CHAPEL HILL The teen pregnancy rate fell by 28 percent in North Carolina between 2003 and 2011, hitting a historic low for the age group and outpacing the nation’s average decline by a solid margin.
Meanwhile, the portion of teens engaging in sexual behavior has remained about the same in the state since 2003, bucking a nationwide trend of decreasing sexual activity among adolescents.
These facts point toward greater use of contraceptives, and possibly a decision by some teens to postpone sexual activity until they’re a little older and wiser, members of the N.C. Adolescent Pregnancy Prevention Campaign said during their meeting Tuesday in Chapel Hill.
“Something is working, because we’ve seen such dramatic declines,” said Bill Albert, chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy, who spoke to those gathered.
If abstinence isn’t on the upswing, factors behind the drop in teen pregnancy may include an increased use of condoms and other forms of contraception, more effective outreach programs in communities across the state and even, perhaps, a shift in cultural norms, Albert said.
“We may be getting the message across that getting pregnant at 16 is just not OK,” he said.
In 2011, the most recent year with figures available, fewer than 5 percent of North Carolina girls ages 15 to 19 became pregnant, down from a high of more than 10 percent in 1990, according to state Division of Public Health records.
An analysis of 2010-2011 numbers by the Adolescent Pregnancy Prevention Campaign shows that pregnancy rates among Hispanic teens shifted the most, dropping 14 percent in one year. Rates for African-American teens declined by 12 percent, and for whites the rate was down 11 percent during the same period.
The numbers demonstrate a strong start in the campaign’s goal of reducing teen pregnancy by 30 percent between 2012 and 2030, said Joy Sotolongo, evaluation specialist for the Adolescent Pregnancy Prevention Campaign.
Older teen parents most common
But Sotolongo remains concerned about the 13,909 teens in the state who became pregnant in 2011. The birth rate among teens in North Carolina remains above the national average, according to the Centers for Disease Control.
“The numbers of those that became pregnant are far more than anyone wants to see,” she said. “We are still facing challenges.”
One disturbing trend is the continued high pregnancy rate among adolescents ages 18 and 19, Sotolongo said. Seventy-two percent of teen pregnancies in North Carolina occur in the older age group.
Of course, 18 year olds are considered adults under some laws, but they are barred from some typically adult activities, such as drinking alcohol. And that’s for a good reason, Albert said.
“Their brains are just not fully baked at age 18 or 19,” he said. “It’s something we know now through neuroscience, but it’s been common sense for a long time. You can’t rent a car until you’re 25, so it follows that you’re not ready to be a parent, either.”
He said that studies show that teens who get pregnant at 18 or 19 wind up with lower educational levels and subsequently less economic stability than their non-parent counterparts. Children of older-teen parents suffer, too. They do worse at school and have higher incarceration rates than those born to parents 20 or older.
“Actually, the outcomes for children born to mothers age 16 or 17 are slightly better,” Albert said. “That’s because a 16-year-old is likely to live with other adults and have someone in the family helping out, while the 18- and 19-year-olds typically do not.”
Other issues of concern are the number of repeat pregnancies and the small number of teens using the most reliable methods of birth control.
About 26 percent of teen pregnancies occur among girls who have been pregnant at least once before, Sotolongo said.
Type of contraception key
While access to contraception may be getting a boost from the federal Affordable Care Act, which mandates that insurance companies include contraception as a copay-free benefit, many teens are using methods that are least reliable, such as condoms and even birth control pills, which require teens to have prescriptions filled and then remember to take them regularly, Albert said.
Condoms are the most popular form of birth control among teens, with birth control pills coming in a distant second.
If teens used more effective methods, such as intrauterine devices, implants or shots, 27 percent more pregnancies could be avoided, according to Adolescent Pregnancy Prevention Campaign research.
A national Centers for Disease Control survey released in 2011 showed about 43 percent of girls and 42 percent of boys under 20 said they had been sexually active at least once. That’s a marked drop from 2002, the last time a similar survey was conducted, when 51.1 percent of girls and 60.4 percent of boys reported having sex.
That’s where a potential shift in cultural mores might be evident, and a place where parents, teachers and religious and community leaders can potentially do the greatest good, Albert said.
“Parents, in particular, need to be able to talk with their kids about sex – not just once but it needs to be an ongoing conversation,” he said. “It’s OK to say to their teen daughter or son: I don’t want you having sex.”
But parents also need to be confident enough to talk to kids about contraception, Albert said.
“Kids are afraid to ask. Most don’t want their parents to know they’re having sex,” he said. “But they don’t need to wait until game time to figure out what they’ll do about contraception.”
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