Birth Control in USA

Pregnancies among America’s teenagers have caught the nation’s attention as one of our greatest troubles. A Gallup poll conducted on May 23 and 24 of 1999 found that 7 percent of those surveyed reported that youth/teen pregnancy was “the most important problem facing this country today” (Gallup Organization, 1999). It was the fifth most common specific problem reported. The concern about teen pregnancy has even led to national goals regarding its reduction. The first family planning objective stated in Healthy People 2000, written in 1990, is to “reduce pregnancies among females aged 15-17,” and additional goals include increased abstinence along with reduced activity and increased contraceptive use among those adolescents who do engage in intercourse (U.S. Department of Health and Human Services, 1999a). Similar goals have been proposed for the next decade in Healthy People 2010 (U.S. Department of Health and Human Services, 1999b). In fact, statistics regarding teen pregnancy are quite startling. Each year, roughly 10 percent of women between the ages of 15 and 19, and 6 percent of women between the ages of 15 and 17, get pregnant (Henshaw, 1999). Approximately half of these pregnancies result in a live birth. The share of teen women who become pregnant per year is considerably higher in the United States than in other developed countries. Rates in England and Canada are one half the level and rates in Japan are one-tenth the level of the United States (Alan Guttmacher Institute, 1998). The high rate of teen pregnancy is a particularly American problem, which rules out the possibility that teens are simply too young to control their sexual activity and/or too shortsighted to use contraception. Social factors
must come in to play.

Researchers from many academic disciplines, including anthropology, demography, developmental psychology, and sociology, have contributed to the literature attempting to identify the factors that would lead to teen pregnancy. From these perspectives, teens’ sexual activity and use of contraceptives is governed by their stage of development, which is dependent upon a complicated array of factors influencing them since birth (and potentially even before that). Within this framework, particular acts are viewed as spontaneous and irrational, and teen pregnancies are viewed as “mistakes.” Economists have rarely contributed to the study of teen sexual activity and birth control use directly, but have examined the determinants of teen fertility. The contribution of economic analysis in that context is that it provides a focus on the costs and benefits of particular decisions and it applies more sophisticated statistical techniques to the study of the topic. The purpose of this paper is to review the theory and empirical evidence regarding teens’ sexual activity and birth control use with an emphasis on the contribution that economic analysis can make. In the next section I present a series of descriptive statistics designed to document recent trends in these activities for the population as a whole and for racial/ethnic subgroups. The third part of the paper will present a review of prior research, including both theoretical contributions across disciplines and well as previous empirical work that has estimated models of the determinants of sexual activity and birth control use. The fourth section will report an analysis of two data sets that are designed to accomplish two different goals. First, examination of cross-section data can provide correlational evidence regarding who engages in sexual activity and uses birth control. Second, I use state-level data over time attempting to identify whether changes in “prices” affect these activities, where prices are measured by economic conditions, AIDS incidence, welfare generosity, and the restrictiveness of abortion policy. The results of this analysis indicate that some prices do indeed matter; if engaging in sexual activity is “more expensive” through, say, an improved labor market or an increased probability of contracting AIDS, then teenagers are less likely to have sex and/or more likely to use contraception. The final section of the paper will review the evidence on the impact of teen child-bearing on the subsequent well-being of women.

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