline in teen pregnancies during our period of interest (17 pregnancies per 1000 teenage women between 2002 and 2010) [1]10

Summary

Introduction

The teen pregnancy rate in the U.S has declined dramatically over the last two decades [1], declining by almost one-third (31%) between 2000 and 2010 (the most recent year for which data are available) from 83.4 pregnancies per 1000 teenaged women to 57.4 pregnancies per 1000 teenaged women This decline is the result of two underlying trends: reductions in the percentage of teenagers who are sexually active and improvements in contraceptive use among teens who are sexually active. A number of studies have attempted to parse out the relative importance of these trends These studies generally find that both factors have contributed to the reduction in teen pregnancies. Santelli et al, [3] calculated that 53% of the decline in Societies 2016, 6, 1; doi:10.3390/soc6010001 www.mdpi.com/journal/societies

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