The headlines screamed: "Teen Birth Rate Rises for First Time in 14 Years!" And that was from the CDC. The newspapers were even more dramatic: "Teen Pregnancy: It's Baaaack!" read one headline.
Most newspaper stories quoted our side blaming the Bush Administration's "abstinence-only" sex-ed policy for the rise in teen births. No question but the CDC report gave us a golden opportunity to criticize this misguided policy.
But, were we right?
What did the CDC report actually say? First, the CDC press release said that the teen birth rate rose 3% from 2005 to 2006 and that this is the first rise in the teen birth rate since 1991.
Buried in the CDC press release, but in the first sentences of the actual CDC report, entitled "Births: Preliminary Data for 2006", was the revelation that all births, adult and teen combined, rose 3% from 2005 to 2006. In other words, the teen "General Fertility Rate" (to use the exact terminology) rose at the same rate as the national General Fertility Rate.
The CDC also reported that the national Total Fertility Rate (another technical measure estimating the average number of births that a group of women would have over their lifetimes) rose to 2.1, the highest rate since 1971, and the first year that the TFR has been above the replacement rate since then.
The CDC also noted that the non-marital birth rate rose 7% in 2006 to 38.5% of total births. Be prepared for next year when it breeches the 40% barrier!
So, one interpretation of the CDC report could be that teens were behaving just as the adults were ? having more babies in 2006.
But do teens always behave as adults do, baby-wise? Not exactly.
As the CDC noted, the increase in the teen general fertility rate was the first since 1991 (the teen birth rate had fallen by about one-third since 1991 until its 2006 rise). What had the adult birth rate done since 1991? Like the teen birth rate, it had fallen since 1991 (and even before) until 1997, falling 10% during those years (less than the teen rate but still a significant drop). Then the adult birth rate began a slow rise, about 1% or less a year, until the big 3% jump from 2005 to 2006. Still the coincidence, if that is was it was, of the teen and adult birth rates each rising 3% in one year after diverging for the last eight years is remarkable.
It leads one to ask why birth rates rise and fall and what might make different groups rise while others fall or, conversely, what might make an entire nation's birthrate for adults and teens rise or fall together. There was little discussion of this issue at all in the press coverage. What there was, on the part of most advocates, was placing the blame on abstinence-only sex-ed, as if this misguided policy sprung fully formed in 2005 wreaking birthrate havoc in 2006, and as if nothing else had happened that might influence the childbearing decisions of teens.
Unfortunately, abstinence-only sex-ed has been around for a lot longer than since 2005. States have had their own abstinence-only programs for years, and substantial Federal funding for these programs took off with the Welfare Reform Act of 1996. Funding has totaled over a billion dollars since then. The results? A Congressionally-mandated evaluation report released in April 2007 showed no effect on age of intercourse, number of sexual partners, contraceptive use, STI infection rates or pregnancy rates. Other evaluations have shown that abstinence-only sex-ed may deter contraceptive use.
My view is that abstinence-only sex-ed is worthless at best, and dangerous at worst, and that it is quite a stretch to say that after ten years it is responsible for a one-year 3% rise in teen pregnancy, after teen pregnancy declined for the first nine years of substantial Federal funding for the program.
As one researcher told me, "We are particularly cautious in making assumptions about the role of abstinence education in this increase because the basic trends run counter to a simple association between the two. Consider that significant funding for abstinence-only education has been around since 1997 and that most years between then and now have witnessed major declines in teen pregnancy. Thus we feel that to assign none of this earlier decrease to abstinence education while assigning all of the recent increase to abstinence education would not be well grounded in empirical evidence..."
I think it safe to say that, if abstinence-only sex-ed programs had any effect on the teen pregnancy rates, up or down, it cannot be quantified.
Virtually alone in a pro-choice sea of condemnation of abstinence-only sex-ed, the National Campaign Against Teen Pregnancy issued a statement saying that no one really knows why the teen pregnancy rate spiked in 2006. They noted, correctly, that we do not have the data for 2006 on the extent of teen sexual activity and contraceptive use, nor do we have pregnancy rates and abortion rates. All we have are childbearing rates. Hence, we don't know if the teen childbearing spike was caused by more sex, less contraception, more pregnancy or less abortion, or some combination of the above. And we don't know what might have caused each of these indices to change from 2005 to 2006.
Researchers have known for years that pregnancy rates, adult and teen alike, arise from many complex factors - socio-economic, cultural and technological. A view of teen pregnancy rates in Latin America might be instructive. In general, unlike the USA, teen childbearing rates have been on the rise in Latin America since 1990. For instance in Brazil, the largest country in the region, the proportion of women age 15-19 who have children rose from 11.5% to 14.8%. Uruguay was the worst performer in the Hemisphere, with the rate rising from 8.4% to 13.9%. For Latin America as a whole, the percentage of live births to teens is 18%, while in Africa it is 17%. In Latin America, while adult fertility continues to decline, adolescent fertility is rising.
There has been economic growth, industrialization, modernization, urbanization in Latin America, along with the spread of modern contraceptives. All this has led to the reduction in the adult fertility rate, but not the adolescent rate. From a gender standpoint, girls in Latin America are in school as much as, or even more than, boys. But there are profound cultural factors that encourage, or at least don't discourage, early childbearing. Adolescents also have difficulty accessing contraceptives (only about 20% of youth use modern contraception) and sex-ed is spotty, even worse than the USA. Meanwhile lifestyle changes have brought on earlier maturation and sexual initiation. While clandestine abortion is widely available, for the very poorest in Latin America early unprotected sexual activity can lead to pregnancy and childbirth.
One mystery is the effect of the availability, or not, of emergency contraception. In the USA it is now available "behind the counter" without a prescription. In Latin America EC availability is not uniform, but a prescription is not needed if a woman can find an agency or store that has it. In the USA EC has become increasingly available since the mid-1990's yet the spike in teen childbearing rates in 2006 occurred despite this. The change in status in the USA from prescription-only status to behind the counter status only came in August 2006, so we will have to wait to see what effect this has on teen childbearing rates, if any, in 2007 and beyond.
In conclusion, the rise in teen childbearing was the story that wasn't in 2007. We don't know what caused it, any more than we know what caused the decline in the 15 previous years. We can make educated guesses. But blaming abstinence-only sex-ed, tempting as it is, is not one of them. My guess is that there was a confluence of factors that led women, adult and teen alike, to decide that 2006 was a good time to have babies.