The Critical Link: Preventing Teen & Unplanned Pregnancy

Article excerpt

The decline in the nation's rate of teen pregnancy and childbearing has been nothing short of extraordinary. The teen pregnancy rate is down nearly 40 percent and the teen birth rate has been cut by one-third since the early 1990s. The rates are down in all 50 states, down among teens of all ages, and down among all racial/ethnic groups. This remarkable progress on an issue many once considered intractable suggests that the work of those concerned about public health, those serving teens and young adults, and many others have made a real difference--a difference with generational effects.

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That is why the recent news that teen pregnancy is on the rise for the first time since 1990 is so sobering. The increase is particularly steep among older teens (those ages 18-19); a group that has traditionally had the highest rate of teen pregnancy. Simply put, one of the nation's great success stories of the past two decades--helping teens and young adults avoid pregnancies they themselves say they are not ready for--is in danger of unraveling.

In addition, even though it doesn't command the headlines that teen pregnancy does, it is important to understand that half of all pregnancies in the United States are unplanned--among 20-somethings the rates are even greater. At present, fully seven in 10 pregnancies among single women in their 20s are unplanned. It is also the case that unplanned pregnancy has increased among poor women.

Not surprisingly, the increase in the teen pregnancy rate, particularly among those aged 18-19, coupled with the stubbornly high rate of unplanned pregnancy among single young adults, has the full attention of The National Campaign to Prevent Teen and Unplanned Pregnancy. However, we realize that significant and lasting progress in helping teens and young adults avoid unplanned pregnancy will only occur in partnership with health and human service agencies around the country.

So what to do? Before discussing remedies, it is worth getting a better understanding of why so many teens and young adults are getting pregnant and starting families when they say they are not ready and underscoring the link between early and unplanned pregnancy and the goals of APHSA and its members.

Why are rates of unplanned pregnancy so high?

As noted above, fully seven in 10 pregnancies among unmarried women in their 20s are unplanned, reflecting the fact that a significant proportion of sexually active, unmarried young adults--who themselves say they do not want to be parents right now--are not fully protecting themselves from pregnancy. The critical question is why? A recent robust, nationally representative survey of 1,800 single young adults (ages 18-29) released by The National Campaign (see http://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdf) provides some important clues about why unplanned pregnancy is so common. Cost and access can make contraception hard to get--especially long-lasting methods--but the survey makes quite clear that there are other barriers and explanations as well such as fear, misinformation and ambivalence. Major findings of the survey include:

* Even though most unmarried young adults say it is important for them to avoid pregnancy right now, only about half of those who are sexually active use contraception every time. Some take a pass on birth control altogether, at least part of the time, and while others are more conscientious, they are often not careful or consistent enough. In addition, a significant portion expects to have unprotected sex in the near future.

* Many say they have little knowledge of even common contraceptive methods such as condoms and the pill, and most have not even heard of less-common methods such as the implant.

* To the extent they have heard of various methods, many express little confidence in their effectiveness and strong concerns about side effects. …