Reasons for and Challenges of Recent Increases in Teen Birth Rates: A Study of Family Planning Service Policies and Demographic Changes at the State Level

The impact of publicly-financed family planning services on pregnancies, births, and costs: A critical review of the peer-reviewed literature

“…Of these eleven studies, six relied on within-subject analysis [7][8][9][10]16,17 while five integrated the use of separate exposure and comparison groups [11][12][13][14][15] , capitalising on the staggered implementation of publicly subsidised family planning programmes among states and the natural division of treatment and control groups formed through income-eligibility cut-offs. Of the five multi-group analyses, two employed a time series approach 14,15 and three relied on a cross-sectional, difference-in-difference design [11][12][13] . Based on study sample selection, response rate, measurement accuracy and validity and attention to confounding variables, all eleven reviewed studies received a quality rating of 'fair' on the US Preventive Services Task Force quality rating scale ( Table 1).…”

“…Four measured reductions in state, national, teen and non-teen birthrates as a proxy for programme impact, citing significant birth-rate reductions in response to the implementation of Medicaid family planning waivers [11][12][13]15 . Another study reported on improvements in birth outcomes in response to publicly financed family planning care, citing a reduced number of low-birth weight births, births with late or no prenatal care, infant deaths and neonatal dates 14 .…”

Abortion Surveillance — United States, 2014

“…Multiple factors influence the incidence of abortion, including access to health care services and contraception (87)(88)(89); the availability of abortion providers (8,9,50,90-92); state regulations, such as mandatory waiting periods (68), parental involvement laws (93), and legal restrictions on abortion providers (94,95); increasing acceptance of nonmarital childbearing (96,97); shifts in the race/ethnicity composition of the U.S. population (98,99); and changes in the economy and the resulting impact on fertility preferences and use of contraception (100,101). However, despite the multiple influences on abortion, because unintended pregnancy precedes nearly all cases of abortions, ¶ ¶ ¶ ¶ ¶ efforts to reduce the incidence of abortion need to focus on helping women, men, and couples avoid pregnancies that they do not desire.…”

State Policy and Teen Childbearing: A Review of Research Studies

“…Yang and Gaydos used more recent data and examined the relationship between teen birth rates and several family planning policies in place between 2000 and 2006. They found that the implementation of a contraceptive conscience clauseda restrictive law permitting health care providers to refuse certain medical services for personal or religious beliefsdis associated with higher teen birth rates among older white teens aged 18e19 years, but there was no association for black or Hispanic 18-to 19-year-olds or for younger teens (aged 15e17 years) of any race [17]. Together, these two studies suggest that, for older white teens, increased access to contraception is linked to lower birth rates, whereas restricted access is associated with higher teen birth rates.…”