Is there a trend of increased unwanted childbearing among teenagers?

Is there a trend of increased unwanted childbearing among teenagers? John E. Anderson, PhD, Dmitry M. Kissin, MD, MPH, Joan Marie Kraft, PhD, Lee Warner, PhD and Denise J. Jamieson, MD, MPH. Centers for Disease Control and Prevention, Division of Reproductive Health

Background • Majority of teen births are unintended • Teenage fertility is declining • Unintended pregnancy is associated with poor health outcomes for both mother and child • Healthy People 2010 goal: increase proportion of intended pregnancies to 70%

Study questions What are the trends in teenage childbearing by categories of planning status? Is there an increase in unwanted teenage fertility?

Methods: National Survey of Family Growth (NSFG) • National Center of Health Statistics • National sample of women 15-44 y/o • Conducted in 1973, 1976, 1982, 1988, 1995 and 2002

Methods: NSFG

Methods: Measurements No births -Intended -Mistimed births -Unwanted Birth intentions right before becoming pregnant

Methods: each birth classified based on women’s responses • Unwanted: Right before you became pregnant, did you yourself want to have a(nother) baby at any time in the future? • Mistimed: Would you say you became pregnant too soon? • Recoded variable created by NSFG • Age at delivery <20 yrs and 20-24 yrs • Births in the past 5 years • Data from 4 surveys: 1982, 1988, 1995, 2002

Methods: Intended, mistimed, unwanted births • Concepts date back to 1950s fertility surveys, most births within marriage • Unwanted: occur at stage in life when no more lifetime births desired • Unwanted childbearing: indicator of ability to control fertility

Table from NSFG Report

Percentage of births in the past 5 years by planning status, all women, 1982-2002 Percentage Year of survey

Percentage of births in the past 5 years by planning status, women <20 y/o, 1982-2002 Percentage Year of survey

Percentage of births in the past 5 years by planning status, women 20-24 y/o 1982-2002 Percentage Year of survey

Percentage of unwanted births in the past 5 years, women <20 y/o, by race/ethnicity of mother, 1982-2002 Percent unwanted Year of survey

Increased percentage of unwanted births among young women • Potential explanations: - Declining ability to control fertility - Decrease of total births, higher concentration of unwanted births - Changing birth expectations and desires among young women

Age-specific Fertility rates, 15-19 y/o, United States, 1970-2003 Age-specific Fertility Rate Year

Mean number of births per woman in past 5 years, women 15-19 y/o, by planning status categories, 1982-2002 Mean births per woman Year of survey

Mean number of births per woman in past 5 years, women 20-24 y/o, by planning status categories, 1982-2002 Mean births per woman Year of survey

Percent of FIRST births in the past 5 years that were unwanted, by age 1982-2002 <20 Percent unwanted all ages Year of survey

Percent of women with no births, who intend no births, 1982-2002 Percent Year of survey

Percent of births unwanted by age of mother and survey year, 1982-2002

Conclusions • Consistent increase in unwanted childbearing among young women • The meaning of young women’s responses to planning status questions not completely understood • It is clear that there is substantial unplanned fertility • More research needed on: • factors associated with unwanted childbearing • trends in other pregnancy outcomes

Is there a trend of increased unwanted childbearing among teenagers?