August 2, 2012 — "[T]he key to lower [teen] pregnancy rates has been a shift from condom use alone to more effective hormonal methods like the pill," writes Slate health care columnist Darshak Sanghavi, chief of pediatric cardiology and associate professor of pediatrics at the University of Massachusetts Medical School. He notes that the U.S. teen pregnancy rate has declined by 40% since 1990 and that teen birth and abortion rates have fallen by about 33% and 50%, respectively, during the same time period.
Sanghavi argues that while sex education has improved and teens generally are waiting longer to have sex for the first time, those factors alone do not explain the drastic decrease in the teen pregnancy rate. For example, he writes that while states' promotion of abstinence-only sex education often is linked to teen pregnancy, rates have declined in states that teach abstinence-only and states with comprehensive sex education programs.
"[T]he decline in teen pregnancy since 1990 shows that the big changes occur only when we also treat reproductive health just like every other kind of medical science -- by discarding problematic treatments and aggressively promoting effective ones," Sanghavi states.
Although condoms "are an important public health tool," Sanghavi notes that in recent decades, "[r]ecognizing that condoms have a high risk of failure due to noncompliance, public health authorities and doctors encouraged more girls to get the pill. That quiet revolution has caused a major decline in unwanted pregnancies."
Research suggests the next step should be a shift to more widespread use of intrauterine devices, Sanghavi argues. In a recent study in the New England Journal of Medicine, almost 10% of women younger than age 21 became pregnant within one year while taking the pill. The study found that "the risk of contraceptive failure was 22 times higher with the pill than with IUDs in adult women, and double that for teens," Sanghavi writes (Sanghavi, Slate, 7/31).
Debra Ness, publisher & president, National Partnership
Andrea Friedman, associate editor & director of reproductive health programs, National Partnership
Marya Torrez, associate editor & senior reproductive health policy counsel, National Partnership
Melissa Safford, associate editor & policy advocate for reproductive health, National Partnership
Perry Sacks, assistant editor & health program associate, National Partnership
Cindy Romero, assistant editor & communications assistant, National Partnership
Justyn Ware, editor
Amanda Wolfe, editor-in-chief
Heather Drost, Hanna Jaquith, Marcelle Maginnis, Ashley Marchand and Michelle Stuckey, staff writers
Tucker Ball, director of new media, National Partnership