By Frank Greve - Knight Ridder
WASHINGTON - U.S. teen pregnancy and birth rates have plummeted to recorded lows as more teenagers delay sex, abstain from it, use contraception and use it more effectively. Abortions also are down.
The decline, to the lowest teen birth rates since national tallies began in 1940, is a remarkable personal health reform, sharper than U.S. declines in smoking or increases in seat-belt use.
The news is even better in California: The teen birth rate has dropped faster than it has in the rest of the nation. Between 1991 and 2000, the birth rate among female teens ages 15 to 19 in the U.S. declined 23 percent. In California, the drop was 36 percent.
In Santa Clara County, teen birth rates have dropped by more than half in recent years. In 1995, 33 of every 1,000 girls ages 15 to 17 in the county gave birth. In 2003, the rate had dropped to 15 of every 1,000.
``I never thought we would achieve it,'' said Dolores Alvarado, division director of community health promotion for the Santa Clara County Public Health Department. The drop in teen pregnancy ``seemed like a huge, daunting task. It's really unbelievable. The danger is we don't want to rest on our laurels. There is a whole group of teens coming up.''
Alvarado credits a concerted effort undertaken a decade ago involving community groups, schools, churches and the health department.
Counselors elsewhere who work with teens also cite community and parent involvement among many factors for dropping pregnancy and birth rates, but give much credit to more cautious and assertive girls.
``A lot more of us are making our own sexual decisions. That way, you don't get pushed around by your partner who wants you to do more,'' said Anna Bialek, 17, of Princeton, N.J. ``Of course, that can work both ways.''
Whatever the reasons, teen pregnancies and births are down about a third nationwide from their peaks in 1991, according to the U.S. Centers for Disease Control and Prevention in Atlanta. If the 1991 rates had persisted, about 1.2 million more children would have been born to teen mothers by 2004, Congress' Joint Economic Committee estimated last year.
``It's a big success story,'' said Dr. John Santelli, a Columbia University public-health professor and the lead author of a recent analysis of the decline. He attributes about half the drop to teens saying no to intercourse. The other half, he said, is due to their using contraceptives more often and more efficiently.
But this rosy picture has two major blemishes. First, the U.S. teen birth rate remains the highest in the industrialized world -- twice Canada's, for example, and five times France's. Second, the rates of sexually transmitted diseases (STDs) in the United States are the highest in the industrialized world.
Nonetheless, the decline in pregnancy among American teenagers is impressive: In 1990, 116 teens out of every thousand aged 15 to 19 got pregnant, according to the CDC. By 2000, just 85 did. More recent estimates of teen births suggest that the decline continues.
Counselors who have worked with teens, especially those who have been in the same settings for years, have some strong hunches -- and sometimes statistics -- about what's been happening.
Among their theories:
? More assertive girls.
``Condoms used to be a guy thing, a guy's choice, really,'' said Andrea Aumaitre, 38, who graduated from New Jersey's Camden High School as a teen mother and has been a sex-ed counselor at the inner-city school since 1996. ``Now our young ladies say, `I want you to use a condom,' or they carry condoms themselves.''
Aumaitre and other Camden counselors said girls were more cautious about sex nowadays because they were more ambitious.
? Abstinence is up.
The latest CDC survey reported that roughly two-thirds of boys ages 15 to 17 said they had never had intercourse. In 1988, half said they had not.
Terri Gosser, 47, a school counselor known as ``the sex lady'' since 1992 to Pinelands junior and senior high students in the mostly white rural area around Tuckerton, N.J., said she was seeing more abstinence pledgers. They tend to be ``strong spiritually'' and to ``have sports and other activities they're interested in that keep them busy,'' she said.
But virginity pledges come with some significant caveats.
Though they do typically defer the age of first sex by about 18 months for adolescents 12 to 18 years old, such pledges rarely hold until marriage, according to an eight-year study by Peter Bearman, a Columbia University sociologist, and Hannah Brueckner, a sociologist at Yale.
More troubling, teenagers who take such pledges are almost as likely to be infected with a sexually transmitted disease as those who never made the pledge, and are also less likely to use condoms and more likely to experiment with oral and anal sex, said the study, released in March.
? Anxieties over AIDS and other STDs are powerful motivators.
Condom use among teens ages 15 to 17 increased almost 30 percent from 1991 to 2001, according to federal surveys. Withdrawal as a means of contraception dropped 35 percent. The number of teens who said they used no contraception dropped 23 percent.
Having multiple partners used to be cool among her South Jersey students, Gosser said, ``for guys and girls, too.''
``Now kids say the `players' are dirty. They don't mean that they're sluts,'' she added. ``It's said with a hygienic implication.''
? The availability of contraceptives is up.
In her day, the only place where Camden's teens could get condoms easily was at Planned Parenthood, Aumaitre said. ``And boys didn't go there; they thought Planned Parenthood was for girls.''
Roughly a third of black female teens who had had sex used condoms the last time, according to a sex-behavior survey that the CDC released Sept. 15. That compares with a quarter of Latina teens and a fifth of white teen girls.
? More parental involvement.
When Gosser started teaching sex education, about a quarter of parents wouldn't let their kids participate. Last year, just five of 400 junior high parents refused. None of the 900 high school parents did.
? The Internet factor.
Of the 11 million adolescents who go online daily, more than a fifth say they have sought information about health topics they find hard to talk about, according to a survey by the Pew Internet & American Life Project released in July.
``Kids know there's no better place than the Internet to explore things that are too embarrassing to ask about publicly,'' according to Erica Gordon of the Children's Aid Society.
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Mercury News Staff Writer Sandra Gonzales contributed to this report.
