There is a widespread consensus among the American public that rates of teen pregnancy and unintended pregnancies to young, unmarried women are too high. Approximately 30 percent of teenage girls in the United States become pregnant, and 20 percent give birth by age 20. In addition, half of all pregnancies in the United States are reported by the mother as unintended. More than one-third of these (1.1 million pregnancies in 2001) are to unmarried women in their twenties. Rates of teen pregnancy and unplanned pregnancy are higher among young unmarried women, lower income women, women with lower levels of education, and minority women.
The concern about rates of teen pregnancy and non-marital pregnancy is driven in large measure by the observed inferior outcomes for children born into disadvantaged situations--in particular, those born to young, unmarried mothers. In this research summary, I describe some of my work on the policy determinants of teen and non-marital childbearing and the socioeconomic differences in rates of teen childbearing and parental time investment in children.
Policy determinants of Teen and Non-marital Pregnancy
There are several commonly suggested policy approaches to reducing the level of teen and unintended pregnancies. One is increased access to contraception. As an initial matter, the term "unintended" as captured in surveys is fraught with measurement and interpretation issues, and it is not always clear what is meant when a woman reports her pregnancy to be unintended. Furthermore, there is ethnographic and anecdotal evidence that a substantial number of teen pregnancies may be deliberate. Policies on contraception will be effective only to the extent that teenagers or other young women are committed to avoiding pregnancy and to the extent that they serve women who were not already using contraception.
Research that I conducted with Phil Levine suggests that expanded access to publicly provided family planning services results in a moderate reduction in overall births and in births to teens. (1) Between December 1993 and March 2007, 25 states received waivers from the federal government to extend the coverage of family planning services to women who do not otherwise qualify for Medicaid health insurance coverage. We conduct difference-in-difference analyses to identify the causal impact of these waiver policies using a wide array of data sources, including Vital Statistics birth data, abortion data from the Guttmacher Institute, and microdata on sexual activity and contraceptive use from the 1988, 1995, and 2002 National Surveys of Family Growth (NSFG). Using data from the Centers for Medicaid and Medicare Services (CMS), we also confirm that these waivers increased the number of women receiving Medicaid-funded family planning services.
We find that extending Medicaid family planning services to women at higher levels of income dramatically increased the number of women receiving those services. By itself, this does not necessarily indicate an effect on behavior, as it could merely reflect a crowding out of privately provided services. However, we demonstrate that the waiver policies reduced overall births to non-teens by about 2 percent and to teens by over 4 percent. Scaling these estimates by the estimated proportion of women in a state made newly eligible by expanded coverage, we find that births to newly-eligible non-teens fell by almost 9 percent. Moreover, our analysis of individual-level data from the NSFG implies that the reduction in fertility associated with income-based waivers is attributable to greater contraceptive use; we find no evidence of an effect on sexual activity. Based on the cost per recipient of family planning services, we find that each birth avoided would cost on the order of $6,800.
Another policy approach to addressing teen and non-marital childbearing is to alter the financial costs and incentives for childbearing. …