Key points
- US teen birth rates have continued to decline since 1991.
- Although US teen births are declining, the US teen birth rate is higher than in many other high-income countries.
- US teen birth rates vary among different racial, ethnic, geographic, and socioeconomic groups.
Overview
The US teen birth rate (births per 1,000 females aged 15-19 years) has declined 78% from 1991 to 2021.
Teen birth rates declined from 15 births per 1,000 females in 2020 to 14 births per 1,000 females in 2021. This is a record low and a decrease of 7% from 2020.1
Reasons for the declines are not totally clear. Evidence suggests these declines are due to more teens abstaining from sexual activity, and more sexually active teens using birth control.2
Although steadily declining, the US teen birth rate is higher than in other high-income countries.3 Additionally, rates vary among different racial, ethnic, geographic, and socioeconomic groups.14
What the data show
Racial and ethnic disparities
The 2021 teen birth rates (births per 1,000 females aged 15-19)1 varied by race and ethnicity:
- 24 for non-Hispanic American Indian/Alaska Native females.
- 22 for non-Hispanic Native Hawaiian and other Pacific Islander females.
- 22 for non-Hispanic Black females.
- 21 for Hispanic females.
- 9 for non-Hispanic White females.
- 2 for non-Hispanic Asian females.
Geographic and socioeconomic disparities
Geographic differences in teen birth rates persist, both within and across states.4
Teens in certain settings are at higher risk of teen pregnancy and birth than other groups. For example, women ever in foster care were more likely to have a teen birth than women who had never been in foster care.5
Social determinants of health (Healthy People 2030)—such as community levels of high unemployment, low education, and low income—have been associated with higher teen birth rates.
Interventions that address socioeconomic conditions like these may play a critical role in addressing disparities observed in US teen birth rates.6
What CDC is doing
Quality sexual and reproductive health services, such as birth control and sexually transmitted infection services, are important for supporting adolescent health. However, best practice recommendations for these services are not always followed.
CDC supports the Quality and Access for Reproductive Health Equity (QARE, pronounced 'care') for Teens project. This project is led by the National Association of Community Health Centers, along with Cicatelli Associates (CAI). It aims to improve best practices in health center services and increase access to those services.
- Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: final data for 2021. Natl Vital Stat Rep. 2023;72(1):1 – 53. https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-01.pdf
- Lindberg L, Santelli J, Desai S. Understanding the decline in adolescent fertility in the United States, 2007-2012. J Adolesc Health. 2016;59(5):577 – 583. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498007/
- Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223 – 230. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852976/
- Romero L, Pazol K, Warner L, et al. Reduced disparities in birth rates among teens aged 15-19 Years - United States, 2006-2007 and 2013-2014. MMWR Morb Mortal Wkly Rep. 2016;65(16):409 – 414. https://www.cdc.gov/mmwr/volumes/65/wr/mm6516a1.htm
- Nugent CN, Ugwu C, Jones J, Newburg-Rinn S, White T. Demographic, health care, and fertility-related characteristics of adults aged 18-44 who have ever been in foster care: United States, 2011-2017. Natl Health Stat Report. 2020 Jan;(138):1-14. PMID: 32510314.
- Fuller TR, White CP, Chu J, et al. Social determinants and teen pregnancy prevention: exploring the role of nontraditional partnerships. Health Promot Pract. 2018; 19(1):23 – 30. doi: 10.1177/1524839916680797. Epub 2016 Dec https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701861/