By Rob Stein and Donna St. George
Washington Post Staff Writers
Thursday, March 19, 2009
The rate at which teenage girls in the United States are having babies has risen for a second year in a row, government statistics show, putting one of the nation's most successful social and public health campaigns in jeopardy.
Teen births in the District, Maryland and Virginia mirror the national trend, the numbers show, and local health experts say they are alarmed by the shift.
Nationally, the birthrate among 15-to-19-year-olds rose 1.4 percent from 2006 to 2007, continuing a climb that began a year earlier. The rate jumped 3.4 percent from 2005 to 2006, reversing what had been a 14-year decline.
Although researchers will have to wait at least another year to see whether a clear trend emerges, the two consecutive increases signal that the long national campaign to reduce teen pregnancies may have stalled or even reversed.
"We've now had two years of increases," said Stephanie J. Ventura of the National Center for Health Statistics, which issued the report yesterday. "We may have reached a tipping point. It's hard to know where it's going to go from here."
The reasons for the increase remain unclear, although experts speculated that it could be a result of growing complacency about AIDS and teen pregnancy, among other factors. The rise may also reflect a broader trend that affects all age groups, because birthrates have also increased among women in their 20s, 30s and 40s and older unmarried women.
The increase raised concerns across the ideological spectrum and fueled an intense debate over federal funding for sex-education programs that focus on encouraging abstinence until marriage. Opponents and proponents are girding for a new round in the battle over funding of abstinence education when President Obama reveals within weeks whether he will seek to continue or cut that funding.
"This is certainly not the time to remove any strategy that is going to provide skills for teens to avoid sex," said Valerie Huber of the National Abstinence Education Association.
But opponents said the findings provide new evidence that the approach is ineffective and that the money should be shifted to programs that include educating young people about contraceptives -- efforts that have been shown to be highly effective.
"The United States can no longer afford to fund failed abstinence-only programs," said James Wagoner of the group Advocates for Youth.
Abstinence programs had been receiving about $176 million in federal funding each year, but Congress cut about $14 million from the current budget.
White House spokesman Reid H. Cherlin called the new numbers "highly troubling."
"President Obama is committed to reducing the number of unintended pregnancies in this country, and we are reviewing these programs as part of the budget process," he said. "The president has supported abstinence programs if they are part of a comprehensive, age-appropriate and evidence-based effort to reduce teenage pregnancy."
The teen birthrate rose sharply from 1986 to 1991, leading to a widespread campaign that caused teenage sexual activity and births to decrease. But a long decline in teenage sexual activity appeared to level off in 2001, and teen births increased in 2005. Experts were uncertain, however, whether the rise represented a one-year aberration or the beginning of a trend.
The latest data, from an annual analysis of birth certificates nationwide, found that while the birthrate among girls ages 10 to 14 remained unchanged, the overall rate for those ages 15 to 19 rose again, from 41.9 births per 1,000 to 42.5.
Locally, the percentage of all births among teenagers in the District increased from 12 percent to 12.1 percent, while the rate in Maryland increased from 8.8 percent to 8.9 percent. It remained unchanged in Virginia at 8.6 percent.
"This should make everyone redouble their efforts on prevention," said Brenda Rhodes Miller, executive director of the DC Campaign to Prevent Teen Pregnancy. "It's troubling after so many years of seeing the numbers decline to see the numbers increase."
India Stevens, who was 16 when she had her daughter in December, said she had always planned on waiting to become a mother until she had a stable job. But she found out she was pregnant as a sophomore at Bell Multicultural High School.
"I was shocked," said Stevens, who lives in Northwest and has two friends who have been pregnant. She said she took a health class in school that included some discussion about contraception and abstinence.
"We went over it, but it wasn't anything in depth," said Stevens, who thinks that teenagers should talk more to their parents about sex and that there should be more education about contraception and abstinence.
"It's good to wait, but if it happens you should just roll with it," she said.
While the national increase from 2005 to 2006 occurred across all ethnic groups, the trends between 2006 and 2007 were not uniform. The birthrate increased 2 percent among whites and Asians and 1 percent among blacks, but it decreased 2 percent among Hispanics.
The mixed statistics and modest increase raised the odds that the two years of increases could be a statistical blip, Ventura said. But other experts said the two-year data probably represent a trend and fit with other research showing a stall in the long drop in sexual activity among teenagers, as well as a decrease in condom use.
"I think it's a real trend," said John S. Santelli of Columbia University, who studies teenage sexual behavior. "It's a huge disappointment and a huge failure in public policy to see this reverse itself."
Experts noted that the U.S. rate remains far higher than that of other industrialized nations.
"This is deeply disturbing," said Sarah S. Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "It should be a wake-up call."
One contributing problem may be teenagers having repeat pregnancies, said Margaret Rodan of Georgetown University, who directs the research project GirlTalk, which tracks first-time teenage mothers and pairs them with counselors who help them set goals, do better in school and space their next pregnancy.
"We have seen in the past that if you have a first pregnancy at 14, the likelihood of having a second pregnancy at 16 or 17 is very high," said Davene White, director of a program at Howard University Hospital that provides support services for maternal and child health.
Yasmin Herrera, 19, said she learned a month ago that she is pregnant with her second child, at a time when she had a new prescription for birth-control patches but not enough money to fill it. She and her boyfriend live together in Hyattsville with his family and their first child, who is 3.
"We were planning some other things we wanted to do," she said. But she said that they adjusted to the news without a problem. "I just look at it as a part of life."
The economy also may be at work in the rise in teen births, said Lee Beers, director of the Healthy Generations Program at Children's National Medical Center.
"Teen pregnancy is not an issue in isolation," she said. When families are stressed by economic forces, parental communication and supervision may decline, which in turn may have an effect, she said.