Unintended Pregnancy Down Among Teens But Up for Young Adults
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News that America's teen pregnancy rate fell 36 percent made for celebratory headlines this year, but a lesser-known finding is that among young adult women, rates of unwanted and unintended pregnancy have actually increased.
"The nation has made extraordinary progress in teen pregnancy, but there's been no corresponding progress among twenty-somethings," says Bill Albert, deputy director of the National Campaign to Prevent Teen Pregnancy.
The rate of unwanted pregnancies among women ages 20 to 24 rose by 6 percent from 1994 to 2001, though it declined among teens, according to the National Campaign. Further, 54 percent of unwanted pregnancies occur to women in their twenties, with the largest proportion, 32 percent, among women 20-24.
In complementary findings, the Guttmacher Institute calculated an increase in the rate of unintended pregnancies among women ages 19-35. (The 'unintended' category includes unwanted pregnancies, described as such by the women surveyed, as well as those that are wanted but poorly planned or ill-timed.)
From 1994 to 2001, according to Guttmacher, unintended pregnancies among 25 to 29-year-olds rose from 66 to 71 per 1,000 women. In the same period, unintended pregnancies among 30- to 34-year-olds increased from 38 to 44 per 1,000 women. This trend has given researchers and reproductive health activists cause for concern:
"What you find is one in three pregnancies are unwanted. There's a lot of fertility chaos out there," Albert says. (Both Guttmacher and the National Campaign estimate the majority of unintended and unwanted pregnancies to be among unmarried women.)
The two organizations drew heavily on newly released data from the U.S. National Survey of Family Growth, which collected information from more than 17,000 women in 1994 and 2001.
Researchers are trying to find out why adolescents appear to be more capable of controlling their reproductive destinies than young adults. Most experts agree on one fairly obvious explanation: young adults are more likely than teens to be sexually active, though they don't appear to use birth control any more consistently.
The National Campaign has conducted 16 focus groups around the country this year with college- and non-college-educated 20-somethings, some with firsthand experience in pregnancy, and found that while many do not actively pursue pregnancy, they knowingly take their chances through hit-or-miss birth control.
"The question is, why is it that so many young people who say they do not want to get pregnant are rolling the dice?" Albert asks.
Experts are finding that young people's reasons for foregoing a condom or some other measure may have less to do with the urgency of the moment and more to do with their feelings about marriage and child-bearing.
"We are talking to women about why some do and don't use contraception even if they don't want to get pregnant," says Lawrence Finer, director of domestic research at the Guttmacher Institute. "Some people are ambivalent about getting pregnant. They see it as something that happens or doesn't happen, something they have less control over."
Adding to their feelings of helplessness about pregnancy prevention is a casual acceptance of unintended pregnancy. In fact, young people are more alarmed by the prospect of an STD than an unwanted pregnancy, Albert's organization has found.
"It's almost as if pregnancies are not as important," he says, citing some of the statements that surfaced in focus groups, including:
- "Having an STD is so much worse than getting pregnant"
- "If it [pregnancy] happens, it happens"
- "It's not going to kill me if I have one"
- "I'm 28. A baby is not the worst thing that could happen to me."
Similar statements emerged in in-depth interviews with 48 unmarried, mostly low-income parents in a study by Paula England, senior scholar at the Council on Contemporary families and a sociology professor at Stanford University. Here is a sample of one 22-year-old woman's reasoning from England's upcoming book, Unmarried Couples with Children:
"Well, we were planning on getting married, and planning to save for a house, so Myron and I are very committed to each other, so we just were -- I don't know. If we were to get pregnant it wouldn't be a big deal. Or it wouldn't be something unwanted or unplanned. And if we didn't [get pregnant] it wasn't a big deal either."
In England's study, low-income parents said they had access to birth control and could afford it. Further, they used it properly in the beginning of the relationship, but as the partnership grew more serious, they tended to use it less regularly. One explanation is that some people see the use of condoms, in particular, as a sign of mistrust in the relationship because condoms have come to be associated with disease prevention, according to England.
Another reason for the increased rate of unintended and unwanted pregnancies is the widening window of opportunity for them to occur: the age of matrimony has risen even as the onset of sexual activity has fallen. The median age of first marriage has risen from 23 to 27 for men and 21 to 26 for women over the last 25 years, according to the U.S. Census Bureau.
Further, there may be more unplanned pregnancies because of because of changing attitudes about births outside marriage, which have skyrocketed since 1970. But there is probably far more to the story, England says.
"If I had to take a guess, I'd say it's not because single motherhood is more legitimate. It's that shotgun marriage has really changed," England says. "If you go back 40 or 50 years, a fair number of marriages were shotgun. What was really stigmatized wasn't so much being a single mother per se but revealing that you had non-marital sex... The fact that you got pregnant revealed the woman was a fallen woman. I think now that it's not enough to get you the slut label. Therefore that makes people less likely to have to get married over this [unplanned pregnancy]."
And while social conservatives might argue that marriage has lost its significance among young people, as evidenced by out-if-wedlock births, England disagrees. Research of low-income people's attitudes about marriage shows that declining marriage rates among the poor do not indicate a lack of respect for marriage. If anything, the opposite:
"Even if you take poor black women where 80 percent of births are outside marriage, marriage is still the norm. If you interview people in these situations, they'll say it's ideal to be married if you have a house and have your economics together," England says.
"The poor have really internalized the middle class ideal that you have to have your economics together to get married," England says. "They keep finding themselves in these situations where they don't think it's appropriate to be married -- they don't have a house, they can't make ends meet."
Low-income people deferring matrimony represent "what demographers and sociologists call 'the retreat from marriage'," England says. The term is widely used to describe declining marriage rates across society but is especially concentrated among people living in poverty and men who are not college-educated.
An ongoing landmark study at Princeton University, "Fragile Families," confirms that unmarried couples with children commonly defer marriage on economic grounds, but it also notes other reasons: the woman's reticence, in particular, based on her concern that her partner is not mature enough or will not be faithful.
Yet another reason noted in the study is the desire for an elaborate, expensive wedding ceremony, which has become a middle-class norm and a highly celebrated ritual in magazines and on TV. Social conservatives are well aware of the trends in young adult pregnancy. Last year, one Bush official publicly suggested a need to promote abstinence to the 20-29 age group, citing rising pregnancy rates. His idea did not gain widespread support, however.
Still, the much-derided prospect of an adult abstinence campaign raises some important issues for activists in the field: How do you address adult behavior effectively?
One effort undertaken by the National Campaign to Prevent Teen Pregnancy is to correct widespread misunderstandings. First, surveys show that most Americans think the problem of unwanted or unintended pregnancies is mainly a teen issue, and second, that such pregnancies among young adults are not problematic.
But unwanted pregnancy is often attended by serious consequences to children, whatever the mother's age, including less prenatal care and lower educational achievement, as well as greater familial instability, according to the National Campaign.
Women in their 20s generally fare better with unwanted pregnancies than teens but not always significantly, and in occasional cases, teen pregnancies actually result in better environments for children because the grandparents are involved and provide support, Albert of the National Campaign says.
Meanwhile, Guttmacher's research shows that even as unintended pregnancies are on the rise among non-teen women, subsets of that population often experience variations in access, affordability and attitudes relating to reproductive health.
For example, the rate of unintended pregnancy of Hispanic women who are poor is the highest of all ethnic groups studied, but it is twice the rate of non-poor Hispanic women, a trend mirrored overall. In 2001, poor women had unintended births at five times the rate of their counterparts in the highest income category, according to Guttmacher.
Further, the rate of unintended births among women living with a partner was more than twice that of married women or of unmarried women not living with a partner. One reason for this statistic might be that adult women living with a boyfriend fail to use birth control consistently out of a desire -- deliberate or unconscious -- to start a family.
But facile explanations do not always prove reliable when subjected to scrutiny, researcher Paula England has found. In her research, for example, England found little evidence of entrapment on the part of the women.
She remembers only one woman in her study saying, "He may not have been planning it but I was." More typically, however, the couples followed a pattern of using contraception unreliably, rolling the dice and responding to pregnancy with a mixture of happiness and ambivalence. If anything, she adds, "The men were more likely to be happy about the pregnancy than the women."
Amy DePaul is a writer and college instructor who lives in Irvine, Calif. Her articles have appeared in The Washington Post and many other newspapers.