Most teens would probably say they don’t want to become pregnant–in fact 87% of teen pregnancies in 2001 were reportedly unintended (see Figure 1). Even though there have been tens of thousands of teen pregnancies in recent years, teen births in the US have actually declined over the last 20 years, from 61.8 live births per 1,000 females aged 15-19 years in 1991 to 29.4 in 2012. This trend, which is due to factors that include teens making more informed decisions regarding their sexual health, is encouraging and suggests we can continue to make progress in preventing teen pregnancies.

First, we need to understand what makes teens more likely to get pregnant. Isabel Sawhill, Adam Thomas, and Emily Monea, in the Future of Children, outline several plausible explanations including cultural norms of increased acceptance of premarital sex and having children outside of marriage, a lack of positive alternatives to single motherhood, an attitude of fatalism, the high cost and limited availability of contraception, lack of knowledge about contraception and reproductive health, and inconsistent or incorrect use of contraception. The authors point out that these explanations generally fall into the categories of motivation, knowledge, and access.

Next, we can examine possible solutions. The Centers for Disease Control and Prevention recently released a Vital Signs brief outlining what the federal government, health care professionals, parents/caregivers, and teens can do to prevent teen pregnancy. What I like about the CDC’s suggestions is that they start where the teen is and show how adults can support teens’ healthy development. For example, professionals can encourage teens to delay sexual activity but should also encourage sexually active teens to consider the most effective methods of birth control. Parents can know where their teens are and what they are doing (isn’t there an app for that?), especially after school, and talk with their teens about sex.

Finally, are programs that promote these types of solutions worth the cost? Sawhill and colleagues, in their Future of Children article, conducted simulations of the costs and effects of policy initiatives that encouraged men to use condoms (motivation), discouraged teen sexual activity and educated participants about proper contraceptive use (knowledge), and expanding access to Medicaid-subsidized contraception (access). All three had good benefit-cost ratios, suggesting they are excellent social investments that can actually save taxpayer dollars. For more information on how to prevent teen pregnancy and unintended pregnancies in general, see the Fragile Families volume of Future of Children.