The teen pregnancy rate in the United States is higher than other developed nations. Researchers at Washington University School of Medicine in St. Louis, Missouri have reported a method to slash that rate. They published their findings on October 2 in the New England Journal of Medicine.
The study authors note the good news that the teen pregnancy rate has dropped significantly over the past two decades in the United States; however, the bad news is that it remains a major health problem. Each year, more than 600,000 teens become pregnant, and 3 of 10 teens will become pregnant before the age of 20 years. The rates are higher among African American and Hispanic teens: 4 of 10 becoming pregnant by 20 years of age, compared to 2 of 10 Caucasian. The problem not only results in serious negative health and social consequences to teen mothers and their children but also imposes a significant financial burden on the nation. In 2010, the healthcare cost associated with a teen birth cost almost $10 billion in increased public assistance and healthcare costs. It also produced loss of income due to lower educational attainment and reduced earnings among children born to teenage mothers.
The Contraceptive researchers were involved in the CHOICE Project, which was a large prospective (forward-looking) study designed to encourage the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St. Louis region. The teens were educated regarding reversible contraception, with an emphasis on the benefits of LARC methods. They were provided with their choice of reversible contraception at no cost, and were followed up for two to three years. The investigators examined pregnancy, birth, and induced-abortion rates among teenage girls and women 15 to 19 years and compared them with those observed nationally among US teens in the same age group.
The study group comprised 1,404 teens enrolled in in CHOICE. The researchers found that 72% chose an intrauterine device (IUD) or implant (both are LARC methods); the remaining 28% chose another method. From 2008 through 2013, the average annual rate of pregnancy was 34.0 per 1,000 teens; the annual birth rate was 19.4/1,000, and the annual abortion rate was 9.7/1,000. In comparison, the rate of pregnancy among sexually experienced US teens was 158.5/1,000; the birth rate was 94.0/1,000, and the abortion rate was 41.5/1.000.
The authors concluded that teenage girls and women who were provided free contraception and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were significantly lower than the national rates for sexually experienced teens.
Take home message:
Not uncommonly, parents discover that their daughter is sexually active after she becomes pregnant. I once delivered a pregnant teen who informed her dad she was pregnant on the drive to the hospital after her labor started. Her mother was a registered nurse and she wore baggy clothes to conceal her pregnancy. Today’s parents must be aware that many teen girls become sexually active in high school—and even earlier. Thus, it is prudent for parents to arrange an appointment with a gynecologist or other healthcare professional knowledgeable about contraception when she reaches puberty. The newer LARCs are well tolerated by many teens and avoid compliance issues with oral contraceptives (i.e., missed pills).