Teen Pregnancy and Inequality

Young mothers fall into cycles of poverty, making it difficult for their children to achieve the American Dream

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17 teenagers out of every 1,000 is a teen mom in America. The developed countries with levels most similar to this are Hungary, Russia, Slovakia, and Turkey. Just 10 years ago, this number was twice as high, making the US the worst country among developed nations for teenage pregnancies. While this decline is incredible, the US still has a long way to go before it can catch Korea, Switzerland, Denmark, or the Netherlands. 

Fortunately, teen births have been declining in America. In 2018, the teen pregnancy rate was less than half of what it had been in 2008 (41.5 births per 1,000). The CDC explains: “Although reasons for the declines are not totally clear, evidence suggests these declines are due to more teens abstaining from sexual activity, and more teens who are sexually active using birth control than in previous years.” Most interestingly, a 2014 Brookings report found that reality TV shows like 16 and Pregnant and Teen Mom may have contributed to up to a third of the decline in teen births from June 2009 (when they began airing) through the end of 2010. 

Benson county, North Dakota has the highest rate of teen pregnancy in America. 91% of all women aged 15–19 in Benson become teen mothers. The men in Benson earn $65,000 on average while the women earn $47,000. 

Hunterdon, New Jersey, on the other hand, has the lowest rates of teenage pregnancy in America. 2.2% of all women aged 15–19 in Hunterdon become teen moms. New Jersey has one of the best sex education programs in America, with teachers required to complete 100 hours of training over a 5-year period on how to teach sex ed, though the Department of Education has received some flack for its program to stress abstinence as a form of teen pregnancy prevention.

When Natasha Vianna got pregnant with her son at age 17, everything got harder. Her parents kicked her out of the house, stopped paying her school tuition (she was at a Catholic school at the time), and after she told her school nurse about the pregnancy, her entire school knew within days. She went into her high school advisor’s office to discuss college prospects and was promptly told, “It’s unlikely you’ll even graduate, so let’s just focus on finishing high school.” But Natasha beat the odds — now 33, she gave a TedTalk in 2014 and worked with Boston politicians to revise and implement a new policy for parenting students that has been very successful.

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Poverty

Teen pregnancy and child poverty are deeply intertwined. Data from all US counties reveals a 73% correlation between teen pregnancy rates and child poverty rates. 67% of teenage mothers who don’t live with their parents live in poverty. 

Education

Only 40% of teenage mothers will graduate high school (compared to 90% who don’t become mothers), and fewer than 2% will graduate college by the age of 30. On top of this, children of teenage mothers are also much less likely to acquire basic literacy skills needed to perform well in schools. 

Race

The connections between race and teenage pregnancy are complex. Unfortunately in America, Black and Latinx communities tend to have lower incomes, meaning they often have fewer health resources. We systematically fail these communities, which tends to drive up teenage pregnancy rates when access to contraception, abortions, or commonsense sex education is out of reach.

The map at the top also shows a clear trend in the southern border of Texas, which is home to many Latinx families, and along the Mississippi river, which is home to many Black families. Although these two groups have seen tremendous declines in teen pregnancy in the last decade, birth rates still remain high, at more than double White teen pregnancy rates. 

Intergenerational challenges

The child of a teen mother is also more likely to become a teen mother herself. While teen pregnancy is not genetic, it can be hereditary. As The Atlantic explains, “The child of a teen mom is bound to inherit the circumstances — poverty, familial instability — that potentially contributed to the pregnancy in the first place… By the time the children of teen moms start school, many are already at a disadvantage relative to their peers.”

The Role of Society

Most religions have something to say about birth and childbearing. States where half of residents say that religion plays an “important part” in their life are also the places where the teenage birth rates are highest — a rate of 25 teenage moms per 1,000 teenage women. This relationship becomes particularly acute when we layer in poverty rates for those mothers. Religious regions thus tend to have higher teenage pregnancy rates.

We cannot talk about teenage pregnancy and religion without also talking about abortion. The US abortion rate is now at its lowest levels in the last 30 years at the same time as teenage pregnancies are also at their lowest levels. Most researchers contend that the declining abortion rate is not, in fact, due to increased state restrictions on abortion, but instead is in part due to increased availability of contraceptives as well as increased sex education. 

The alternative to abortion that many major religions have put forth is abstinence. However, a 2005 study found a positive correlation between teen pregnancy rates and abstinence-only education. The stricter the abstinence-only curricula was in these states (as mandated by state law), the higher the teenage pregnancy rate was. Hunterdon, NJ as noted above has figured out how to teach sex education in a way that reverses this relationship.

Social institutions play a huge role in determining whether a community will tend towards equality or inequality. Religious institutions in particular have a long history of being some of our most powerful forces for creating social change — from Martin Luther King’s Ebenezer Baptist Church to Jerry Falwell’s Moral Majority. Though he is probably the furthest thing from a teenage mother, President Joe Biden will be quick to tell you about the confounding challenges of faith, abortion, and family. Nevertheless, choice, safety, and education are critical factors when looking at the challenges facing teenage mothers. 

The Path Forward

One of my favorite quotes from Tim Geithner, former Treasury Secretary, is this: “Condoms don’t cause sex.” 

Improving access to contraceptives, helping young people get the healthcare they need, and talking about safe sex won’t cause teenage pregnancy. We need a path forward if we are going to reduce these inequalities. 

Improve Contraceptive Access and Use — Several studies have shown that around the world, “declines in teen pregnancy risk [are] entirely driven by improved contraceptive use.” This improved contraceptive use accounted for the entire 28% decline in teen pregnancy risk between 2007 and 2012 in the US. This means funding Planned Parenthood through donations and continued reimbursements through Medicaid and reestablishing parts of Title X that were slashed under President Trump.

Permit SBHCs to offer LARCs — School Based Health Centers (SBHCs) should be allowed to offer Long Acting Reversible Contraception (LARCs), like IUDs, to young adults in need. The country’s 2,000 SBHCs are mostly located in urban areas and are basically school health clinics located on site with a focus on preventative care. While SBHCs have proven to increase academic performance by improving student health, they have come under fire because they also offer IUDs. In 2014, the American Academy of Pediatrics recommended LARCs as the first line of defense in preventing teen pregnancy. SBHCs tend to support low-income and underinsured populations, and increasing their reach across the US has shown in some cases to decrease teenage pregnancy in by 40%

Promote sex education at home and in schools — In the Netherlands, sex education starts at an early age, coming from both teachers and parents. This early intervention has proven to give Netherlands one of the lowest teenage pregnancy rates in the world, lowest abortion rates, and lowest HIV prevalence rates. France has mandatory sex education which has resulted in a teenage pregnancy rate that is 3.5x lower than that of the US. American parents can learn from their peers abroad about how to have “the talk” to reduce teenage pregnancies. This type of comprehensive sex education from both teachers and parents about a range of healthy options can reduce teenage pregnancy rates by half

No One Size Fits All

Her grandmother was a teenage mother. Her mother was a teenage mother. And like the two generations of women before her, Rosemary Oglesby-Henry was a teenage mother. But she graduated from high school as a young mom, working for a steady income since she was 15. She took jobs where she experienced discrimination and sexual harassment, but she continued to work there because it “gave me the opportunity to give my kids a life that was different from my own.” Rosemary (who prefers to go by Rosie) knew the challenges that teenage mothers face, and she knew that the odds were stacked against her. So she founded a nonprofit to help teenage mothers break the cycle and to reduce child poverty across America.

The World Health Organization has found that one single intervention rarely works alone — “single interventions were not found to be effective.” But instead “combined interventions (such as education and contraceptive promotion) can play a key role in reducing unintended pregnancies among adolescents.” If the US wants to reduce teen pregnancies and match its peers, it will take a village.