In 2013, the teen birth rate was the lowest it has been since 1991, with 27 births per 1,000 teenage women. While this decrease of 57% from 1991 is certainly a move in the right direction, this rate is still high. According to the World Bank, the United States’ teen fertility rate was 31 births per 1,000 women in 2012, while other countries, such as Germany, Denmark, and China, had births per 1,000 in the single digits (4; 5; and 9, respectively).
An unintended pregnancy can dramatically affect teen women in numerous areas, such as educational attainment, economic well-being, and overall health. These findings are intuitive; if a woman is unable to complete high school, she is unlikely to find employment that pays her to live comfortably, particularly if she is raising children. Poverty, as we discussed last month, is a large contributor to overall health, whether it relates to being able to buy healthy food, having the time to exercise, paying for health insurance, being able to afford both the time and money for necessary medical appointments, and myriad other factors. Many teenage mothers remain caught in the vicious cycle of poverty, and furthermore, studies have shown that this environment and history can affect the child: children who are born to teen mothers are less likely to perform as well as their peers who were born to older mothers on measures such as communication, cognition, and social skills. This affects overall educational performance, which can begin a new cycle all over again. Earlier this month, NPR, the Robert Wood Johnson Foundation, and the Harvard School of Public Health published a study on Adverse Childhood Experiences (ACE), indicating how these experiences affect children later in life.
Furthermore, teen mothers who are unable to earn a sufficient living to support themselves and their children are often supported by public programs, such as Medicaid and WIC. According to the National Campaign to Prevent Teen and Unplanned Pregnancy, the estimated cost to taxpayers (federal, state, and local) that supported programs associated with teenage childbearing was $9.4 billion. The average annual cost to taxpayers to support a child born to a teen mother during each year from birth to age 15 is $1,682.
Given the impact that teen pregnancy can have on both the individual teen mother, and the greater public concern, it is clear that family planning is an essential element that contributes to women’s health and economic futures.
Since 2009 in Colorado, an anonymous donor has provided the Department of Public Health and Environment (CDPHE) with funding to provide long-acting, reversible contraception (LARC) at no or low-cost to teens and low-income women seeking these methods at the Title X family planning clinics, which included local public health clinics. By providing more than 30,000 LARC devices, which require very little maintenance from the woman, as opposed to a traditional oral contraceptive pill or other methods that require regular action by the woman, the program served to decrease Colorado’s teen birth rate by 40 percent. Health officials from CDPHE estimate that the costs averted from Medicaid from 2010-2012 was between $49 and $111 million, since fewer mothers needed to be covered by Medicaid or apply for WIC. Furthermore, by preventing unintended pregnancies, the abortion rate also decreased for teens in Colorado during the years of the program, which had been set at three to five years, and has been stretched to seven. Currently, there is a bill in the Colorado legislature (House Bill 15-1194) that would allocate general funding ($5 million in the first year) to expand the program, allowing more teens and low-income women to receive these types of contraceptives after the end of the grant in June 2015.
HMACS recognizes the importance of family planning to both women as individuals, as well as the impact that unintended pregnancies have on the health care environment, including public programs. We have worked with national and local family planning providers on several projects, such as assisting with planning for Leadership Transitions, as well as helping sites to achieve PCSP certification, conducting community and market assessments, and other activities in order to help family planning clinics remain viable in the post-ACA environment. Through projects like these, we continue to strive towards helping others succeed at building healthy and sustainable programs in their communities.