Less Sex, More Education Behind Falling Teen Birth Rates
(January 2000) After rising sharply between 1986 and 1991, the teenage birth rate continued its decline for the seventh year in a row in 1998. Two recent surveys of teens supported by the National Institute of Child Health and Human Development (NICHD) suggest that this much heralded good news may be linked to:
- a decrease in sexual activity
- an increase in the use of condoms and injectable contraceptives that offset a decline in pill use
- the impact of AIDS prevention education
- declining approval among teens of premarital sex.
Source: NSAM and NSFG.
The decline in births to teens is not linked to an increase in abortion; in fact, abortion rates for teens have been declining since 1988.
The National Survey of Family Growth (NSFG) reported that the percentage of teenage women who had sexual intercourse in 1995 leveled off and possibly declined for the first time after increasing steadily for more than two decades. It found that 50 percent of women ages 15 to 19 had ever had intercourse. A previous survey found that 53 percent of 15-to-19-year-old women had ever had intercourse in 1988, an increase from 47 percent in 1982. Earlier surveys found the percentages to be 36 percent in 1975 and 29 percent in 1970.
The National Survey of Adolescent Males (NSAM), carried out by The Urban Institute, confirmed a similar trend for teenage men. The percentage of never-married men ages 15 to 19 who have ever had sexual intercourse declined from 60 percent in 1988 to 55 percent in 1995, reversing a trend measured since 1979.
The share of sexually active teens not currently using contraception remained relatively stable, according to the surveys. The NSFG documented that 7 percent of sexually active teenage women ages 15 to 19 were not using a contraceptive method in 1995, compared with 8 percent in 1988. On a related measure, the NSAM found that the share of 15-to-19-year-old men who reported that neither they nor their partner had used a condom or a female contraceptive method at their last intercourse had changed little: 20 percent in 1995 compared with 23 percent in 1998.
However, both surveys found large increases in the use of contraceptives at the time of first intercourse. Among women of all ages, some 76 percent of all those who began having intercourse in the 1990s used contraception at first intercourse, up from 64 percent in the late 1980s, according to the NSFG. The increase in contraception at first intercourse was a result of marked increases in condom use: from 18 percent in the 1970s to 36 percent in the late 1980s and 54 percent in the 1990s. Similar increases in the use of contraceptives by teenage males or their partners at the time of first intercourse were reported. Also, the NSAM found a growing share of men used condoms consistently; 45 percent of men ages 15 to 19 reported always using condoms in 1995, up from 33 percent in 1988.
More recent findings reported from the Youth Risk Behavior Surveillance Survey, conducted by the Centers for Disease Control and Prevention, confirm the results of the two NICHD-supported studies. The new survey shows that among teenagers attending school, sexual activity declined and condom use increased in the 1990s through 1997.
Getting the Message on Safe Sex
These increases in condom use during the 1980s and early 1990s may be related to another finding of both NICHD-supported surveys: near universal HIV prevention education. The NSFG found that 90 percent of women ages 18 to 19 reported having received formal instruction on sexually transmitted diseases, safe sex to prevent HIV, and how to say no to sex. Similarly, the NSAM reported that in 1995 for males living in metropolitan areas ages 17 to 19 virtually all had received HIV prevention education (96 percent) and most also received information about birth control (87 percent) and sexually transmitted diseases (88 percent).
Along with increases in condom use, the NSFG found a drop in pill use by teens using contraception, from 59 percent in 1998 to 44 percent by 1995. Implant and injectable contraceptives appear to have partially offset the decline in pill use among teen women. These longer lasting methods are more effective than oral contraceptives for preventing pregnancy, so even small increases in their use can have an important impact on pregnancy rates. The use of implants or injectable contraceptives, which were unavailable in 1988, rose to 3 percent among non-Hispanic white teen contraceptive users and to 8 percent among black teens by 1995.
The decline in teen birth rates cannot be linked to any one factor. Changes in sexual activity and increases in condom and injectable contraceptive use played different roles for different groups of teens. For teens who had already given birth, the increased use of injectable contraceptives and, to a lesser extent, implants, appear to have played the largest role. For black teens, increases in condom use were also an important factor, while changes in sexual activity may have been more important for white teens.
Another finding of the NSAM may explain the drop in sexual activity among teen males: The survey found growing disapproval of premarital sex among teenage males, reversing a steep increase between the late 1970s and 1980s. The share of men ages 17 to 19 living in metropolitan areas who approved of premarital sex when the couple did not intend to marry dropped from 80 percent in 1988 to 71 percent in 1995.
The NSAM also found that receiving AIDS prevention education was linked to lower levels of sexual activity, which suggests that education on safe sex and condom use did not lead to more sexual activity. Young men who said that religion was important to them were more likely to disapprove of premarital sex in 1995 than in 1988, suggesting that the abstinence programs promoted by religious groups may also have had an impact.