Although teen pregnancy rates dropped significantly in the USA over the past decade, rates remain higher than in many other developed countries (Ventura et al., 2001; Flanigan, 2001). Almost 900,000 teenage girls still become pregnant each year in the USA and significant racial/ethnic disparities exist (Ventura et al., 2001). Given the adverse economic and health consequences stemming from teen pregnancy, including low birth weight and economic hardship, no one is claiming that the battle is won. Instead, experts are debating what motivated the decreases in sexual activity and increases in the use of contraceptives at first intercourse, and strategizing ways to continue the positive trends. Possible explanations for the good news include economic prosperity, more informed and cautious attitudes about sex, improved use of contraceptives, and funding of new teen pregnancy prevention efforts through welfare reform (Darroch and Singh, 1999; Flanigan, 2001). Previous research has attributed a girl's increased risk of pregnancy to the possible consequences of a father leaving such as, lower family income, conflict at home and weak parental monitoring. Yet even when these factors were taken into account, the study found that a father's absence in itself seemed to put daughters at risk for having children early. Girls' whose fathers left before they were born or previous to age five were seven to eight times more at risk of becoming pregnant as an adolescent, than girls living with their fathers. A father's departure between ages six to thirteen suggested that teen girls are two to three times' at greater risk of becoming pregnant. (Psychology Today, 2003) Girls who see their single mothers date many partners may become primed for early sexual exploration. Or, a father's absence early in life may trigger doubts in girls about male reliability that hasten sexual activity and reproduction, as well as promote a preference for brief relationships.
Juvenile abuse of alcohol and other drugs is strongly associated with risk-taking behavior, including promiscuity. According to the 1999 National Center on Addiction and Substance Abuse (CASA) study "Dangerous Liaisons," increased promiscuity leads to a greater risk for sexually transmitted diseases and unplanned teenage pregnancy (National Center on Addiction and Substance Abuse 1999). Adolescents aged fourteen and younger who use alcohol are twice more likely to engage in sexual behaviors than non-drinkers; drug users are five times more likely to be sexually active than youth who are drug-free. Teens between the age of fifteen and nineteen who drink are seven times more likely to have sex and twice as likely to have four or more partners than those who refrain from alcohol. Furthermore, more than 50 percent of teenagers say that sex while drinking or on drugs often produces unplanned pregnancies. An Ohio study of high school girls who tried cocaine indicated that these adolescents were five times more likely to have experienced an unintended pregnancy than peers who avoided cocaine (Rome, E.S., Rybicki, M.S., & Durant, R.H. 1998).
Nevertheless, the results suggested that preventive efforts should be initiated within the family, targeting systematic functioning, drug and alcohol problems, and violent behaviors. Secondary, efforts should be made when physical or sexual abuse is uncovered, or when adolescents engage in delinquent acts or substance abuse. Once a teenager becomes pregnant, intervention must focus on her vulnerability to abuse. Unfortunately, teenage mothers are more likely to associate with abusive partners (Berenson, San Miguel, & Wilkinson, 1992a.).
A 1990 study showed that almost one-half of all teenage mothers and over three-quarters of unmarried teen mothers began receiving welfare within five years of the birth of their first child (National Campaign to Prevent Teen Pregnancy). The growth in single-parent families remains the single most important cause for increased poverty among children over the last twenty years, as documented in the 1998 Economic Report of the President. Out-of-wedlock childbearing (as opposed to divorce) is currently the driving force behind the growth in the number of single parents, and half of first out-of-wedlock births are to teens (Sawhill, I.V. 1998). Therefore, reducing teen pregnancy and child-bearing is an obvious place to anchor serious efforts to reduce poverty in future generations.
Adolescent pregnancy is a complex problem. There is no single or simple approach that will reduce adolescent pregnancy among all groups of teenagers. Because the causes of teen pregnancy are complicated, the strategies should be multi-pronged (Kirby, 1997). Over the past two decades, there has been dramatic growth in the number and variety of programs aimed at preventing adolescent pregnancy. These have included education programs, family planning/contraceptive services, school-based health centers, youth development programs, and multi-component programs. Unfortunately, recent comprehensive reviews of adolescent pregnancy prevention programs concluded that few programs have been well evaluated. Of those that have been evaluated, none have been significantly successful in reducing adolescent pregnancy. However, although there are studies that indicate that some programs can have some success at reducing one or more sexual behaviors for at least a brief period of time, few studies have measured long-term effects (Kirby, 1997, 1999; Moore et al., 1995). Youth and communities need a comprehensive approach to teen pregnancy prevention that involves multiple intersecting strategies, including comprehensive sexuality education, access to contraceptives and reproductive health care, and youth development. When employed together, the following policy strategies will have the most significant impact on reducing teen pregnancy. There are three main goals in preventing teen pregnancy. First there is comprehensive sexuality education. Research confirms that comprehensive sexuality education programs (those that include information about both abstinence and contraceptive methods) can delay the onset of sex, reduce the frequency of sex, reduce the number of sexual partners, and increase the use of condoms and other forms of contraception. In schools a effective way to help prevent students from being sexually active is having teachers that want to volunteer and are comfortable with using scientifically evaluated best practices programs and curricula. By teachers volunteering to do this program it could work more effectively because they want to help teens learn more about it. Instead of a teacher that is picked and does not want to help as much would not bring the best approach to help the teen learn about what goes on in a pregnancy and the consequences of becoming a teen parent. Next is access to contraceptives and reproductive health care. In order to reduce teen pregnancy rates, sexually active teens, estimated to be over 60% of teens by age 18, and 80% by age 20 (Alan Guttmacher Institute. 2001), must have access to reproductive health care and contraception. Nationally, publicly funded family planning prevents 385,800 unintended pregnancies among adolescents aged 15 to 19 annually, avoiding 154,700 teenage births and 183,300 abortions (Forrest, J.D., & Samara, R. 1996). Health care providers could adopt policies and procedures that are teen friendly, such as convenient hours and drop-in appointments; and care that is non-judgmental and respectful of teens; care provided by peer providers; and services provided off-site.
Finally, youth development plays a big role in preventing teen pregnancy. There is a widely held belief that one of the most effective pregnancy prevention strategies is to provide youth with supportive environment and a positive sense of the future. Youth development programs are one way to improve life skills and life options for youth who may be likely to become pregnant because they perceive a lack of opportunity. With these three options open for teens, the rate of teen pregnancy would drop effectively.