January 26, 2010, Washington Post

The pregnancy rate among teenage girls in the United States has jumped for the first time in more than a decade, raising alarm that the long campaign to reduce motherhood among adolescents is faltering, according to a report released Tuesday.

The pregnancy rate among 15-to-19-year-olds increased 3 percent between 2005 and 2006 -- the first jump since 1990, according to an analysis of the most recent data collected by the federal government and the nation's leading reproductive-health think tank.

Teen pregnancy has long been one of the most pressing social issues and has triggered intense political debate over sex education, particularly whether the federal government should fund programs that encourage abstinence until marriage or focus on birth control.

"The decline in teen pregnancy has stopped -- and in fact has turned around," said Lawrence Finer, director of domestic research for the Guttmacher Institute, the nonprofit, nonpartisan research group in New York that conducted the analysis. "These data are certainly cause for concern."

The abortion rate also inched up for the first time in more than a decade -- rising 1 percent -- intensifying concern across the ideological spectrum.

"One of the nation's shining success stories of the past two decades is in danger of unraveling," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today."

The cause of the increase is the subject of debate. Several experts blamed the increase in teen pregnancies on sex-education programs that focus on encouraging abstinence. Others said the reversal could be due to a variety of factors, including an increase in poverty, an influx of Hispanics and complacency about AIDS, prompting lax use of birth control such as condoms.

"It could be a lot of things coming together," said Rebecca Maynard, a professor of economics and social policy at the University of Pennsylvania. "It could be we just bottomed out, and whenever you are at the bottom, it tends to wiggle around. This may or may not be a sustained rise."

The report comes as Congress might consider restoring federal funding to sex-education programs that focus on abstinence. The Obama administration eliminated more than $150 million in funds for such groups, but the Senate's health-care reform legislation would reinstate $50 million.

The new findings immediately set off a debate over funding. Critics argued that the disturbing new data were just the latest in a long series of indications that the focus on abstinence programs was a dismal failure.

"Now we know that after 10 years and over $1.5 billion in abstinence-only funding, the U.S. is lurching backwards on teen sexual health," said James Wagoner of Advocates for Youth, a Washington advocacy group.

Supporters of abstinence programs, however, said the findings provided powerful evidence of the need to continue to encourage delayed sexual activity, not only to avoid pregnancy but also to reduce the risk for AIDS and other sexually transmitted diseases.

"Research unmistakably indicates that delaying sexual initiation rates and reducing the total number of lifetime partners is more valuable in protecting the sexual health of young people than simply passing out condoms," said Valerie Huber of the National Abstinence Education Association, who blamed the increase on several factors.

"Contributors include an over-sexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences," Huber said. The Obama administration is launching a $110 million pregnancy prevention initiative focused on programs with proven effectiveness but has left open the possibility of funding some innovative approaches that include encouraging abstinence.

The rate at which U.S. teenagers were having sex rose steadily through the 1970s and 1980s, fueling a sharp rise in teen pregnancies and births. That trend reversed around 1991 because of AIDS, changing social mores about sex and other factors, including greater use of contraceptives, which pushed the U.S. teen pregnancy rate to historic lows.

The U.S. rates still remained higher than those in other industrialized countries.

The decline in teen sexual activity had leveled off starting about nine years ago, and the teen birth rate began to increase in 2005. It wasn't known before if the increase was due to more pregnancies or fewer abortions and miscarriages. For the first time, the new analysis uses those factors in calculating the teen pregnancy rate.

The analysis examined data on teenage sex and births collected by the federal Centers for Disease Control and Prevention's National Center for Health Statistics and data on abortions collected by the CDC and Guttmacher -- the two best sources of such data.

The abortion rate among teenagers rose 1 percent in 2006 from the previous year -- to 19.3 abortions per 1,000 women in that age group, the analysis found. Taking that and miscarriages into account, the analysis showed that the pregnancy rate among U.S. women younger than 20 in 2006 was 71.5 per 1,000 women, a 3 percent increase from the rate of 69.5 in 2005. That translated into 743,000 pregnancies among teenagers, or about 7 percent of women in this age group.

"When birth rates go up and down, it could be the result of kids getting fewer abortions," said John Santelli, a professor of population and family health at Columbia University. "This shows that it's a true rise in pregnancies."

The rate remained highest for blacks but increased for all racial groups. Among blacks, the rate increased from 122.7 per 1,000 in 2005 to 126.3. For Hispanics the rate rose from 124.9 per 1,000 women to 126.6. Among whites, the rate increased from 43.3 per 1,000 women to 44.0.