Despite the recent decline in the teen birth rates, teen pregnancy remains a significant problem in this country. It is a problem that impacts nearly every community. Thus, the responsibility to solve this problem lies with all of us, including families, communities, and young people themselves.

The President and Congress called on HHS to develop a National Strategy to address this serious challenge and to assure that at least 25 percent of communities in this country have teen pregnancy prevention programs in place--as mandated under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The Department responded to this call by releasing a National Strategy to Prevent Teen Pregnancy in January of 1997.

This Strategy presented a comprehensive new plan to prevent teen pregnancies in the United States by strengthening, integrating, and supporting teen pregnancy prevention and other youth-related activities in communities across this country.

The Department is required by this law to report to the Congress by June 30th of each year on progress made with the Strategy. This represents our first Report to the Congress on the National Strategy to Prevent Teen Pregnancy. In this document, we also report that in FY 1997, HHS funded teen pregnancy prevention programs in at least 31% of the communities in the country. This is a conservative number as it only includes HHS funds that flow directly to the communities.

Good News. Statistics and data demonstrate some encouraging trends:
•           From 1991 through 1996, HHS reported that teen birth rates declined for white, black, American Indian, Asian or Pacific Islander and Hispanic women ages 15-19.
•           The birth rate for black teens demonstrated the largest decline-down a fifth from 1991 to 1996-reaching the lowest birth rate ever reported for blacks.
•           Teen birth rates have decreased in every state.
•           The teen pregnancy rate has also declined by 8 percent from 1991 to 1994.

Our Charge and the Work Ahead. While these data indicate that concerted efforts to reduce teen pregnancy may be succeeding, we still have a long way to go. The Federal government, the private sector, parents and other caring adults are all helping send the same message:
Don't become a parent until you are truly ready to support a child.
Key Principles. In implementing this National Strategy, we have adhered to and advanced the five principles highlighted in the January 1997 report. According to research and experience, these five principles are essential to community efforts.

The Five Principles
1.         Parents and other adult mentors must play key roles in encouraging young adults to avoid early pregnancy and to stay in school.
2.         Abstinence and personal responsibility must be the primary messages of prevention programs.
3.         Young people must be given clear connections and pathways to college or jobs that give them hope and a reason to stay in school and avoid pregnancy.
4.         Public and private-sector partners throughout communities-including parents, schools, business, media, health and human service providers, and religious organizations-must work together to develop comprehensive strategies.
5.         Real success requires a sustained commitment to the young person over a long period of time.

Reporting Our Progress. We hope that this annual report-and those that follow-will provide useful information on the efforts of the Department of Health and Human Services. We also hope to complement the efforts of others, such as those of the non-profit National Campaign to Prevent Teen Pregnancy, individual states and communities, foundations, other non-governmental entities, parents, youth, and other caring adults.
Trends in Teen Births & Pregnancies

Declining Teen Birth Rates. According to several reports from HHS's National Center for Health Statistics (NCHS), teen birth rates have decreased nationally and in all states since 1991.
Birth rates for teenagers 15-19 years declined between 1991 and 1996 in all states and the District of Columbia, echoing the national trends during this time. (Declines in three states were not statistically significant.) The reductions in state-specific teen birth rates reflect, and in many cases, exceed those reported for the country as a whole. Between 1991 and 1996:

•           The U.S. teen birth rate fell 12 percent.
•           Teen birth rates fell by 12 percent or more in 28 states.
•           Teen birth rates dropped by 16 percent or more in 13 states.
•           Declines in four states exceeded 20 percent.

Trends by Age.
Though teenage childbearing patterns differ considerably by age, birth rates for all age groups have declined in the 1990's, partly reversing the 24 percent rise in the overall birth rate from 1986 to 1991.

•The U.S. birth rate for teenagers in 1996 was 54.4 live births per 1,000 women aged 15-19 years, down 4 percent from 1995 and 12 percent from 1991.

•The birth rate for teens aged 15-17 was 13 percent lower than in 1991. Half of the recent decline occurred between 1995 and 1996.

•The birth rate for older teens 18-19 years dropped 9 percent between 1991 and 1996; the decline between 1995 and 1996 was 3 percent.
The figure below illustrates the trends in teenage birth rates from 1980 to 1996, offering a comprehensive picture of the last two decades.
Trends by Race. Birth rates for black teens have dropped sharply. The largest declines, measured by race, since 1991 were black women.

•The overall birth rate for black teenagers 15-19 years fell 21 percent between 1991 and 1996.

•           The birth rate for young black teenagers, 15-17 years, declined 23 percent between 1991 and 1996, while the birth rate for older black teenagers, 18-19 years, fell 16 percent.

Despite the sharp decline in the birth rates for black teenagers, their birth rates and the birth rates for Hispanic teenagers remain higher than for other groups. The birth rate for Hispanic teens declined in 1996 after being stable through the early 1990's. The declines among teen women's birth rates are outpacing the declines among birth rates for women of all ages.

Data Collection and Analysis.
Accurate and timely reporting of trends and patterns of teen birth rates is based on information reported on the birth certificates for all babies born in the United States. This information is provided by state health departments to the National Center for Health Statistics (NCHS) through the Vital Statistics Cooperative Program. NCHS and the states share the costs for collecting and processing the data.

Teen birth data from the vital statistics system have been reported more quickly in the last year and a half. NCHS has inaugurated a new statistical series, taking advantage of faster data collection and processing at the state level and by NCHS.

The preliminary file provides snapshot information based on a very large sample. Data from the 1996 file, based on 94 percent of U.S. births, were published in September 1997, just nine months after the end of the year. Findings from the preliminary 1995 and 1996 files (published October 1995 and September 1996, respectively) were validated with the final birth file (published in June 1997 and June 1998).

Declining Teen Pregnancy Rates.
The estimated teen pregnancy rate for 1994 is 108 pregnancies per thousand women aged 15-19 years; this reflects an 8 percent decline from 1991.2 while this is the most recent national level data, in June 1998, the Centers for Disease Control and Prevention (CDC) issued a report presenting the latest data showing adolescent pregnancy rates by state for 1992-1995. In each of the 42 states (plus District of Columbia) with available data, adolescent pregnancy rates for females aged 15-19 decreased between 1992 and 1995. This report presents the first data to show that fewer teens became pregnant during that time frame. In the same time period, teen abortion rates also declined in 40 of 43 reporting states.

According to the report, pregnancy rates varied widely by state. In 1995, state pregnancy rates ranged from 56 per 1,000 15 to 19-year-old adolescents in North Dakota, to 117 per 1,000 in Nevada. The pregnancy rate in the District of Columbia, also measured in the report, was 230 per 1,000. Decreases in the pregnancy rates ranged from 3 percent in Arkansas to 20 percent in Vermont.

Decreases in teen pregnancy rates were greater among blacks than among whites, although teen pregnancy rates remained higher for blacks than for whites. Pregnancies are estimated as the sum of live births, legally induced abortions, and estimated fetal losses such as spontaneous abortion or stillbirth among adolescents 19 and younger.

States not reporting data to CDC and thus not included in today's report are Alaska, California, Delaware, Florida, Illinois, Iowa, New Hampshire, and Oklahoma. Reporting of these data to CDC is voluntary by states.3

Causes and Effects of Teen Pregnancy
You may be wondering about the causes and effects of teenage pregnancy. A teenage girl may become pregnant as a result of many different situations. Some teenage girls become pregnant while involved in long-term dating relationships. Other girls become pregnant after hooking up. And, some girls may become pregnant as a result of a rape situation.

All teenage pregnancies are the result of sexual activity, whether voluntary or involuntary. No matter what measures are taken for birth control, the only 100% effective way to prevent pregnancy is abstinence from all sexual activity. If you have questions about this please call 1-800-395-HELP or e-mail us. Only abstinence is guaranteed not to cause teen pregnancy.

Common methods of birth control include:
•           the birth control pill or patch
•           condoms
•           intrauterine devices (IUD)
•           the Depo-Provera injection
•           diaphragms
•           spermicides
•           cervical caps

Each of these birth control methods can fail even when used correctly. However, studies show that teens are more likely to use birth control methods improperly, leading to a higher likelihood that they may fail and cause a teen pregnancy to occur.

Effects of Pregnancy on Teens
Facing an unplanned teen pregnancy can be hard. The effects of teenage pregnancy are not limited to having to decide whether or not to keep the baby, how to cope with motherhood or whether to make an adoption plan. One of the most immediate effects of teen pregnancy is how the growing baby changes a teenager's body as well as their lifestyle.
Because a teen's body immediately begins the process of carrying a child and preparing for childbirth, a teenager needs to consider the effect that her physical activities may have on her developing baby. A variety of activities common to teens may have a negative effect on a developing baby:

•           Drinking alcoholic beverages
•           Smoking cigarettes or marijuana
•           Lack of sleep
•           Unhealthy eating patterns
Other physical changes that take place as her uterus expands may impact things as simple as clothing choices or her ability to safely participate in sports. This means that an average teenage girl will need to speak with her doctor about what activities need to be limited during her pregnancy as well as what changes she might need to make to her diet.
Emotional Effects of Teen Pregnancy
Dealing with an unplanned pregnancy can be scary and confusing. Some of the emotions that you may encounter when facing an unplanned pregnancy are:
•           Initial excitement
•           Confusion
•           Fear
•           Resentment
•           Frustration

It's a natural response for you to think about and want to protect the baby that is growing inside you. It is also natural for you to be scared and confused about how to deal with this unplanned pregnancy.

Causes of Teenage Pregnancy

Teenage pregnancy is a growing problem in America. Teenage mothers often drop out of school and end up on welfare, barely able to support their child. Sometimes, teenagers who give birth do not live through the ordeal, as their bodies are not ready to handle the stress of childbirth. Why do teenage girls get pregnant? The answer is, there are many causes of teenage pregnancy.

The lack of education on safe sex be it from parents, schools, or otherwise, is a cause of teenage pregnancy. Many teenagers are not taught about methods of birth control and how to deal with peers who pressure them into having sex before they are ready. According to the article "Lack of Parental Guidance Contributes to Teen Pregnancy", many pregnant teenagers do not have any cognition of the central facts of sexuality" (2). Emily claims that she was pressured into having sex with her boyfriend when she was thirteen and that no one had taught her how to deal with this pressure and to say "no". Emily wound up pregnant but aborted the child, as she felt there was no way that she, at thirteen, could take care of a baby.

Felisha went to a high school in the mid-west that did not have sex education classes and Felisha's parents did not discuss sex in the house. At sixteen, Felisha became pregnant by having unprotected sex with her boyfriend, Jake. Due to complications during birth, Felisha's daughter did not live. Her parents were very ashamed of Felisha for getting into this situation, but she was upset with her parents for not discussing with her the facts about safe sex. The lack of safe sex education is just one cause of teenage pregnancy.