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Teenage Pregnancy and Birth Rates -- United States, 1990

In 1990, there were an estimated 1 million pregnancies and 521,626 births to U.S. women aged 15-19 years (1). Because of the adverse health, social, and economic consequences of teenage childbearing, CDC analyzed data on teenage pregnancies and births (1,2). These data will be used to monitor progress toward national goals and to assist in targeting program efforts to reduce teenage pregnancy (2). This report presents pregnancy and birth rates for states by race/ethnicity for 1990 and compares rates with those for 1980 (3).

For this report, teenage pregnancy rates were defined as the sum of live births and legal induced abortions per 1000 women aged 15-19 years. Teenage birth rates were defined as the number of live births per 1000 women in the age group, and abortion rates, as the number of legal induced abortions per 1000 women. Information on births was obtained from 1990 birth certificates, and on abortions, from state reports to CDC. Births were reported by state of residence, and abortions, by state of occurrence. Numbers of women aged 15-19 years were obtained from unpublished tabulations provided by the U.S. Bureau of the Census. Because the numbers of abortions by age of women were not available for 10 states, pregnancy rates for women aged 15-19 years could be calculated for only 40 states and the District of Columbia (DC); birth rates were calculated for all 50 states and DC. For this analysis, pregnancy and birth rates were calculated for white, black, and Hispanic women (pregnancy rates were calculated only for the 30 states where information on abortions was available by race and ethnicity of women) *; rates for other racial/ethnic groups were not calculated because the numbers of pregnancies and births for other groups were too small at the state level to compute reliable rates. In addition, abortion data were not available for other racial/ethnic groups. Differences in rates for 1980 and 1990 are statistically significant at the 0.05 level.

During 1990, pregnancy rates ranged from 56.4 per 1000 women aged 15-19 years (North Dakota) to 110.6 per 1000 (Georgia) **; birth rates ranged from 33.0 per 1000 women (New Hampshire) to 81.0 per 1000 (Mississippi) (Table_1).

Pregnancy and birth rates were generally higher for blacks than for Hispanics and whites (Table_1), although these rates could not be adjusted for socioeconomic or educational status of mothers. For blacks, in the 24 states for which rates could be calculated, pregnancy rates ranged from 103.9 per 1000 (West Virginia) to 217.9 per 1000 (Minnesota); for Hispanics (20 states), rates ranged from 56.2 per 1000 (Tennessee) to 142.1 per 1000 (Arizona); and for whites, (30 states) pregnancy rates ranged from 46.0 per 1000 (South Dakota) to 105.6 per 1000 (Nevada).

From 1980 to 1990, pregnancy rates declined significantly in 21 of the 40 states and in DC (Figure_1). However, rates in 14 of these 21 states decreased less than 10%. During the decade, pregnancy rates significantly increased in 12 states, and six states reported increases of more than 10%.

From 1980 to 1990, significant declines in abortion rates occurred in 26 of the 40 states and in DC. In 23 of these, the declines were more than 10%; 15 reported decreases of more than 20%. Abortion rates significantly increased in eight states; in five, increases were more than 10%.

In most states, birth rates increased from 1980 to 1990 because declines in abortion rates generally exceeded those of pregnancy rates. Birth rates significantly declined in 13 states ***; in eight of these states, the decrease was more than 10%. In contrast, birth rates increased significantly in 29 states and in DC.**** Rates in 20 areas increased more than 10%; of these, rates in nine increased more than 20%. Reported by: Behavioral Epidemiology and Demographic Research Br, Statistics and Computer Resources Br, Women's Health and Fertility Br, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion; Natality, Marriage, and Divorce Statistics Br, Div of Vital Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note: Despite national goals to reduce teenage pregnancy in the United States (2), pregnancy and birth rates in the United States in 1990 exceeded those in most developed countries (Alan Guttmacher Institute, unpublished data, 1988; 4). Small declines in pregnancy and birth rates during the early 1980s subsequently reversed, resulting in little net change in the U.S. teenage pregnancy rate over the decade (1,5). From 1986 through 1990, the U.S. birth rate increased nearly 20%, suggesting that a larger proportion of teenage pregnancies resulted in live births (1,6). Other factors that may have affected pregnancy and birth rates included trends in sexual experience among teenagers and variations in the accessibility and use of family-planning and abortion services.

In 1990, teenage pregnancy rates in 10 states could not be calculated because those states did not collect data on the age of women obtaining abortions. However, these 10 states accounted for approximately 39% of all U.S. abortions in 1990. Births alone cannot be used as a surrogate for monitoring overall pregnancies. Because so many teenage pregnancies end in abortion and the rates vary widely by state, states that fail to collect abortion data by age will be unable to adequately monitor their trends in teenage pregnancy.

Differences in teenage pregnancy and birth rates by race/ethnicity may reflect differences in factors such as socioeconomic status, access to family-planning and abortion services, and the use of contraception. For example, during 1983- 1988, Hispanic and black women were less likely to use contraception during their first reported premarital sexual intercourse than were white women (32% and 58% versus 70%) (7).

The personal and societal impact of teenage pregnancy in the United States is enormous; an estimated 84% of teenage pregnancies are unintended (i.e., they occur sooner than desired or are not wanted at any time) (2). From 1985 through 1990, the public costs (e.g., Aid to Families with Dependent Children, Medicaid, and food stamps) related to teenage childbearing totaled $120.3 billion (8). Of this amount, an estimated $48.1 billion could have been saved if each birth had been postponed until the mother was at least 20 years old. For every public dollar spent on family-planning services for all women, an average of $4.40 is saved by averting expenditures on medical services, welfare, and nutritional services (9).

More than 70 national health and social welfare organizations support age-appropriate comprehensive school health-education programs to reduce teenage pregnancy (10). These programs counsel abstinence as well as provide teenagers with the knowledge and skills they need to avoid unplanned pregnancy. In addition to health education efforts, family-planning services for sexually active teenagers are essential for reducing teenage pregnancy.

References

  1. NCHS. Advance report of final natality statistics, 1990. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1993. (Monthly vital statistics report; vol 41, no. 9, suppl).

  2. NCHS. Health, United States, 1992. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1993.

  3. CDC. Teenage pregnancy and fertility in the United States: 1970, 1974, and 1980: regional and state variations and unintended fertility. Atlanta: US Department of Health and Human Services, Public Health Service, 1987.

  4. United Nations. 1990 Demographic yearbook. New York: United Nations, Department of International Economic and Social Affairs, Statistical Office, 1992 (no. 42).

  5. Ventura SJ, Taffel SM, Mosher WD, Henshaw S. Trends in pregnancies and pregnancy rates, United States, 1980-88. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1993. (Monthly vital statistics report; vol 41, no. 6, suppl).

  6. CDC. Abortion surveillance: preliminary data -- United States, 1990. MMWR 1992;41:936-8.

  7. Mosher WD, McNally JW. Contraceptive use at first premarital intercourse: United States, 1965-1988. Fam Plann Perspect 1991;23:108-16.

  8. Center for Population Options. Teenage pregnancy and too-early childbearing: public costs, personal consequences. 6th ed. Washington, DC: Center for Population Options, 1992.

  9. Forrest JD, Singh S. Public-sector savings resulting from expenditures for contraceptive services. Fam Plann Perspect 1990;22:6-15.

  10. The National Coalition to Support Sexuality Education. Fact sheet #2 on comprehensive sexuality education. The SIECUS Report 1992;20:22-3.

* Because of data-collection methods for 1990 abortions, Hispanic origin was not reported separately by race. Abortion data for Hispanics were included with whites for pregnancy rate calculations because 97% of Hispanic women who had a live-born infant in 1990 were white (1). Six states (Kentucky, Louisiana, Maine, Maryland, North Carolina, and South Dakota) did not report Hispanic origin. 

** DC is not included in these comparisons because its pregnancy and abortion rates were higher than for any state, in part because of large numbers of abortions among nonresidents. 

*** Idaho, Iowa, Kentucky, Maine, Mississippi, Nebraska, North Dakota, Oklahoma, South Dakota, Utah, Vermont, West Virginia, and Wyoming. 

**** Alabama, Arizona, Arkansas, California, Colorado, Connecticut, DC, Florida, Georgia, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, and Wisconsin.
Table_1
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TABLE 1. Pregnancy rates * and birth rates + for 15-19-year-olds, by race/ethnicity & and
state -- United States, 1990
============================================================================================================================
                                   Pregnancy rate                           Birth rate
                         ----------------------------------     -----------------------------------
State                    White @  Black    Hispanic   Total **  White    Black    Hispanic    Total **
------------------------------------------------------------------------------------------------------
Alabama                    ++       ++        ++        ++       55.3    105.3      33.8      71.0
Alaska                     ++       ++        ++        ++       53.8      &&        &&       65.3
Arizona                   96.3    147.7     142.1     100.3      72.3    115.1     123.3      75.5
Arkansas                  82.6    157.1       &&       98.3      66.2    131.9       &&       80.1
California                 ++       ++        ++        ++       73.9    101.0     112.3      70.6
Colorado                   @@       @@        @@       82.0      52.1    105.9     110.6      54.5
Connecticut                ++       ++        ++        ++       30.5    102.5     121.9      38.8
Delaware                   ++       ++        ++        ++       37.4    120.4       &&       54.5
District of Columbia       ++       ++        ++      252.0      11.8    121.4      88.7      93.1
Florida                    ++       ++        ++        ++       52.9    135.0      60.2      69.1

Georgia                   86.0    162.2      87.5     110.6      56.6    116.2      73.0      75.5
Hawaii                     @@       @@        @@       88.2      42.0      &&        &&       61.2
Idaho                     58.5      &&      126.0      58.8      50.3      &&      118.6      50.6
Illinois                   ++       ++        ++        ++       44.3    144.2      94.8      62.9
Indiana                   65.1    157.2      76.4      74.3      51.9    122.4      64.5      58.6
Iowa                       ++       ++        ++        ++       38.5    119.1      79.9      40.5
Kansas                    74.3    180.9      99.3      81.1      50.8    131.9      86.1      56.1
Kentucky                  84.1    163.6       ++       90.9      63.5    115.8       &&       67.6
Louisiana                 68.5    128.5 ***   ++       92.0      52.1    109.1      20.9      74.2
Maine                     67.5      &&        ++       68.3      42.7      &&        &&       43.0

Maryland                  61.1    141.2       ++       84.7      36.0     95.5      46.0      53.2
Massachusetts              ++       ++        ++       70.9      30.9     89.5     121.1      35.1
Michigan                   ++       ++        ++       85.1      43.1    131.1      94.4      59.0
Minnesota                 54.6    217.9      89.9      61.9      30.6    151.7      79.4      36.3
Mississippi               71.6    130.5       &&       97.8      55.5    112.7       &&       81.0
Missouri                  64.7    197.4      57.0      82.6      50.3    143.9      46.4      62.8
Montana                    @@       @@        @@       81.7      39.7      &&        &&       48.4
Nebraska                   ++       ++        ++       74.2      36.9    135.1      81.7      42.3
Nevada                   105.6    156.8     112.8     107.4      68.9    129.3     107.5      73.3
New Hampshire              ++       ++        ++        ++       33.1      &&       +++       33.0

New Jersey                52.6    181.3     114.9      75.3      28.1     99.6      79.9      40.5
New Mexico                99.5    115.5     122.1     100.4      75.6     94.6      96.9      78.2
New York                  74.6    162.4     134.3      92.4      36.7     75.6      81.6      43.6
North Carolina            84.9    155.1     106.1     105.8      52.0    106.6     106.1      67.6
North Dakota              50.4      &&        &&       56.4      29.2      &&        &&       35.4
Ohio                      58.2    162.7      81.5      73.2      47.7    129.4      73.9      57.9
Oklahoma                   ++       ++        ++        ++       60.2    116.0      +++       66.8
Oregon                    87.4    175.5     133.2      89.0      54.0    108.0     113.9      54.6
Pennsylvania               ++       ++        ++       74.6      35.1    124.8     126.1      44.9
Rhode Island              79.9    198.3     134.9      87.7      38.7    114.3     129.8      43.9

South Carolina            76.6    127.0      84.5      95.0      54.3    101.1      66.8      71.3
South Dakota              46.0      &&        ++       56.9      35.0      &&        &&       46.8
Tennessee                 86.0    165.1      56.2     101.8      60.3    121.3      40.9      72.3
Texas                     96.0    153.4     124.5     102.7      70.6    114.0     103.8      75.3
Utah                      62.0      &&      128.7      62.9      47.8      &&      115.0      48.5
Vermont                   72.4      &&        &&       72.1      34.3      &&        &&       34.0
Virginia                  70.2    148.8      74.4      86.4      41.1     98.5      55.5      52.9
Washington                 @@       @@        @@       95.4      52.2     94.3     113.4      53.1
West Virginia             66.4    103.9       &&       67.4      57.1     74.4       &&       57.3
Wisconsin                  ++       ++        ++       66.5      31.2    174.7      90.4      42.6
Wyoming                    ++       ++        ++       62.2      54.5      &&       94.2      56.3
------------------------------------------------------------------------------------------------------
  * The sum of live births and legal induced abortions per 1000 women aged 15-19 years.
  + Live births per 1000 women aged 15-19 years.
  & Persons of Hispanic origin may be of any race.
  @ For calculation of pregnancy rates, abortions by white race included women of Hispanic origin. Six states (Kentucky,
    Louisiana, Maine, Maryland, North Carolina, and South Dakota) did not report abortion data by Hispanic origin.
 ** Includes all racial/ethnic groups.
 ++ Because abortion data were not available, pregnancy rates could not be calculated.
 && Rates are not calculated for states with 20 or fewer births to women aged 15-19 years in 1990, or 1000 or fewer women
    aged 15-19 years in respective racial/ethnic group.
 @@ Rates not calculated because 15% or more of the abortions were to women of unknown race/ethnicity.
*** Abortions include all races other than white.
+++ Hispanic origin was not reported on the birth certificate.
============================================================================================================================


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