Teen Births in the United States: Overview and Recent Trends

Contents

• Introduction
• Teen Births in the United States
• Teen Birth Rate Trends
• Recent Trends
• Factors Linked to Declines in Teen Births
• Financial and Social Costs of Teen Births

Summary

Adolescent childbearing is associated with significant social, health, and financial risks for teens, their families, and society more broadly. Data from the National Center for Health Statistics (NCHS), within the Centers for Disease Control and Prevention (CDC), indicate that the teen birth rate has decreased steadily over time. However, the United States continues to have one of the highest rates of teen births among other industrialized countries.

This report focuses on teen birth rates—and the marked decline in recent years. The teen birth rate is defined as the number of live births per 1,000 females aged 15 to 19 each year. The earliest NCHS estimate of the teen birth rate (in 1940) was 54.1, which later peaked in 1957 at 96.3. It then decreased in most years from the 1960s through the 1980s, with a low of 50.2 in 1986. The birth rate increased over the next few years, to 61.8 in 1991. From 1992 onward, the teen birth rate declined except in two years, 2006 and 2007. From 2007 to 2023, the rate declined by approximately 68%, to a historical low in 2023 of 13.1.

The teen birth rate has decreased across all racial and ethnic groups in recent years; however, the rates declined more for certain groups than others. From 2016 to 2023, birth rates fell by 54% for non-Hispanic Asian teens, 41% for non-Hispanic White teens, 40% for non-Hispanic American Indian or Alaska Native teens, 35% for Hispanic teens, 34% for non-Hispanic Black teens, and 26% for non-Hispanic Native Hawaiian or Other Pacific Islander teens. In 2023, the teen birth rates for non-Hispanic American Indian or Alaska Native teens (20.9 per 1,000 females aged 15 to 19), Hispanic teens (20.8), non-Hispanic Native Hawaiian or Other Pacific Islander teens (21.2), and non-Hispanic Black teens (19.3) were each more than double the rate for non-Hispanic White teens (8.4), and more than 10 times the rate for non-Hispanic Asian teens (1.8).

Teen birth rates have varied considerably by state and territory, which may be due to a variety of factors, such as population composition. (An analysis of these factors by state is beyond the scope of this report.) In 2023, the state with the lowest teen birth rate was New Hampshire (4.6); the state with the highest teen birth rate was Mississippi (24.9).

Fifteen states had rates of less than 10 births per 1,000 teens aged 15 to 19 in 2023: New Hampshire, Vermont, Massachusetts, Connecticut, Maine, New Jersey, Rhode Island, Minnesota, New York, Utah, California, Oregon, Washington, Pennsylvania, and Wisconsin (ordered from lowest to highest). Seven states had teen birth rates of 20 births per 1,000 teens or higher: Mississippi, Arkansas, Louisiana, Kentucky, Oklahoma, Tennessee, and Alabama (ordered from highest to lowest). The rates for the territories ranged from 11.6 in the U.S. Virgin Islands to 23.5 in Guam.

Teen birth rates have declined in rural areas over time but continue to remain relatively higher than teen birth rates in urban areas. The number of second (and additional) births to teen parents has also declined over time, with an 80% total decline from a recent high of 8.1 in 2007 to a historical low of 1.8 in 2023.

Research suggests that multiple factors have led to lower teen birth rates in the United States. From the 1990s through 2019, the risk of teen pregnancy decreased primarily because of improved contraceptive use, including an increase in the use of more effective contraceptive methods (e.g., long-acting and reversible methods) and an increase in the use of multiple methods of contraception. During this period, some of the risk of pregnancy among younger teens declined because of decreased sexual activity; however, general trends in adolescent sexual activity have remained relatively stable. Broad economic and social variables may also influence teen behaviors, such as expanded educational or labor opportunities.

Teen pregnancy has high costs for teen parents, their children, and society more generally. Teenage mothers and fathers tend to have less education and are more likely to have lower incomes than their peers who are not parents. Moreover, lower levels of education reduce teen parents' potential for economic self-sufficiency. Children of adolescent parents are also more likely to face certain adverse health and social outcomes, such as preterm birth and other child morbidities.

This report accompanies CRS Report R45183, Adolescent Pregnancy: Federal Prevention Programs, which discusses federal support for programs that seek to prevent pregnancy among adolescents, and CRS In Focus IF10877, Federal Adolescent Pregnancy Prevention Programs, which includes summary information about the programs.

Introduction

This report provides context for Congress about trends in the U.S. teen birth rate—defined as the number of live births per 1,000 females aged 15 to 19—with a focus on recent trends.¹ Since the 1960s, the U.S. teen birth rate has generally been in decline, with the rate reaching a record low in 2023 (the year for which the most recent data are available). Multiple factors have likely contributed to the decrease, though the influence of any single factor is not fully understood and may vary over time. These may include proximate factors, such as contraceptive use, and distal factors, such as broader social and economic factors.²

Teen births are a significant public health concern because of the range of health, social, and economic effects adolescent childbearing can have on adolescents, their children, and broader society.³ Despite substantial declines over time, the teen birth rate in the United States has remained higher than that of comparable high-income countries.⁴ Furthermore, there are persistent racial, ethnic, and geographic disparities.⁵

This report provides a description of teen birth rate trends and a brief discussion on (1) factors that may contribute to the ongoing decline in teen birth rates and (2) the adverse outcomes related to teen births. This report accompanies CRS Report R45183, Adolescent Pregnancy: Federal Prevention Programs, which discusses Congress's current approach of supporting programs that seek to prevent pregnancy among adolescents, and CRS In Focus IF10877, Federal Adolescent Pregnancy Prevention Programs, which includes summary information about the programs.

Teen Births in the United States

Official data on births to adolescent females are provided by the National Center for Health Statistics (NCHS), an agency of the Centers for Disease Control and Prevention (CDC).⁶ The NCHS, in collaboration with states and other jurisdictions, compiles and publishes official national data for all vital events (i.e., births, deaths, marriages, divorces, and fetal death) in the National Vital Statistics System (NVSS).⁷ In particular, birth data in the NVSS draw upon information included in all registered birth certificates and account for nearly every birth in the United States.⁸

Data on births are distinct from data on pregnancies. Whereas the number of births—and related characteristics such as maternal age—are derived directly from vital records, information on pregnancies relies on estimates from several data sources. In addition to data on births, such figures also incorporate calculations of pregnancy losses (e.g. miscarriage, stillbirth) from the National Survey of Family Growth and estimates of induced abortion from both the CDC's Abortion Surveillance System and the Guttmacher Institute's Abortion Provider Census.⁹ Various statistical approaches have been implemented over time to account for strengths and shortfalls of the aforementioned sources, as well as the inherent complexities in measuring pregnancy loss. As this report exclusively focuses on teen birth data, an evaluation of the nuances and challenges with pregnancy data are beyond the scope of this report.

Teen Birth Rate Trends

Since 1940, NCHS has published birth rate data that allow for longitudinal comparison by the age of the birth mother. The earliest estimate of the teen birth rate (in 1940) was 54.1 births per 1,000 females aged 15 to 19.¹⁰ Twenty years later, in 1960, NCHS began publishing teen birth rate data further disaggregated by subgroups; that is, the birth rate among teens aged 15 to 17 as well as among teens aged 18 to 19. Figure 1 shows the national U.S. teen birth rate from 1940 through 2023 (the rate excludes the territories).¹¹ Broadly, the teen birth rate (for ages 15-19) hovered around an average 56.9 throughout the early to mid-1940s, and then ticked up in the baby boom era of the 1950s, peaking in 1957 at 96.3. It then decreased in most years from the 1960s through the 1980s, with a low of 50.2 in 1986.¹² The birth rate increased over the next few years to 61.8 in 1991. From 1992 onward, the teen birth rate declined except in two years, 2006 and 2007. Since 2009, the teen birth rate has fallen to a new record low each year, with the most recent data reflecting a historical low of 13.1 in 2023—a 2% decrease from 2022 and a 68% decrease from the most recent peak observed in 2007.¹³

Recent Trends

In 2023, there were approximately 3.6 million births in the United States.¹⁴ About 141,000 of these births (3.9%) were to teenagers aged 15 to 19. This reflects a teen birth rate of 13.1 births per 1,000 females aged 15-19 in 2023—the lowest rate on record, and a 2% decline from 2022.¹⁵ The 2023 birth rates for 15- to 17-year-olds (5.5 per 1,000) and 18- to 19-year-olds (24.6 per 1,000) were also the lowest on record, though the birth rate among older teens remains consistently higher than the birth rate among younger teens.¹⁶

The 2023 rate reflects an overall decline of 68% since the most recent high in 2007 and a 79% decline from the second most recent high in 1991. Despite a decline in the overall teen birth rate, disparities exist among certain racial or ethnic groups. Teen birth rates in 2023 varied based on race and ethnicity, with four groups—non-Hispanic American Indian and Alaska Native (20.9 per 1,000), Hispanic (20.8), non-Hispanic Native Hawaiian or Other Pacific Islander (21.2), and non-Hispanic Black (19.3) teens—having more than double the teen birth rate for non-Hispanic White (8.4) teens, and more than 10 times the rate for non-Hispanic Asian (1.8) teens.¹⁷

Figure 2 shows the teen birth rate by race and Hispanic origin between 2016 and 2023. From 2016 to 2023, the teen birth rate generally decreased across all racial and ethnic groups; however, the rates declined more for certain groups compared with others and some groups experienced periodic increases.¹⁸ From 2016 to 2023, birth rates fell by 54% for non-Hispanic Asian teens, 41% for non-Hispanic White teens, 40% for non-Hispanic American Indian and Alaska Native teens, 35% for Hispanic teens, 34% for non-Hispanic Black teens, and 26% among non-Hispanic Native Hawaiian or Other Pacific Islander teens.

Teen birth rates have varied considerably by state and territory, which may be due to a variety of factors, such as population composition as well as individual, family, and broader societal factors that may vary by state and geographic region (among other characteristics). An analysis of these factors by state are beyond the scope of this report. Figure 3 displays a map of the five-year teen birth rate averages across each state from 1990 to 2023.¹⁹ For these maps, the teen birth rate is divided into eight categories to show variations across each of the 50 states and the District of Columbia.

Annual teen birth rates for each state and territory (where available) are presented in Table B-1, Table B-2, and Table B-2 in Appendix B. Figure B-1 in Appendix B compares individual state teen birth rates against the national teen birth rate for each year from 1940 through 2023.

In 2023, the state with the lowest teen birth rate was New Hampshire (4.6 per 1,000); the state with the highest rate was Mississippi (24.9). Fifteen states had rates of less than 10 births per 1,000 teens aged 15 to 19 in 2023: New Hampshire, Vermont, Massachusetts, Connecticut, Maine, New Jersey, Rhode Island, Minnesota, New York, Utah, California, Oregon, Washington, Pennsylvania, and Wisconsin (ordered from lowest to highest). Seven states had teen birth rates of 20 per 1,000 teens or higher: Mississippi, Arkansas, Louisiana, Kentucky, Oklahoma, Tennessee, and Alabama (ordered from highest to lowest). The rates for the territories ranged from 11.6 in the U.S. Virgin Islands to 23.5 in Guam. From 2007 (when the birth rate last increased) to 2023, the teen birth rate decreased in each state or territory by between 51.9% and 78.5%.²⁰

Teen birth rates have also declined in rural areas over time but remain relatively higher than rates in urban areas.²¹

Figure 3. Five-Year Average Teen Birth Rates, by State Number of live births per 1,000 females aged 15 to 19.

Source: Figure created by CRS using data from Michelle J.K. Osterman et al., "Births: Final Data for 2023." Notes: Due to the degree of missing longitudinal data, teen birth rates for U.S. territories are not included in the figure. All available individual-year data for each territory are included in Table B-1, Table B-2, and Table B-3 in Appendix B.

Although the majority of teen births are first births, some teens have additional children while still in their adolescent years. These births, sometimes referred to as repeat births, affect the overall teen birth rate and are associated with further risks to teen parents and their children.²² The total teen birth rate can also be understood as a combination of the "first child" teen birth rate and the "second child and over" teen birth rate, also referred to as "second and higher-order" births. Over the past two decades, teenagers have experienced greater declines in the number, rate, and percentage of "second child and over" births than for first births.²³ Figure 4 displays trends in the total teen birth rate alongside the rate of "first child" and "second child and over" births.

Based on available data, the highest "first child" teen birth rate (63.7) occurred in 1955, whereas the highest "second child and over" teen birth rate (27.7) occurred in 1960 (Figure 4).²⁴ As with the total teen birth rate, the "first child" and "second child and over" rates declined in most years from the 1960s to the 1980s; however, the "first child" teen birth rate increased slightly in 1966 and 1970, while the "second child and over" rate continued to decline. Both rates generally declined from 1971 to 1986, reaching a record low (at the time) "first child" teen birth rate of 38.8 and a record low (at the time) "second child and over" teen birth rate of 11.4, both of which occurred in 1986.²⁵ Over the next few years, both rates began ticking upwards again, with the "first child" teen birth rate reaching 46.3 and the "second child and over" teen birth rate reaching 15.5 in 1991.

As with the total teen birth rate, both rates declined from 1992 onwards, aside from increases in both rates in 2006 and a subsequent increase in "first child" teen birth rates in 2007. The 2023 "first child" teen birth rate of 11.3 reflects a historical low and a 65.8% decrease from the most recent high in 2007; the "second child and over" teen birth rate of 1.8 also reflects a historical low and a 77.8% decrease from the most recent high of 8.1 (observed in both 2006 and 2007).

Factors Linked to Declines in Teen Births

Researchers suggest that multiple factors have contributed to the near continuous decline in U.S. teen birth rates; these factors include a variety of individual, family, and broader societal factors, each of which may influence teen births to varying degrees.²⁶

Over time, individual behaviors among teens have contributed to the declining teen birth rate in various manners. For instance, data from 1995 to 2002 indicate that an older age at first sexual experience accounted for 23% of the decline in teen pregnancy among younger teens (i.e., teens aged 15 to 17).²⁷

More recent data indicate that trends in adolescent sexual activity have not changed significantly, but rather that decreases in the teen birth rate are attributed to an increased use of contraception. From 2006 through 2019, teens reported an increase in the use of contraception and more consistent use of highly effective methods.²⁸ Teens more frequently report the use of long-acting reversible contraceptives (LARCs; e.g., intrauterine devices, or IUDs, and birth control implants), though data concerning the use of condoms remains mixed.²⁹ Further, the choice to use certain contraceptive methods in conjunction with or instead of other methods may be influenced by a variety of factors, including clinical guidelines and related updates, physical and financial access, and individual preferences (a discussion of these influences among adolescents are beyond the scope of this report).³⁰ Differences observed in some trends in adolescent sexual behavior and contraceptive use may also depend on the sampling approach used by particular surveys.³¹

Broad economic and social variables may influence teen behaviors, such as whether they will abstain from sex or use contraceptives.³² Behavioral changes may have been driven by a confluence of factors, such as expanded educational and labor market opportunities for women and improvements in contraceptive technology.³³ Some observers theorize that the long-term downward trend in teen birth rates is attributable to the recession that began in 2007. They contend that during economic downturns the decrease in teen births—like the decrease in overall births—is partly due to teenagers being more careful as they witness the economic difficulties faced by their families.³⁴ Despite this rationale, the teen birth rate continued to diminish after the recession (as well as during periods of economic expansion in the 1990s).³⁵ Some researchers have aimed to quantify how media exposure may affect teen birth rates and related attitudes about contraceptive use and adolescent childbearing. The extent of this influence is not well understood.³⁶

Some observers contend that teen pregnancy prevention programs, such as those supported with federal funding, could potentially play a role in the declining birth rate for teenagers.³⁷ The extent to which these programs have contributed to a decline in the teen birth rate is not fully known.³⁸ Some researchers have found that the proportion of teens who receive formal sex education has changed little in recent years, and that teens are less likely to be instructed on topics such as how to access contraception, how to refuse sex, and/or how to prevent sexually transmitted infections (STIs).³⁹ Additionally, the receipt of this information can vary by teens' sociodemographic characteristics.⁴⁰

While the U.S. teen birth rate has decreased over time, it has been higher than that of most other industrialized countries.⁴¹ For instance, the 2021 U.S. teen birth rate of 13.9 per 1,000 was higher than the rate of the United Kingdom (8.2), France (5.1), Canada (4.9), and Sweden (2.5) (based on the most recent international data available that include the teen birth rate).⁴² The reasons for the high teen birth rate in the United States relative to other industrialized countries have not been fully explored. Economic conditions and income inequality within and between countries, as well as societal differences, such as rates of alcohol consumption, may play a role.⁴³ Further, the research literature, which is somewhat limited, indicates that use of contraceptives among teens appears to be greater in other developed countries compared with the United States.⁴⁴

Financial and Social Costs of Teen Births

Adolescent childbearing has high costs for the families of teen parents and society more generally.⁴⁵ Teenage mothers and fathers tend to have less education and are more likely to have lower income than their peers who are not teen parents. For example, approximately 90% of women who do not give birth during adolescence graduate from high school, whereas about 50% of teen mothers receive a high school diploma by 22 years of age.⁴⁶ In addition, according to the HHS Office of Population Affairs,⁴⁷ adolescents who have children before turning 20 (compared with older parents) are

• more likely to need public assistance;
• more likely to have low income as adults; and
• more likely to have children who face challenges such as poorer educational, behavioral, and health outcomes.⁴⁸

These adverse outcomes may be explained in part by the accompanying stressors and risk factors linked to having a child as a teen. They are also partly explained by underlying differences between those who give birth as teens and those who delay childbearing. Lower levels of education reduce teen parents' potential for economic self-sufficiency. At the same time, having lower income and less education can also increase the likelihood of teens becoming pregnant in the first place.⁴⁹ Compared with their counterparts who have children at a later age, teen mothers often come from more disadvantaged backgrounds (e.g., family more likely to receive public welfare benefits, parents have lower levels of education) or, as discussed below, may be the children of teen parents themselves.⁵⁰ In addition, teen sexual activity, even among those who do not become pregnant, can increase the risk of sexually transmitted infections (STIs), which can lead to long-term health issues. Some STIs are disproportionately common among adolescents and young adults.⁵¹

Adolescent childbearing can also affect the children of teen parents. Children of teenage mothers have poorer outcomes than children of mothers who give birth in their early 20s or later. They are generally more likely to (1) have chronic medical conditions, (2) use public health care, (3) have lower school readiness scores, (4) do poorly in school, (5) give birth during their teen years (females), and (6) be incarcerated (males).⁵² Relatedly, NVSS data examining linked infant and maternal health records indicated that infants born to teen mothers are more likely to face higher rates of neonatal and infant mortality and morbidity, including preterm birth or low birth weight, while teen mothers also face heightened risk of maternal health complications.⁵³

In addition to the consequences for teens and their families, teen childbearing has societal impacts. One study examined these societal impacts, specifically estimating the cost savings to public programs that were associated with avoiding unintended pregnancies during the teen years. The Power to Decide⁵⁴ did a simulation analysis to estimate the number of births to teenagers that had been averted due to the decrease in teen fertility rates from 1991 to 2015. The analysis then estimated total savings of $4.4 billion for this period, taking into consideration the cost savings to Medicaid that would have been associated with labor and delivery, postpartum care for the mother, and infant care, and receipt of Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits. Additional research of decreased or delayed teenage pregnancy and childbearing could help to inform the impacts for teen parents, their children, and society more generally.⁵⁵

Appendix A. Teen Birth Rate, 1940-2023

Appendix B. Teen Birth Rates

This report was originally authored by Adrienne Fernandes-Alcantara, former CRS Specialist in Social Policy. The most recent edition of the report received invaluable assistance on graphics from Juan Pablo Madrid, CRS Visual Information Specialist, as well as data support from Sylvia Bryan, CRS Research Assistant.

Footnotes