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Home > Advocacy > CWLA 2008 Children's Legislative Agenda > Teen Pregnancy Prevention


CWLA 2008 Children's Legislative Agenda

Teen Pregnancy Prevention

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  • Increase funding for the Title X family planning program, while also maintaining its status as a categorical federal program that mandates informed patient consent, confidentiality protection for alls patients, types of services offered, and medical standards.

  • Pass and fully fund the Prevention First Act (H.R. 819/S. 21).

  • Encourage more teen pregnancy prevention programs to serve youth in foster care and require teen pregnancy prevention programs directed at foster care populations to specifically evaluate their effectiveness within that particular community.

  • Support funding for comprehensive health and sex education in our communities and schools that is medically accurate and includes information about abstinence.


Young people represent our nation's future. Given the right tools, including proper support and an array of services and opportunities that promote their health and positive development, they can make informed decisions and achieve selfsufficiency, economic independence, and long-term family stability. Many youth involved with the child welfare and foster care systems, however, do not have access to these tools and instead find themselves living in trying circumstances, likely lacking supportive relationships or combating grave social problems such as poverty, poor health, and social injustice. For these disconnected youth, paths forward may not be clear and may influence the disproportionate rate of teen pregnancy and birth rates among them.
While the teenage pregnancy rate and birthrate have declined nationwide, the United States continues to have the highest rates of teen pregnancy and births in the industrialized world. 1 An estimated 1 in 3 young women in the United States will become pregnant at least once before the age of 20. 2 Youth in the foster care system and those who have transitioned out of the system appear even more likely to become pregnant. By age 19, nearly half of the surveyed foster care females report ever having been pregnant, while only 20% of non-foster care females have ever been pregnant. 3 Females who have been in foster care also have higher birth rates (31.6% versus 12.2%) and higher subsequent pregnancy rates (46% versus 29%). 4 A series of focus groups with foster youth and foster parents found certain themes help explain the correlation between foster care and teen pregnancy, including: Many foster youth lack key relationships and may, for instance, have no one to discuss sex and pregnancy with; foster youth, despite hardships and supportive interpersonal relationships, see many benefits to having a child of their own; and foster youth, even if they realize long-term implications, may be more prone to act on present impulses. 5

Adolescent childbearing, in combination with other pre-existing factors, is linked to negative consequences for mother and child and to significant societal costs. Just over half of teenage mothers complete high school during adolescence or early adulthood and teen mothers generally are likely to have limited employment opportunities and to live in poverty and depend on welfare. 6 In 2004 alone, public sector costs associated with teen childbearing in the United States totaled at least $9.1 billion, including $2.3 billion in increased child welfare costs. 7

As these statistics reveal, the problem is far from solved. Reducing the nation's teen pregnancy rate is one of the most strategic and direct means available to reduce persistent and cyclical child poverty and improve overall child and family well-being.

Title X

Young people, including youth in foster care, need access to reproductive health and family planning services. Since 1970, the federal family planning program, Title X of the Public Health Service Act, has provided resources for health services and counseling to low-income or uninsured individuals who may otherwise lack access to health care. Currently, Title X supports a network of 4,400 family planning clinics nationwide that provide clinical services to prevent unintended pregnancies, lower rates of sexually transmitted diseases (including HIV), detect breast and cervical cancer at the earliest stages, and improve women's overall health.

Unfortunately, the Title X program has been systematically underfunded over the years, considering health care inflation and the growing demand for subsidized family planning services without corresponding increases in funding. This poses very serious challenges to its effectiveness and survival. Title X received $283 million for FY 2006 and FY 2007, and $300 million for FY 2008; had Title X funding kept up with inflation since 1980, it would now be funded at more than $725 million. 8 Greater financial commitment to the Title X program is necessary so that low-income women and men who may have nowhere else to turn can receive community-based family planning services.

Prevention First Act
The 110th Congress should pass and fully fund the Prevention First Act (H.R. 819/S. 21). This important legislation would provide grants to public and private entities to establish or expand teen pregnancy prevention programs; ensure federally-funded sex, family life, abstinence, comprehensive health, or character education is medically accurate and provides information on both the health benefits and failure rates of contraceptives; and improve education about emergency contraception to female victims of sexual assault. The bill would also increase funding for Title X family planning services and require that pregnant, Medicaid-entitled women receive prenatal, labor, delivery, and postpartum care. Youth in foster care, as well as youth aging out of foster care, would benefit from these initiatives.

Need for More Foster Care-Specific Programs and Data to Drive Appropriate Policy
While regional studies have been helpful, more consistent, ongoing nationwide data about teen pregnancy rates and trends among youth in foster care is needed to guide appropriate policy. Programs and interventions for teens in foster care should start early and address both primary and secondary prevention, with primary prevention helping the youth avoid pregnancy in the first place, and secondary prevention helping parenting youth avoid subsequent pregnancies. These programs should attempt to pinpoint and subsequently avoid the factors that motivate foster teens to become pregnant in the first place; cover multiple aspects of sexuality, conception, contraception, and the nature and benefits of healthy, respectful relationships; inform both teenage boys and girls; and be evaluated specifically for their effectiveness with foster care youth.

In addition to better educating teenagers in foster care, service providers need additional support and training on teen pregnancy prevention and related issues. This is necessary because the providers, in turn, can and should offer much-needed assistance to foster youth and foster parents and caregivers.

Comprehensive and Accurate Education
Congress must ensure all federally funded pregnancy prevention programs do not contain false, misleading, or distorted information about reproductive health, particularly in abstinence-only-until-marriage programs. A 2006 Government Accountability Office (GAO) report found that abstinence-only programs were not being monitored sufficiently to ensure the scientific accuracy of curriculum materials. 9 The same GAO report also indicated a lack of evidence that abstinence-only-until-marriage programs are effective. Similarly, a congressionally authorized multi-year, experimentally- based impact study that followed more than 2,000 elementary- and middle-school children into high school found that abstinence-only sex education simply does not stop teenagers from having sex; the youth that had received abstinence-only education were just as likely to have had sex as the youth who had not. 10 In view of these reports, Congress should suspend funding for abstinence-untilmarriage programs until the necessary accountability is in place or until they are proven effective.

Key Facts

  • Despite the United States' teenage pregnancy and birth rates decrease, 1 in 3 teen girls in the United States becomes pregnant by age 20. Most of the pregnancies are unplanned. 11

  • Females who have been in foster care are 2.5 times more likely than those who have not been in foster care to have become pregnant by age 19. 12

  • Females who have been in foster care have higher birth rates than their non-foster care counterparts (31.6% versus 12.2%) and higher subsequent pregnancy rates (46% versus 29%). 13

  • Teenage mothers are less likely to complete high school and only 1.5% earns a college degree by age 30. This, in turn, influences their earning capacity and likelihood to live on welfare. 14

  • In 2004 alone, teen childbearing cost United States taxpayers $9.1 billion, including a $2.3 billion increase in child welfare costs. 15 Between 1991-2005, the U.S. birth rate for teens, age 15 to19, declined 35% to 40.4 births per 1,000 teen girls in 2005, after reaching its highest point in two decades (61.8 births per 1,000 teen girls, age 15 to 19 in 1991). Between 2005 and 2006, preliminary data suggest that rates have risen approximately 3%. 16


  1. Guttmacher Institute. (2006). U.S. teenage pregnancy statistics: National and state trends and trends by race and ethnicity. Available online. New York: Author; Hoffman, S.D. (2006). By the numbers: The public costs of teen childbearing. Available online. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
  2. National Campaign to Prevent Teen and Unplanned Pregnancy. (2007). National teen pregnancy and birth data. Available online. Washington, DC: Author. back
  3. Bilaver, L.A., & Courtney, M.E. (2006). Science says: Foster care. Available online. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
  4. Ibid. back
  5. Thiessen Love, L., McIntosh, J., Rosst, M., & Terzakian, K. (2005). Fostering hope: Preventing teen pregnancy among youth in foster care. Washington, DC: National Campaign to Prevent Teen Pregnancy. back
  6. Maynard, R. (Ed.) (1996). Kids having kids: Economic costs and social consequences of teen pregnancy. Washington, DC: Urban Institute Press. back
  7. Hoffman, By the numbers: The public costs of teen childbearingback
  8. Planning & Reproductive Health Association. (2007). Title X (ten) national family planning program: Critical women's health program struggles to meet increasing demand. Available online. Washington, DC: National Family Planning and Reproductive Health Association. back
  9. Government Accountability Office. (2006). Abstinence education: Efforts to assess the accuracy and effectiveness of federally funded programs (GAO-07-87). Available online. Washington, DC: Author. back
  10. Trenholm, C., Devaney, B., Fortsen, K., Quay, L., Wheeler, J., & Clark, M. (2007). Impacts of four Title V, Section 510 abstinence education programs: Final report. Available online. Princeton, NJ: Mathematica Policy Research, Inc. back
  11. National Campaign to Prevent Teen and Unplanned Pregnancy, National teen pregnancy and birth databack
  12. Bilaver & Courtney, Science says: Foster careback
  13. Ibid. back
  14. Maynard, Kids having kids: Economic costs and social consequences of teen pregnancyback
  15. Hoffman, By the numbers: The public costs of teen childbearingback
  16. National Campaign to Prevent Teen and Unplanned Pregnancy, National teen pregnancy and birth databack

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