By Rob Stein
Washington Post Staff Writer
Thursday, December 6, 2007
After falling steadily for more than a decade, the birth rate for American teenagers jumped last year, federal health officials reported yesterday, a sharp reversal in what has been one of the nation's most celebrated social and public health successes.
The birth rate rose by 3 percent between 2005 and 2006 among 15-to-19-year-old girls, after plummeting 34 percent between 1991 and 2005, the National Center for Health Statistics reported.
"This is concerning," said Stephanie J. Ventura, who heads the center's reproductive statistics branch. "It represents an interruption of 14 years of steady decline. Now unexpectedly we have an increase of 3 percent, which is a significant increase."
Ventura said it is too soon to know whether the increase was an aberration or the beginning of a trend. But she said the magnitude of the rise, especially after many years of decline, is worrisome.
"This early warning should put people on alert to look at the programs that are being used to see what works," Ventura said.
While experts said it was unclear what may be causing the reversal, the new data reignited debate about abstinence-only sex-education programs, which receive about $176 million a year in federal funding. Congress is currently debating whether to increase that by $28 million.
"The United States is facing a teen-pregnancy health-care crisis, and the national policy of abstinence-only programs just isn't working," said Cecile Richard, president of the Planned Parenthood Federation of America. "It is time for everyone who cares about teenagers to start focusing on the common-sense solutions that will help solve this problem."
But proponents of abstinence education defended the programs, blaming the rise on the ineffectiveness of conventional sex-education programs that focus on condom use and other contraceptives, as well as the pervasive depiction of sexuality in the culture.
"This shows that the contraceptive message that kids are getting is failing," said Leslee Unruh of the Abstinence Clearinghouse. "The contraceptive-only message is treating the symptom, not the cause. You need to teach about relationships. If you look at what kids have to digest on a daily basis, you have adults teaching kids about the pleasures of sex but not about the responsibilities that go with it."
Other experts said many factors could be playing a role. It could be, for example, that complacency has set in, or that the increase reflects of a broader trend cutting across all ages. Birth rates have also increased for women in their 20s, 30s and early 40s.
The teen birth rate rose sharply between 1986 and 1991, when it hit an all-time high of 61.8 births per 1,000 girls. The increase led to a massive campaign to counter the trend, and the rates of both teenage sexual activity and teen births began falling steadily every year. Locally, teen birth rates followed that trend, plummeting between the 1990s and 2005.
This summer, however, the federal Centers for Disease Control and Prevention reported that the long decline in teenage sexual activity appeared to have stalled nationally, raising fears that it could presage an increase in teen births.
The most recent data come from birth certificates nationwide. While the birth rate among 10-to-14-year-old girls continued to fall, the rate for those ages 15 to 19 increased from 40.5 per 1,000 girls to 41.9 births per 1,000 in 2006. [Read the Full Report]
"It's a pretty astounding increase," John Santelli, who studies teen health issues at Columbia University. "It's really a sea change, since it's been going down and getting better for so long."
Advocates noted that despite the 14-year decline, U.S. teens are still far more likely to get pregnant and have children than those in other developed countries, and teenage mothers and their children are far more likely to live in poverty.
"The vast majority of teenage mothers never finish high school," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Teen pregnancy and child care is directly related to poverty, both for the mother and the child. This should be a wake-up call for a renewed focus on preventing teen pregnancy."
The increase was greatest among black teens, whose birth rate rose 5 percent between 2005 and 2006, reaching 63.7 per 1,000 teens. That was particularly disappointing because black teens had previously made the greatest gains, with the rate among 15-to-17-year-olds dropping by more than half.
"There had been dramatic, dramatic improvement in that community," Brown said. "All of us had hoped it would continue to decline."
The rate rose 2 percent, to 83 births per 1,000, for Hispanic teens, and 3 percent, to 26.6 per 1,000, for white teens.
The report did not include the latest rates for individual states or the District.
Federal officials also reported other disturbing trends, including a continued increase in the rate of babies being born preterm and underweight, as well as another increase in the rate at which babies were born by Caesarean section, which reached an all-time high.
"These are all trends we'd like to reverse," Ventura said.