Teen Pregnancy

Abstract

Teen pregnancy and resulting births pose many individual and societal challenges, and as a result require the collective efforts of many to provide solutions. The economic costs of teens giving birth are significant, and there are many compelling reasons to reduce teen pregnancy rates. Research shows that reducing the number of births to teens and increasing the age at which a woman gives birth yields significant cost savings for the public sector. Efforts to reduce teen pregnancy are mainly focused on prevention, and sex education is a large part of the effort. Twenty-first-century sex education programs focus on two main strategies: abstinence-only education and abstinence-plus education. Abstinence-only teaches that abstaining from sexual activity is the only truly effective way to prevent unintended pregnancy; abstinence-only education offers little to no information about alternative methods of birth control and or safe-sex practices. Abstinence-plus education focuses on delaying the initiation of sexual activity and teaches various methods of contraception for teens who are sexually active. The success of abstinence-only education has been exaggerated according to many sociologists and researchers, and studies have found that abstinence-only programs are not effective at delaying the initiation of sexual activity or reducing teen pregnancy rates. Scientific research indicates that abstinence-plus education is much more effective in preventing teen pregnancy. The observed reduction in teen pregnancy rates has largely been due to increasing rates of contraceptive use. Most sociologists believe that reducing the rate of teen pregnancy requires developing more comprehensive and holistic solutions.

Overview

Teen pregnancy is regarded as an individual and societal problem that is most effectively dealt with through prevention strategies. However, some researchers argue that the discrepancies between the realities of teen pregnancy and the strategies for its prevention hinder the issue from being adequately addressed on a holistic level (Kohili & Nyberg, 1995). Cultural and political attitudes toward sexuality may also hinder the formulation of a concerted effort toward preventing teen pregnancy. Instead, policymakers, educators, researchers, and parents have generally focused on preventing teen pregnancy itself rather than on addressing the societal influences that may encourage teen pregnancy. Variables such as the age at which a teen first engages in sexual intercourse and the use or non-use of contraception can all predict the likelihood of a teen becoming pregnant. However, both of these variables are in turn influenced by a number of societal indicators such as peer pressure, pro-social values, parent-child communication, and self-esteem (Kohili & Nyberg, 1995). Risk factors for teen pregnancy include poverty, limited maternal educational achievement, having a mother who gave birth before the age of twenty, living in a home with high levels of family conflict, early sexual activity, and early use of alcohol and drugs.

Changes in the language associated with the issue illustrate significant shifts in the subjective perception of teen pregnancy throughout history (Luker, 1997). In the colonial era, women who gave birth outside of wedlock were called "fallen women" and considered to be sinners. Children born out of wedlock were called "bastards" or "illegitimate." The economic impact of these children and their mothers were a pressing social concern: without a husband's support, unwed mothers and their children might need to become wards of the state. During the Progressive era of the early 1900s, a more compassionate attitude toward unwed women and their children evolved. Unplanned pregnancies were no longer considered a moral or economic problem, but rather "a societal problem, an index of what was wrong with society" (Luker, 1997, p. 20). As a stigma was long associated with giving birth out of wedlock, the fear and shame that went along with bearing children outside of marriage kept the number of unmarried births low until relatively recent decades. In the 1990s, some sociologists considered that the stigma was largely gone, and that its disappearance had at least some relation to an increase in teen sexual activity and pregnancy (Kohili & Nyberg, 1995). In the early twenty-first century, sociologists and health care workers made efforts to further reduce the stigma associated with teen pregnancy because it impedes effective prenatal and postnatal care and compounds the challenges already facing teen mothers (Smith Battle, 2013).

After a significant rise in the late 1980s and early 1990s, the teen birth rate in the United States began steadily falling throughout the 2010s and 2020s. Teen pregnancy rates declined by 36 percent from 1990 to 2002 and by 33 percent among girls aged fifteen to nineteen from 1991 to 2004. The decline was particularly sharp beginning in the late 2000s. A Pew Research Center study found that from 2008 to 2018, teen births dropped by more than half, from 41.5 births per 1,000 girls and women to 17.4 (Livingston & Thomas, 2019). This trend continued in the 2020s until the rate hit a record low in 2021 at 13.9 births per 1,000 individuals. Between 2007 and 2021, however, the teen birth rate declined each year by around 8 percent, but the data for 2021 indicated a decrease of only 3 percent, a plateau in progress (Kekatos, 2023).

The Economic Cost of Teen Pregnancy. Despite drastic reductions, the teen pregnancy rate in the United States remains high compared to other Western industrialized nations, according to data from the United Nations. Children born to teens are more likely to have lower academic achievement and drop out of school, have more health problems, be arrested and/or incarcerated as a teenager, and be unemployed as an adult; mothers who give birth when they are teenagers are less likely to earn a high school diploma, resulting in less earnings over their lifetime due to reduced employment opportunities (Centers for Disease Control and Prevention, 2019). According to Haskins and Sawhill, "reversing the trend toward single-parent families would have an immediate effect in reducing poverty rates. But perhaps more important, it would also have a long-term effect on children's growth and development" (p. 4).

The age of a woman when she has her first child significantly impacts the public sector costs associated with the birth. The younger the mother is, the higher the net cost of the birth (Hoffman, 2006). A 2006 report, By the Numbers: The Public Costs of Teen Childbearing, and a 2013 report, Counting It Up: The Public Costs of Teen Childbearing (both released by the National Campaign to Prevent Teen and Unplanned Pregnancy, which changed its name to Power to Decide in 2017), attempted to calculate the relative costs associated with births to teens. The former report describes the methodology that both use:

The cost estimates provided in this report are based on a very conservative research approach that only includes costs that can be confidently attributed to teen childbearing itself rather than to other traits or disadvantages that often accompany teen childbearing (such as poverty) (Hoffman, 2006, p. 3).

By the Numbers calculated the costs in two areas: costs associated with the mother and her partner and costs associated with the children of teen mothers. Public-sector costs associated with teen mothers and partners are calculated primarily as loss of tax revenue due to lower lifetime earnings. Public-sector costs associated with children of teens include publicly provided health care, foster care, and child welfare services. The more indirect costs incurred by children who are born to teens often show up as incarceration costs and lost tax revenue due to the children's lower earnings (Hoffman, 2006).

Sociologists' goals in reviewing these net costs associated with teen births is to "make apparent the economic value of preventing early pregnancy" (Hoffman, 2006, p. 3). Delaying the age of first birth saves significant money in the public sector because teen parents frequently rely on social services for support and, over their lifetimes, pay lower taxes (Hoffman, 2006). The primary goal is to measure the costs that could be averted if mothers delay their first birth until their early twenties (Hoffman, 2006). The total cost estimated in 2013 was $9.4 billion, with an average annual cost to taxpayers of $1,682 per child until the age of fifteen.

Teen pregnancy declined by about one-third between 1991 and 2009, consequently reducing the number of children in poverty. By 2018, the rate of teen pregnancy was still declining and had reached a record low of 17.4 births per 1,000 teen girls between the ages of fifteen and nineteen. From its peak in 1991, the teen birth rate had declined by 72 percent (Power to Decide, 2021). Teen sexual activity and contraceptive use data suggested that existing policies and changes in culture produced these reductions (Haskins & Sawhill, 2007). Birth rates fell by 10 percent for mothers between the ages of fifteen and seventeen and by 6 percent for women aged eighteen to nineteen between 2016 and 2017 (Centers for Disease Control and Prevention, 2019). This trend continued in 2021 and 2022, as birth rates of those aged fifteen to seventeen declined from 5.6 to 5.5 per 1,000 girls, and those aged eighteen to nineteen from 26.6 to 25.6 per 1,000 (Kekatos, 2023).

Applications

Prevention Programs. Prevention of teen pregnancy through sex education has historically focused on two strategies—teaching teens abstinence-only, encouraging teens to delay sexual activity, and, if they do choose to become sexually active, to use contraception.

The effectiveness of abstinence-only programs has been largely debated. In 2001, the National Campaign to Prevent Teen Pregnancy published a study titled Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. The report, which reviewed a number of programs designed to reduce teen pregnancy by delaying the initiation of sex and increasing use of contraception, stated that "the evidence is not conclusive about the impact of abstinence-only programs," and that "there do not currently exist any abstinence-only programs with reasonably strong evidence that they delay the initiation of sex or reduce its frequency" (Kirby, 2002a, p. 8).

A year after Emerging Answers was published, Robert Rector, a senior research fellow at the Heritage Foundation, published The Effectiveness of Abstinence Education Programs in Reducing Sexual Activity among Youth. Rector's study pointed to ten studies of abstinence-only programs found to be effective in reducing teen pregnancy and concluded that "abstinence education programs for youth have been proven to be effective in reducing early sexual activity" (Rector, as quoted in Kirby, 2002b, p. 1).

The different conclusions reached by the two studies prompted sociologist Doug Kirby to embark on his own review of the ten studies from the Heritage study. Kirby teamed with the Effective Programs and Research Task Force (EPR) of the National Campaign to Prevent Teen Pregnancy to establish criteria by which research could be objectively reviewed. Kirby (2002b) and his team determined that for the programs to be considered scientifically valid, they needed to meet the following criteria:

• "The study must have used an appropriate and valid experimental or quasi-experimental design" (p. 2)
• "Post-intervention data must have been collected for a minimum number of months after the intervention"
• "Have a sample size of at least 100 and must measure actual behavior"
• "The study must have employed proper statistical analysis" (Kirby, 2002, p. 2)

These same criteria were used to determine if a study qualified for inclusion in Kirby's Emerging Answers report. Following these criteria outlined by Kirby, Mark and Wu conducted a quasi-experiment examining the success of abstinence-only sex education and federally funded comprehensive sex education—providing scientifically and medically accurate information to students concerning contraception options and reproductive health. Their findings support the use of comprehensive programs across cultures to reduce teen pregnancy (Mark & Wu, 2021).

Results and Validity of Abstinence-Only Research. According to Kirby, nine of the ten programs identified as "successful" by the Heritage study failed to provide "credible evidence" that the programs caused teens to delay sexual activity or reduce their sexual activity (Kirby, 2002b). Further, Kirby argued that the ten studies in the Heritage report were not representative of all the studies on abstinence-only programs. Rather, he claimed, they were selected because they showed positive outcomes, whereas many other studies were inconclusive or showed negative outcomes (Kirby, 2002b). Kirby concluded that, "It seems likely . . . that sooner or later studies will produce strong evidence that some abstinence-only programs are effective at delaying sex and that others are not. However, until needed research is completed, we won't know which programs delay the initiation of sex, nor will we know whether they affect contraceptive use and teen pregnancy" (Kirby, 2002, p. 6).

Other research concurs with Kirby's findings. Many studies have found that abstinence-only programs have not been proven to prevent teen pregnancy and may in fact provide teens with misleading information. For example, a major review of US sex education programs found those promoting abstinence-only-until-marriage were not only ineffective, but risked compromising students' healthy sexual development by withholding facts and providing inaccuracies (Guttmacher Institute, 2017). Despite evidence proving the inadequacy of abstinence-only sex education, federal funding continued to be allocated to such programs in the 2020s. Between 1996 to 2021, the US allocated $2.1 billion to federally funded abstinence-only programs according to the Sexuality Information and Education Council of the United States. However, states which utilize the bulk of this funding tend to have higher rates of teen pregnancy, implying this type of education actually increases teen pregnancy (Ritschel, 2019).

Abstinence-Plus or Comprehensive Sex Education. Abstinence-plus programs encourage abstinence as the first and best choice for avoiding pregnancy and sexually transmitted infections (STIs), yet also encourage young people to use contraception if they do have sex. Sometimes called comprehensive sexuality education, abstinence-plus programs outline a hierarchical approach to reducing teen pregnancy, which includes abstinence or delay of sex and information about contraception and sexually transmitted diseases.

Research on these programs has shown that, overall, their outcomes are positive. One 2008 report by the National Campaign to Prevent Teen and Unplanned Pregnancy indicated that 66 percent of the studied abstinence programs positively affected teens' sexual behavior ("Sex Ed Programs Actually Can Work"). They were shown to help teens delay sexual activity as well as use contraception; additionally, there was little evidence demonstrating that the programs caused teens to become sexually active sooner or engage in sexual activity more often ("Sex Ed Programs Actually Can Work", 2008). The National Campaign to Prevent Teen and Unplanned Pregnancy published a pamphlet in 2012 called "What Works," outlining curriculum-based programs proven to be effective in preventing teen pregnancy. However, the pamphlet also underscored the many causes of teen pregnancy and remarked that "it is unreasonable to expect any single curriculum or community to make a serious dent in the problem on its own. Making true and lasting progress in preventing teen pregnancy requires a combination of community programs and broader efforts to influence values and popular culture, to engage parents and schools, to change the economic incentives that face teens, and more" (National Campaign to Prevent Teen and Unplanned Pregnancy, 2012). While these programs continued to be used in the 2020s, they were proven time and time again to be less effective and to fail to impart sufficient, accurate knowledge to students about sex (Mark & Wu, 2021). Students who make informed decisions were increasingly using intrauterine devices (IUDs) or other more effective forms of birth control at the start of the 2020s (Kekatos, 2023).

The Need for Prevention Programs. Though policymakers, parents, and researchers may continue to debate which prevention programs ought to be implemented, they are all in agreement that some type of program is needed. Amato and Maynard claimed in 2007 that:

• If teens aged twelve to nineteen were to delay their first intercourse by an average of one year, it would lower their risk of pregnancy by 9 percent
• This delay would in turn lower the number of teen births by 24 percent
• If half of the teens not using contraception were to begin doing so, the number of births to teen parents would decline by 14 percent (Haskins & Sawhill, 2007).

They advise that, "ideally, the federal government would provide districts with tested curriculum models that emphasize both abstinence and the use of contraception" (Haskins & Sawhill, 2007, p. 11). Further, they recommend the following guidelines to support comprehensive sex education:

• Start sex education in middle school and enforce a message about the challenges of parenthood for unmarried teens and young adults
• Enlist school systems, parents, and community groups to help educate teens about all methods to prevent unintended pregnancies
• Ensure that young people understand that pregnancy is preventable and that it has significant costs for the mother, the father, and the child, as well as society in general (Haskins & Sawhill, 2007).

Issues

Role of Boys in Preventing Teen Pregnancy. Efforts to reduce teen pregnancy have traditionally focused on girls, but researchers are speculating that targeting teen boys and young men can have significant effects on preventing teen pregnancy as well. Boys and young men have for too long been a "neglected piece of the teen pregnancy puzzle" argues Hutchins (1999, p. 59). Involving boys and young men as the "other half" of the issue may prove to be a key part of effective pregnancy prevention.

A 1999 study Involving Teen Boys and Young Men in Teen Pregnancy Prevention was one of the first studies to examine what types of male-only programs are most successful reaching young men and boys with a consistent and effective message about their role in teen pregnancy. The study recommended several programs and strategies that were showing success in educating and involving boys in teen pregnancy prevention:

• Developing education modules to teach young men and boys about responsible fatherhood
• Implementing community-based programs that are led by male staff
• Having health clinics target men with information about contraception
• Casting a wider net to reach boys who may be in nontraditional schools, have dropped out of school, or be incarcerated (Hutchins, 1999).

A 2006 study It's a Guy Thing: Boys, Young Men, and Teen Pregnancy Prevention found that many of the strategies recommended in Hutchins's report have proved to be effective in helping to reduce unwanted teen pregnancies. It's a Guy Thing looked back at nearly a decade of research and statistics to identify best practices for involving boys and young men in further reducing instances of teen pregnancy. A number of emerging trends were revealed in the 2006 study which indicated that "there have been dramatic shifts in the sexual behavior of boys" (Marsiglio, Ries, Sonenstein, Troccoli, & Whitehead, 2006, p. 1). The report found that fewer boys were having sex, that condom use had increased, and that boys were reporting having had fewer sexual partners. However, the researchers admitted that they knew much more about how girls' attitudes and behaviors affect trends related to sex than they did about boys'. They concluded that further research was needed to prove that boy's attitudes and behaviors are responsible for the positive trends found in the study (Marsiglio, Ries, Sonenstein, Troccoli, & Whitehead, 2006).

Still, the suggested positive outcomes of these programs have led to an increased interest in implementing them. The authors of It's a Guy Thing encouraged the following approaches when creating "male-only" programs.

• Make initiatives welcoming and engaging for young men; have male-only services and employ male staff.
• Establish a trusting environment and foster rapport with young men and boys.
• Make the messages about teen pregnancy positive rather than punitive. Focus on the overall meaning of fatherhood through discussions of the emotional support and parental involvement it requires rather than just the financial aspect.
• Tailor programs to specific populations by age, ethnicity, and socioeconomic background.
• Making connections between pregnancy and other issues is important. Emphasize the importance of education and the future attainments that boys can achieve by delaying fatherhood.
• Involve parents—both mothers and fathers—in prevention programs. Help parents communicate with their children and give them consistent messages.
• Creative outreach programs work best. One size does not fit all, and success can come from a variety of outreach methods.

(Marsiglio, Ries, Sonenstein, Troccoli, & Whitehead, 2006)

In 2018, the role of boys in preventing teen pregnancy was beginning to equalize with the understanding that this responsibility falls on both sexes. Stratifies such as including female birth control options in male sex education, encouraging communication between couples regarding contraceptive use and family planning both contribute to an increase in shared responsibility and equality in birth control (Parekh, 2018).

Conclusion

Teenage pregnancy can directly cost billions in such areas as child health care, foster care, and public assistance. Total cost to society resulting from teen births is even higher, due to factors such as loss of tax revenue associated with lower earning potential, lower educational attainment, and increased chance of contact with the criminal justice system. Teens who give birth make up a large proportion of single-parent households. Research shows that "reversing the rate of single parent households would have a very positive effect on children by reducing poverty rates" (Haskins & Sawhill, 2007).

Proponents of abstinence-only programs claim that many of these programs are effective in reducing teen pregnancy. However, claims about the success of these programs have not been substantiated when rigorous scientific research principles are applied. Abstinence-plus programs encourage teens to delay the initiation of sex and provide teens and young adults with comprehensive information regarding contraception and other pregnancy and disease prevention techniques. A number of abstinence-plus programs have been proven to be successful in reducing teen pregnancies.

Terms & Concepts

Abstinence Only: A sex education method that teaches that abstaining from sex is the only reliable means to prevent unintended pregnancies.

Abstinence Plus (or Comprehensive Sexuality Education): A sex education method that encourages teens to delay initiation of sexual activity, but also provides information about contraception if a teen is sexually active.

Non-Marital Births: All births to single mothers, not just to teenage mothers.

Public Sector Costs: Costs associated with federal, state, local agencies, as well as taxpayers.

Punitive: Referring to actions that denote punishment.

Teen Childbearing: In the literature, refers to teens seventeen or under or those who have not completed their primary education (high school).

Bibliography

About teen pregnancy. (2019, March 1). Centers for Disease Control and Prevention. Retrieved May 26, 2020, from http://www.cdc.gov/teenpregnancy/about/index.htm

Abstinence-only-until-marriage programs are ineffective and harmful to young people, expert review confirms. (2017, August 22). Guttmacher Institute. Retrieved May 26, 2020, from https://www.guttmacher.org/news-release/2017/abstinence-only-until-marriage-programs-are-ineffective-and-harmful-young-people

Barret, D., et al. (2015). Predictors of teen childbearing among delinquent and non-delinquent females. Journal of Child and Family Studies, 24(4), 970–978. Retrieved January 27, 2016, from EBSCO Online Database SocINDEX. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=101603364&site=ehost-live&scope=site

Grose, R. G., Grabe, S., & Kohfeldt, D. (2014). Sexual education, gender ideology, and youth sexual empowerment. Journal of Sex Research, 51, 742–753. Retrieved January 13, 2015, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=96920857&site=ehost-live&scope=site

Haskins, R., & Sawhill, I. (2007). Introducing the issue. Future of Children. Retrieved March 17, 2007, from http://www.futureofchildren.org/usr_doc/7_01_Intro.pdf

Hoffman, S. (2006). By the numbers: The public costs of teen childbearing. National Campaign to Prevent Teen Pregnancy. Retrieved March 21, 2008, from http://www.teenpregnancy.org/costs/pdf/report/BTN_National_Report.pdf

FT. Huang, C., Costeines, J., Kaufman, J., & Ayala, C. (2014). Parenting stress, social support, and depression for ethnic minority adolescent mothers: Impact on child development. Journal of Child and Family Studies, 23, 255–262. Retrieved January 13, 2015, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=93646316&site=ehost-live&scope=site

Hutchins, J. (1999). Involving teen boys and young men in teen pregnancy prevention. U.S. Department of Health and Human Services. Retrieved March 21, 2008, from http://aspe.hhs.gov/HSP/get-organized99/ch4.pdf

Kekatos, M. (2023, June 1). Teenage birth rates in the US reached historic lows in 2022, CDC report finds. ABC News. Retrieved June 25, 2023, from https://abcnews.go.com/Health/teenage-birth-rates-us-reached-historic-lows-2022/story?id=99720479

Kirby, D. (2002). Do abstinence-only programs delay the initiation of sex among young people and reduce teen pregnancy? National Campaign to Prevent Teen Pregnancy. Retrieved March 17, 2008, from: http://www.teenpregnancy.org/resources/research/reports.asp

Kohili, V, & Nyberg, K (1995) Teen pregnancy prevention through education. CSU.edu. Retrieved March 19, 2008, from http://www.csus.edu/calst/government_affairs/reports/Teen_Pregnancy_Prevention_Through_Education.pdf

Livingston, G., & Thomas, D. (2019, August 2). Why is the teen birth rate falling? Pew Research Center. Retrieved May 26, 2020, from https://www.pewresearch.org/fact-tank/2019/08/02/why-is-the-teen-birth-rate-falling

Luker, K. (1997). Dubious conceptions: The politics of teenage pregnancy. Harvard University Press, 1966. Retrieved March 19, 2008, from http://books.google.com/books?id=Vayy1oxHPbAC

Mark, N., & Wu, L. (2022, Feb. 22). More comprehensive sex education reduced teen births: Quasi-experimental evidence. Social Sciences, 119(8). https://doi.org/10.1073/pnas.2113144119

Marsiglio,W., Ries, A., Sonenstein, F., Troccoli, K. & Whitehead,W. (2006). It's a guy thing: Boys, young men, and teen pregnancy prevention. National Campaign to Prevent Teen Pregnancy. Retrieved March 17, 2008, from http://www.teenpregnancy.org/resources/reading/pdf/Guy_Thing.pdf

National Campaign to Prevent Teen and Unplanned Pregnancy. (2012). What works, 2011–2012: Curriculum-based programs that help prevent teen pregnancy. National Campaign to Prevent Teen and Unplanned Pregnancy. Retrieved from http://thenationalcampaign.org/sites/default/files/resource-primary-download/WhatWorks.pdf

National data. (2021). Power to Decide. Retrieved June 11, 2021, from https://powertodecide.org/what-we-do/information/national-state-data/national

Parkh, J., Johnson, M., & Manlove, J. (2018). Young men play an important role in pregnancy prevention. Child Trends. Retrieved June 25, 2023, from https://www.childtrends.org/blog/young-men-play-an-important-role-in-pregnancy-prevention

Sex Ed Programs Actually Can Work. (2008). USA Today Magazine. Retrieved March 17, 2008, from EBSCO online database Academic Search Premier: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=28833162&site=ehost-live

Ritschel, C. (2019, Feb. 4). Abstinence-only sex education increases teen pregnancy in conservative US states, study finds. Independent. Retrieved June 25, 2023, from https://www.independent.co.uk/news/world/americas/abstinence-sex-education-us-teen-pregnancy-rates-states-a8763051.html

Sisson, G. (2012). Finding a way to offer something more: Reframing teen pregnancy prevention. Sexuality Research & Social Policy: Journal Of NSRC, 9, 57–69. Retrieved November 15, 2013, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=70842585

Smith Battle, L. I. (2013). Reducing the stigmatization of teen mothers. MCN: The American Journal of Maternal Child Nursing, 38(4), 235–243. Retrieved January 27, 2016, from EBSCO Online Database CINAHL Plus. http://search.ebscohost.com/login.aspx?direct=true&db=jlh&AN=107957992&site=ehost-live&scope=site

Teen births cost U.S. taxpayers $10 billion. (2011). Contemporary Sexuality, 45, 7. Retrieved November 15, 2013, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=64394540

Trends in teen pregnancy and childbearing. (2019, May 30). US Department of Health & Human Services. Retrieved May 26, 2020, from https://www.hhs.gov/ash/oah/adolescent-development/reproductive-health-and-teen-pregnancy/teen-pregnancy-and-childbearing/trends/index.html

Weber, J. (2012). Becoming teen fathers: Stories of teen pregnancy, responsibility, and masculinity. Gender & Society, 26, 900–921. Retrieved November 15, 2013, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=83329581

Suggested Reading

Ayadi, M., Kuo, T., Adams, E., & Gavin, N. I. (2012). Contraceptive use among medicaid-covered teens and risk of teen conception: A longitudinal study. Journal Of Women's Health (15409996), 21, 146–153. Retrieved November 15, 2013, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=70945201

Chen, C., Yamada, T., & Walker, E. M. (2011). Estimating the cost-effectiveness of a classroom-based abstinence and pregnancy avoidance program targeting preadolescent sexual risk behaviors. Journal Of Children & Poverty, 17, 87–109. Retrieved November 15, 2013, from EBSCO Online Database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=59362625

Girma, S., & Paton, D. (2013). Does parental consent for birth control affect underage pregnancy rates? The case of Texas. Demography, 50, 2105–2128. Retrieved January 13, 2015, from EBSCO online database SocINDEX with Full Text. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=92757005&site=ehost-live&scope=site

Kotz, D. (2007). A Debate About Teaching Abstinence. U.S. News & World Report, 142, 28-28. Retrieved March 17, 2008, from EBSCO online database Academic Search Premier: http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=28024570&site=ehost-live

McCave, E. (2007). Comprehensive Sexuality Education vs. Abstinence-Only Sexuality Education: The Need for Evidence-Based Research and Practice. School Social Work Journal, 32, 14-28. Retrieved March 17, 2008, from EBSCO online database SocINDEX with Full Text: http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=26650504&site=ehost-live

Patel, P. R., et al. (2016). Postpartum teenagers' views on providing contraception in school-based health clinics. Journal of Women's Health, 25(1), 32–37. Retrieved from EBSCO Online Database SocINDEX. http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=112338872&site=ehost-live&scope=site

Samuels, C. (2006). Abstinence Programs Lack Factual Reviews, GAO Study Concludes. Education Week, 26, 11-11. Retrieved March 21, 2008, from EBSCO online database Academic Search Complete: http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=23289074&site=ehost-live