Each year in the United States, approximately 1 million adolescents, or 10 percent of females 15 to 19 years of age, become pregnant. (1) These pregnancies, which account for 13 percent of all births, usually are unintended and occur outside of marriage. (2) Since 1991, the adolescent pregnancy rate in the United States has fallen by 25 percent, from 116 to 87 per 1,000 females 15 to 19 years of age. (3) This decline has been attributed to delayed initiation of sexual intercourse, increased use of contraception, and education about human immunodeficiency virus transmission and pregnancy prevention. (4,5) Despite the decline, adolescent pregnancy remains a major public health problem with lasting repercussions.

In 2001, the U.S. Surgeon General presented “The Surgeon General’s Call to Action to Promote Sexual Health and Responsible Sexual Behavior,” (6) which discussed the need for a national dialogue on this topic, expanding research into sexual health, and improving health care access and social interventions to increase responsible sexual behaviors.

Impact of Teenage Pregnancy

Compared with nonpregnant adolescents, teenage mothers are less likely to graduate from high school and are more likely to score below average in language and reading skills. (7,8) These teenagers also are more likely to have low self-esteem and symptoms of depression. (9,10) Many of them have behavior and substance-abuse problems and lack the resources to fully foster the emotional development and enrichment of their children’s lives. (11-13)

Children of adolescent mothers are at greater risk of preterm birth, low birth weight, child abuse, neglect, poverty, and death. (14-17) They are more likely to have behavior disorders and difficulties in school, and to engage in substance abuse. (18,19) In 1996, the poverty rate among children born to teenage mothers was 42 percent, twice that of the overall rate in children. (20) The infant mortality rate (i.e., deaths in infants younger than one year per 1,000 live births) is higher in children of teenage mothers than in other children. (21)