A New Report Finds a Disturbing Increase in Teenage Pregnancies—and Tragic Problems Born with Them
Why are so many teenagers getting pregnant?
Lincoln: The basic reason is that more teenagers are sexually active than ever before. Between 1970 and 1978 the number of sexually active teenagers increased by 50 percent. Young women have sex earlier and possibly more often than ever before. At the same time, the rise in contraceptive use has not been nearly as steep and dramatic as the sexual activity.
When are teenagers starting sex?
Dryfoos: At age 16. And by the time they reach 19, only one-fifth of young men and one-third of young women have not had intercourse.
Do most teenagers know enough about sexuality to practice it responsibly?
Dryfoos: No. Half of all teens use no contraceptive method at all when they begin to have sex. And most who seek advice from a doctor or a clinic do not do so until nearly a year after beginning intercourse. This delay means that half of all teenage pregnancies occur within six months of first intercourse and one-fifth occur in the first month.
Why don't they use contraception?
Lincoln: The use is rising, but most teenagers are still woefully misinformed. Forty percent of unmarried girls who didn't use contraception said that they didn't think they could get pregnant either because they thought they were too young or it was the wrong time of month. More than half don't realize they are fertile in mid-cycle.
What's the result?
Dryfoos: Well, in 1978 we had 1.1 million teenage pregnancies. Three out of every four were unintended. Of the total, 554,000 ended in births and 434,000 in abortions. Only 17 percent of the pregnancies were conceived following marriage, and 10 percent were conceived premaritally but were legitimated by marriage. Another 22 percent ended as out-of-wedlock births. The rest were miscarried.
How does a pregnancy harm a teenage girl?
Lincoln: If she has an abortion, there are physical risks and some psychological traumas. However, if she has the baby, the risks are more serious and long-lasting. The social consequences are that her education is curtailed so she is going to have difficulty getting jobs. She is more likely to be on welfare. If she gets married, it is three times more likely to break up than among those who postpone childbirth until their 20s.
How is the baby harmed?
Dryfoos: The child is more likely to be brought up in a single-parent home, on welfare, in poverty, especially if the mother is under 17. It may affect the child socially, economically, psychologically and intellectually.
Why are teen mothers more likely to have problems giving birth?
Lincoln: Those under 15 are themselves physiologically underdeveloped so the nutrition goes as much to the mother, who is still growing, as the baby, who tends to be born with low birth weight. We know that with excellent prenatal care a lot of this can be reversed. But pregnant teenagers are less likely to get this care because they are more likely to be poor, not to know where to go for help, and to get it late.
Has there been a change in contraceptive trends?
Dryfoos: Between 1971 and 1976 kids overwhelmingly went to the pill. But between 1976 and 1979 there was a tremendous amount of publicity about the side effects, and there was a great increase in two methods: withdrawal—which doesn't seem to do a lot of good—and condoms, which can be effective if used properly, but leave girls totally dependent on boys.
What is the best contraceptive available to teenagers?
Lincoln: There is no one method that seems to be the most effective, and, in fact, there are problems with all of them. The condom and the diaphragm have higher failure rates than the pill. But the pill isn't practical for someone having sex sporadically. Condoms are more effective than diaphragms among teenagers. Withdrawal is a rotten method. What is needed is some new kind of morning-after or once-a-month pill.
What about the IUD?
Lincoln: The most common serious complication with an IUD is pelvic inflammatory disease, which could lead to future infertility, a tragedy for young girls. Also, it is more difficult for girls who haven't had babies to use the IUD.
What's wrong with sex education in this country?
Dryfoos: It doesn't start early enough. It is not consistent enough. It doesn't reach enough children. And because of its nature, it's subject to political pressure at the school district level. There are only a very few states where it is mandatory. Yet research shows that the overwhelming majority of parents and children want sex education in their schools.
Should the federal government be spending money on family planning and abortion counseling?
Lincoln: These are very cost-effective programs. But right now the Reagan administration seems to be moving in the opposite direction. Richard Schweiker, Secretary of Health and Human Services, has spoken out against support of sex education in schools, arguing that the federal government should not be involved in such matters. Others are pressing for a constitutional amendment to abolish abortion and for legislation to prevent federally funded clinics from prescribing contraceptives without parental consent.
What would happen if these measures were carried out?
Lincoln: It would be a disaster. It would mean a lot more pregnancies, a lot more illegal abortions and a lot more out-of-wedlock births. For example, we estimate that existing contraceptive use by teenagers prevents 680,000 premarital pregnancies each year.
But doesn't contraceptive information promote sexual activity?
Dryfoos: No. Teenagers are becoming sexually active regardless of their access to contraceptives. About two million sexually active teens who do not want to get pregnant are not receiving any counseling whatsoever. Of those who do go to family planning clinics, half have already told their parents. But one-quarter would not come to the clinic if their parents had to be told. Most of them would continue to be sexually active and many would get pregnant as they abandoned contraception or used less effective drugstore or folk methods.
What are the social and economic costs of having so many teenage mothers?
Dryfoos: They are twofold. You are losing the economic contributions teenagers would otherwise make to society if their educations were not cut off. And as a result of the births, these teenagers are more dependent on welfare and are unable to get good jobs and to pay taxes. Half of the funding for Aid to Families with Dependent Children goes to homes in which the woman became a mother as a teenager. More directly, society must pay for the births of poor teenage mothers. The government stopped paying for Medicaid abortions, but is still paying for Medicaid births, which are much more expensive.
What do you see as the solution?
Lincoln: We need a program to get out information about sex, reproduction, contraception and parental responsibilities before young people become sexually active. We also need more research for better contraceptives for teenagers. Finally, we badly need services for teenage parents, which would include education and day care.
Wouldn't a less expensive solution be to tell 14-year-olds to stop sleeping around?
Lincoln: That has been proposed by a lot of people, but it hasn't changed anything. To alter trends in our society among teenagers, you will have to change patterns that involve everybody else. Teenagers aren't doing something different from the rest.
Why aren't parents dealing more effectively with sex education?
Dryfoos: The problem is that parents lack a great deal of information themselves. One study has shown that parents really don't know what to tell their children—and these are the people who grew up in the sexually liberated '60s. Yet by the time they became parents they felt inadequate to discuss sexuality with their children.
What is your own advice to teenagers?
Lincoln: Demand more information. Don't get pushed into sex. And don't get pregnant.