Teenage Birth Research Articles

Preventing Unintended Pregnancy: The Contraceptive CHOICE Project in Review.

The Contraceptive CHOICE Project (CHOICE) sought to reduce unintended pregnancies in the St. Louis Region by removing cost, education, and access barriers to highly effective contraception. CHOICE was a prospective cohort study of over 9,000 women 14-45 years of age who received tiered contraceptive counseling to increase awareness of all reversible methods available, particularly long-acting reversible contraceptive (LARC) methods. Participants were provided with contraception of their choice at no cost for 2-3 years. We studied contraceptive method choice, continuation, and population outcomes of repeat abortion and teen pregnancy. Seventy-five percent of study participants chose one of the three LARC methods (46% levonorgestrel intrauterine system, 12% copper intrauterine device, and 17% subdermal implant). LARC users reported greater continuation than non-LARC users at 12 months (87% versus 57%) and 24 months (77% versus 41%). In our cohort, LARC methods were 20 times more effective than non-LARC methods. As a result, we observed a reduction in the percent of repeat abortions from 2006 to 2010 in St. Louis compared with Kansas City and nonmetropolitan Missouri and found substantial reductions in teen pregnancy, birth, and abortion (34.0, 19.4, and 9.7 per 1000 teens, respectively) compared with national rates among sexually experienced teens (158.5, 94.0, and 41.5 per 1000, respectively). Improved access to LARC methods can result in fewer unintended pregnancies and abortions and considerable cost savings to the health care system.

Contamination in the Prospective Study of Child Maltreatment and Female Adolescent Health.

To evaluate the impact of contamination, or the presence of child maltreatment in a comparison condition, when estimating the broad, longitudinal effects of child maltreatment on female health at the transition to adulthood. The Female Adolescent Development Study (N = 514; age range: 14-19 years) used a prospective cohort design to examine the effects of substantiated child maltreatment on teenage births, obesity, major depression, and past-month cigarette use. Contamination was controlled via a multimethod strategy that used both adolescent self-report and Child Protective Services records to remove cases of child maltreatment from the comparison condition. Substantiated child maltreatment significantly predicted each outcome, relative risks = 1.47-2.95, 95% confidence intervals: 1.03-7.06, with increases in corresponding effect size magnitudes, only when contamination was controlled using the multimethod strategy. Contamination truncates risk estimates of child maltreatment and controlling it can strengthen overall conclusions about the effects of child maltreatment on female health.

The effects of household assets inequality and conflict on population health in Sudan

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey, we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy, infant mortality, height-for-age (stunting), adequacy of food consumption, teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan, outcomes were significantly worse in the states with more unequal asset distribution, with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states, as well as a political resolution of conflict, may improve population health.

Is education the best contraception: The case of teenage pregnancy in England?

This paper examines potential explanations for recent declines in teenage pregnancy in England. We estimate panel data models of teenage conception, birth and abortion rates from regions in England. Although point estimates are consistent with the promotion of long acting reversible contraception (LARC) having a negative impact on teenage pregnancy rates, the effects are generally small and statistically insignificant. In contrast, improvements in educational achievement and, to a lesser extent, increases in the non-white proportion of the population are associated with large and statistically significant reductions in teenage pregnancy.

Adolescent Pregnancy, Birth, and Abortion Rates Across Countries: Levels and Recent Trends

PurposeTo examine pregnancy rates and outcomes (births and abortions) among 15- to 19-year olds and 10- to 14-year olds in all countries for which recent information could be obtained and to examine trends since the mid-1990s. MethodsInformation was obtained from countries' vital statistics reports and the United Nations Statistics Division for most countries in this study. Alternate sources of information were used if needed and available. We present estimates primarily for 2011 and compare them to estimates published for the mid-1990s. ResultsAmong the 21 countries with complete statistics, the pregnancy rate among 15- to 19-year olds was the highest in the United States (57 pregnancies per 1,000 females) and the lowest rate was in Switzerland (8). Rates were higher in some former Soviet countries with incomplete statistics; they were the highest in Mexico and Sub-Saharan African countries with available information. Among countries with reliable evidence, the highest rate among 10- to 14-year olds was in Hungary. The proportion of teen pregnancies that ended in abortion ranged from 17% in Slovakia to 69% in Sweden. The proportion of pregnancies that ended in live births tended to be higher in countries with high teen pregnancy rates (p = .02). The pregnancy rate has declined since the mid-1990s in the majority of the 16 countries where trends could be assessed. ConclusionsDespite recent declines, teen pregnancy rates remain high in many countries. Research on the planning status of these pregnancies and on factors that determine how teens resolve their pregnancies could further inform programs and policies.

73. “Birth Control is Like Having an Abortion: Attitudes, Beliefs and Knowledge About Sex and Contraception Among Latino Youth in Rural Kansas”

Despite the rapid growth of the Latino adolescent population and high teen pregnancy rates in rural areas, limited pregnancy prevention studies have focused on this vulnerable population. The objective of this study is to describe the attitudes, beliefs, and knowledge about contraception, teen pregnancy, and strategies for family planning among rural Latino adolescents.

Investigating recent trends in the U.S. teen birth rate

We investigate trends in the U.S. rate of teen childbearing between 1981 and 2010, focusing specifically on the sizable decline since 1991. We focus on establishing the role of state-level demographic changes, economic conditions, and targeted policies in driving recent aggregate trends. We offer three main observations. First, the recent decline cannot be explained by the changing racial and ethnic composition of teens. Second, the only targeted policies that have had a statistically discernible impact on aggregate teen birth rates are declining welfare benefits and expanded access to family planning services through Medicaid, but these policies can account for only 12.6 percent of the observed decline since 1991. Third, higher unemployment rates lead to lower teen birth rates and can account for 16 percent of the decline in teen birth rates since the Great Recession began.

Unmet social needs and teenage pregnancy in Ogbomosho, South-western Nigeria.

Consistent high teenage pregnancy rates in South-western Nigeria are characteristically underpinned by the unmet social needs of the teenagers. To elicit intergenerational views on the influence of unmet social needs on teenage pregnancy. Through a descriptive and cross-sectional design, a total of 174 respondents who were either pregnant teenagers, teenage mothers during the survey or had been pregnant as teenagers, were interviewed, using questionnaire supplemented with 12 key informant interviews. With the mean age of 16.5 years, and educational status range of between primary and below (25.8%) and tertiary (9.8%) levels, only 39.7% respondents were married, about half (47.7%) remained single while others were separated (12.6%). Less than half (44.9%) of the respondents were engaged in occupational activities. The unmet material and financial supports expected from parents (43.1%), the lack of free education from government up till secondary school level (51.2%), the lack of sex education and knowledge needs for signs of maturity (53.4%) and discouragement from friends not to have boyfriend (66.1%) prone teenagers to unplanned pregnancy. Promotion of sexual education and parental care is encouraged as strategy against unplanned pregnancy among teenagers.

Common Law Marriage and Teen Births

Using microdata from Current Population Survey Fertility supplements 1990-2010 we examine whether Common Law Marriage (CLM) laws in the US affect teen birth rates. CLM effects are identified through cross-state and time variation, as four states repealed the law over the period of study. We find that in the states where CLM laws were first available but then repealed the odds that teens would become new mothers increased, with a larger increase among young black teens. When we include dummies for CLM at various times around the timing of the repeal, it turns out that the likelihood of becoming a mother is most affected by availability of CLM between 1 and 4 years prior to the repeal. There is a small negative effect of CLM on older women becoming mothers. To the extent that they reduce teen births CLM laws are socially desirable and worthy of further study.

High rate of teenage pregnancy and sexually transmitted infections in Fort Beaufort, Eastern Cape Province, South Africa

There is increased in teenage pregnancy despite the presence of dual protection practice and health care awareness programmes related to health and sexuality education in South Africa. The present study explores the underlying causes of high teenage pregnancy and sexually transmitted diseases rates, including HIV and AIDS in Fort Beaufort. The sample comprised of 70 conviently selected pregnant teenagers aged 15-19 years. Data were collected through self-administered questionnaire. About 56.9% participants knew nothing about family planning, 27.5% concieved family planning as prevention of pregnancy, and regard injection as a method of family planning, while 11% described family planning as planning for future babies. Those who knew about family planning mentioned friends, clinics, schools, family and neighbours as the source of information about family planning. Concerning condom use, majority (96.1%) heard about condoms, 66.7% once used the condoms and 72.5% were knowledgeable about condom use and 27.5% did not know how to use the condoms. About 34% knew that condoms protect against pregnancy and STIs, pregnancy (20.0%), STIs (37.1%) and 9% did not know anything about condoms. Regarding knowledge about STIs, 47% knew that one gets STIs through sex with an infected partner, though infectious, can be treated, 45% had no knowledge about STIs, 7.8% knew that one gets STIs when he/she sleeps with a partner without using condoms. Only 3.0% admitted having been treated for STIs. Teenagers are not well informed about family planning methods. Those who used condoms are not consistent and had limited knowledge about their use. The teenagers had knowledge about HIV and AIDS as well as STIs, but they did not use condoms during sexual intercourse which indicate negligence. There is need to reinforce health education on family planning and counseling to clients for better choices of methods including dual protection in order to prevent pregnancy and STIs, including HIV and AIDS. Keywords : Teenage pregnancy, condom use, sexually transmitted infections, Eastern Cape.

Why the United States preterm birth rate is declining

The preterm birth rate in the United States declined to 11.4% in 2013, the lowest level since 1997. Although the United States has one of the highest preterm birth rates in the developed world, we are improving this outcome and therefore improving the lives of thousands of infants. Demographic changes that may be responsible include a reduced teenage birth rate and fewer higher-order multiple births. Additionally, a public policy shift to prevent nonmedically indicated births at <39 weeks' gestation and smoking bans in several states have been associated with the reduced rate of preterm births. Last, interventions such as 17 hydroxyprogesterone caproate, vaginal progesterone, and the use of cerclage in selected populations probably are contributing to the reduction in preterm deliveries. However, a large portion of these births could still be prevented with greater access and implementation of our current interventions, the reduction of modifiable risk factors for preterm birth, and expanded reporting of outcomes and risk factors to facilitate research for both prevention and treatment.

Association between long-acting reversible contraceptive use, teenage pregnancy, and abortion rates in England.

BackgroundSince the late 1990s, the British government has launched major strategies to address high teenage pregnancy and abortion rates in England. These have focused in part on improving access to contraception through national campaigns. This study assessed teenage pregnancy and abortion rate trends since 1998 and possible associations with usage of long-acting reversible contraceptives (LARCs).MethodsTeenage conception rates and age-specific abortion rates were obtained from the Office for National Statistics and the Department of Health. LARC usage data was obtained for Depo-Provera, Implanon/Nexplanon, intrauterine devices, Mirena, and Noristerat from the IMS British Pharmaceutical Index, IMS Hospital Pharmacy Audit, IMS Disease Analyzer, and KT-31 reports. Through linear regression methods, changes in conception and abortion-related outcomes during 1998–2011 and the associations with LARC usage were assessed.ResultsConception rates for girls younger than 18 years of age decreased significantly between 1998–2011, from 46.6 to 30.7 per 1,000 girls. A statistically significant association was observed between this decrease and increased LARC usage (P=0.0024) in this population. Abortion rates among females aged <18 years or aged 18–19 years decreased between 1998–2011, and their associations with increased LARC usage were statistically significant (P=0.0029 and P=0.0479, respectively). The pattern in older women was complex; abortion rates in women aged 20–24 years or 25–34 years increased slightly from 1998 to 2011, with stabilization during 2007–2011.ConclusionIncreased LARC usage in England was significantly associated with decreased teenage pregnancy rates and abortion rates in females aged <20 years. Government strategies appears to have a positive impact on these outcomes; however, abortion rates among women over 20 years of age remain an issue.

Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?

ObjectivesThe United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. MethodsWe carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. ResultsThe state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different—for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P < .0001) and ethnic distribution of the population were the only variables associated with a difference between mean teen births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. ConclusionWhile teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates.

A systematic review of risk factors for neonatal mortality in adolescent mother's in Sub Saharan Africa.

BackgroundWorldwide, approximately 14 million mothers aged 15 – 19 years give birth annually. The number of teenage births in Sub Saharan Africa (SSA) is particularly high with an estimated 50% of mothers under the age of 20. Adolescent mothers have a significantly higher risk of neonatal mortality in comparison to adults. The objective of this review was to compare perinatal/neonatal mortality in Sub Saharan Africa and it’s associated risk factors between adolescents and adults.ResultsWe systematically searched six databases to determine risk factors for perinatal/neonatal mortality, and pregnancy outcomes, between adolescent and adults in SSA. Article’s quality was assessed and synthesized as a narrative. Being single and having a single parent household is more prevalent amongst adolescents than adults. Nearly all the adolescent mothers (97%) were raised in single parent households. These single life factors could be interconnected and catalyze other risky behaviors. Accordingly, having co-morbidities such as Sexually Transmitted Infections, or not going to school was more prevalent in younger mothers.ConclusionsInter-generational support for single mothers in SSA communities appears essential in preventing both early pregnancies and ensuring healthy outcomes when they occur during adolescence. Future studies should test related hypothesis and seek to unpack the processes that underpin the relationships between being single and other risk indicators for neonatal mortality in young mothers. Current policy initiatives should account for the context of single African women’s lives, low opportunity, status and little access to supportive relationships, or practical help.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-0500-7-750) contains supplementary material, which is available to authorized users.

Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy

BackgroundThe rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential.MethodsThe Contraceptive CHOICE Project was a large prospective cohort study designed to promote the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St. Louis region. Participants were educated about reversible contraception, with an emphasis on the benefits of LARC methods, were provided with their choice of reversible contraception at no cost, and were followed for 2 to 3 years. We analyzed pregnancy, birth, and induced-abortion rates among teenage girls and women 15 to 19 years of age in this cohort and compared them with those observed nationally among U.S. teens in the same age group.ResultsOf the 1404 teenage girls and women enrolled in CHOICE, 72% chose an intrauterine device or implant (LARC methods); the remaining 28% chose another method. During the 2008–2013 period, the mean annual rates of pregnancy, birth, and abortion among CHOICE participants were 34.0, 19.4, and 9.7 per 1000 teens, respectively. In comparison, rates of pregnancy, birth, and abortion among sexually experienced U.S. teens in 2008 were 158.5, 94.0, and 41.5 per 1000, respectively.ConclusionsTeenage girls and women who were provided contraception at no cost and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were much lower than the national rates for sexually experienced teens. (Funded by the Susan Thompson Buffett Foundation and others.)

The effects of household assets inequality and conflict on population health in Sudan

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey, we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy, infant mortality, height-for-age (stunting), adequacy of food consumption, teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan, outcomes were significantly worse in the states with more unequal asset distribution, with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states, as well as a political resolution of conflict, may improve population health.

Compositional or Contextual Effects? Neighbourhoods and Teenage Parenthood in Stockholm, Sweden

Selection bias constitutes a major problem in neighbourhood effect research but perhaps especially so for studies of effects on teenage birth rates. Results from both the U.S. and Europe are highly inconsistent: where some find substantial effects and others no effects. This inconsistency in combination with the clear correlations between neighbourhood environment and teenage birth rates where teenage mothers and mothers-to-be are overrepresented in low SES neighbourhoods makes it unclear if and to what extent neighbourhoods exerts a causal influence on teenage birth rates or whether correlations are mere reflections of differences in choices on the housing markets. This study adds to the (mainly American and British) body of literature on neighbourhood effects on teenage birth but focuses on a context—Stockholm, Sweden—where teenage birth rates are substantially lower. It offers a discussion on the potential impacts of selection bias on estimates of neighbourhood effects on teenage birth rates and empirically tests the existence of such neighbourhood effects. To account for selection bias I use a random effects model with a Mundlak correction (a hybrid model), a model that corrects for selection similarly to a fixed-effects model but also allows the inclusion of fixed parameters. The hybrid model produces coefficients that are substantially smaller compared to an OLS model that does not control for selection; selection thus biases results upwards. The neighbourhood effects estimated by the hybrid model are so small that they can be ignored.

The effects of household assets inequality and conflict on population health in Sudan

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey, we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy, infant mortality, height-for-age (stunting), adequacy of food consumption, teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan, outcomes were significantly worse in the states with more unequal asset distribution, with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states, as well as a political resolution of conflict, may improve population health.

Helping Clinicians Prevent Pregnancy among Sexually Active Adolescents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use

The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents.

Teenage pregnancies and births in Germany: patterns and developments

We study the development of teenage fertility in East and West Germany using data from the German Socioeconomic Panel and from the German Mikrozensus. Following the international literature we derive hypotheses on the patterns of teenage fertility and test whether they are relevant to the German case. We find that teenage fertility is associated with teenage age and education, with the income of the teenager’s family, with migration status, residence in East Germany and aggregate unemployment. Our evidence supports counter-cyclical teenage fertility.