Contact Name
Barbara Dietsch
562-985-9488

Contact Email
bdietsc@WestEd.org

Susan K. Flinn, M.A.,
Debra Hauser, M.P.H.,
Sue Alford, M.L.S.
Advocates for Youth

An Analysis Of Recent Trends & Federal Expenditures Associated With Teenage Pregnancy

Recent declines in teen sexual activity and increases in contraceptive use by sexually active teens have resulted in reduced rates of teenage pregnancy and births. Nevertheless, the United States continues to exhibit the highest rate of adolescent births in the industrialized world as well as a rate higher than those in at least 46 developing nations.

The social and economic consequences of too-early childbearing for teens and their children can be grave and long-lasting. The public costs associated with teenage pregnancy also are great. Advocates for Youth estimates that, in fiscal year 1995 (FY95) alone, the federal government spent over $39.3 billion to help families that began with a teenage birth.

Increased public commitment to prevention is clearly warranted. In FY95, the federal government allocated less than one-fifth of $1 billion ($131 million) for teen pregnancy prevention. This was three hundred times less than the amount of expenditures to support families begun by a teenage birth. It is unquestionably important that the United States government continues to help young families, but the nation must also reduce the number of adolescents who will require this support in the future, by increasing investment in pregnancy prevention. For example, in 1996 the Alan Guttmacher Institute estimated that publicly subsidized contraceptive services annually avert 385,800 teen pregnancies, consequently preventing 154,700 teen births and 183,300 abortions. For every dollar invested in publicly subsidized contraceptive services, U.S. taxpayers save $3.00 in Medicaid costs for pregnancy and neonatal related health care alone. Just as important, 385,800 fewer teenage women suffer the emotional, social, and economic consequences of an unwanted pregnancy.

Tragically, current levels of pregnancy prevention funding are insufficient to sustain recent declines in teenage pregnancy rates. Experts project that, by the year 2005, 13 percent more young people ages 10 through 19 will live in the United States than did in 1995. Higher levels of prevention investment will be necessary simply to sustain current teenage pregnancy rates.

Investments in pregnancy prevention must be made wisely. Returns on prevention investments are maximized when prevention dollars are allocated to the most effective and promising approaches. Research indicates that comprehensive sexuality education, including information on both abstinence and contraception, can delay the onset of sexual activity and increase contraceptive use by sexually active teens. Contraceptive availability programs, such as family planning clinics and condom availability projects, can also reduce risky adolescent sexual behavior. Youth development programs, which motivate teens to avoid pregnancy by helping them develop their skills and abilities, are particularly effective for young people at high risk for too-early childbearing.

In 1996, Congress enacted welfare reform legislation, Public Law 104-193, which allocated $50 million each year for five years to fund abstinence-until-marriage education - education that withholds information about contraception. Unfortunately, there is no evidence that abstinence-until-marriage education effectively reduces adolescent pregnancy or rates of sexual activity or promotes long-term changes in attitudes among young people. If the abstinence-until-marriage education funds were invested instead in adolescent contraceptive services, the savings would be at least three-fold in averted Medicaid expenses for pregnancy and neonatal-related care.

Congressional funding of ineffective pregnancy prevention strategies may reflect discomfort with adolescent sexuality and with sexually active youth, and it ignores the more pragmatic attitudes of the American public which overwhelmingly wants youth to have information on both abstinence and contraception. Pragmatic adults are aware that by age 19, over 80 percent of teens have had sexual intercourse. Yet, Congress continues to allocate precious prevention dollars to programs that withhold vital information about contraception and disease prevention.

Public policy in other industrialized countries reflects a commitment to helping sexually active teens avoid sexually transmitted diseases and unplanned pregnancy. In Sweden and the Netherlands, for example, investments to increase access to sexuality education and contraceptive services have helped sustain a teen birth rate that is almost eight times lower than that of the United States. These findings indicate that the U.S. should:

• Embrace a pragmatic approach. Reduce the costs of teenage pregnancy by investing in effective prevention. Limiting federal support for families begun by a teen birth places both the teen and her child at great risk.

• Invest wisely. Prevention funding should be allocated to scientifically evaluated, effective strategies which help teens delay sexual intercourse and increase their use of contraception when they become sexually active. A growing body of evidence indicates that comprehensive sexuality education, contraceptive services, parent-child communication education, and youth development programs are the wisest prevention investment.

The complete report of this analysis is available from Advocates for Youth, 1025 Vermont Ave., NW, Suite 200, Washington, DC 20005.