Fewer teens are having babies in the United States -- but not few enough, according to a report from the Centers for Disease Control and Prevention. Although teen births dropped 37 percent nationwide over the last two decades to an all-time low in 2009, the rate is still 9 times higher than in other developed countries.
"Though we have made progress in reducing teen pregnancy over the past 20 years, still far too many teens are having babies," CDC director Dr. Thomas R. Frieden said in a statement. "Preventing teen pregnancy can protect the health and quality of life of teenagers, their children, and their families throughout the United States."
Despite the plunge, roughly 410,000 teen girls gave birth in 2009 at an estimated cost of $9 billion to U.S. taxpayers, according to the report.
"I don't think teens really understand the cost," said Dr. Amy Thompson, an assistant professor of obstetrics and gynecology specializing in teen pregnancy at the University of Cincinnati. "Many are enrolled in the Medicaid and WIC [Women, Infants and Children] programs to help them during pregnancy. But teen pregnancy is associated with poor high school performance or dropout and decreased earnings later on in life."
Only half of teen moms earn a high school diploma by age 22 compared with 90 percent of teens who don't have children, according to the report.
Black and Hispanic teens are 2 to 3 times more likely to give birth than white teens, according to the report. And girls born to teen parents are nearly 33 percent more likely to become teen moms themselves.
Thompson said the higher rates for blacks and Hispanics could reflect lack of access to care or cultural issues.
"We don't know if there are other socioeconomic factors at play here. Are they less likely to talk to their parents about sex? Or if they do, are the next steps taken? Do the parents say, 'OK, let's get you on birth control'?"
Numbers Moving in Right Direction
The report suggests fewer high school students are having sex (46 percent compared with 54 percent in 1991), and more of them are using at least one method of birth control (12 percent reported not using contraception compared with 16 percent in 1991).
"Even though we are making process, there's still work to do," Thompson said.
Thompson said she often sees teen moms who are pregnant again, which means they have had access to a doctor and likely had been educated about birth control.
"I think that speaks more to having them use [long-acting reversible contraceptives]," Thompson said, referring to contraceptive implants like intrauterine devices. "Those would provide really good birth control as opposed to birth control pills."
Education is Key
The report highlights the importance of sex and birth control education -- a curriculum that varies widely between states.
"I think we definitely need a more formal approach to how we implement education strategies, whether they're for parents or in the school system," Thompson said.
Between 2006 and 2008, 65 percent of teen girls and 53 percent of teen boys learned about abstinence and birth control during formal sex education. Fewer had spoken to their parents about sex.
Based on teen birth rates in individual states, school systems in the Northeast and upper Midwest may be doing a better job at educating than those in the South, Thompson said.
We need to look at what they're doing there and implement those strategies in other states," Thompson said. "However, this is a very charged issue. And in the face of school budget cuts, it's a challenge for many school systems."