Trends in Repeat Births and Use of Postpartum Contraception Among Teens — United States, 2004–2015

Deborah L. Dee, PhD; Karen Pazol, PhD; Shanna Cox, MSPH; Ruben A. Smith, PhD; Katherine Bower, PhD; Martha Kapaya, MPH; Amy Fasula, PhD; Ayanna Harrison; Charlan D. Kroelinger, PhD; Denise D'Angelo, MPH; Leslie Harrison, MPH; Emilia H. Koumans, MD; Nikki Mayes; Wanda D. Barfield, MD; Lee Warner, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2017;66(16):422-426.

Repeat Teen Births: 2015 and Change From 2004 to 2015

In 2015, among 413,144 births to teens aged 15–19 years, 38,324 (16.7%) were repeat births (Supplementary Table 1; https://stacks.cdc.gov/view/cdc/). The prevalence of teen births that were repeat births was highest among Hispanics (18.7%), followed by non-Hispanic black (black) (17.9%), and non-Hispanic white (white) (14.3%) births. The proportion of teen births that were repeat births varied by state, from 10.6% in Vermont to 21.4% in the District of Columbia.

Overall, the number of repeat teen births declined 53.8%, from 82,997 in 2004 to 38,324 in 2015. In addition, the percentage of teen births that were repeat births decreased 16.9%, from 20.1% in 2004 to 16.7% in 2015. By race/ethnicity, the largest declines in the percentage of teen births that were repeat births occurred among blacks (21.8%), followed by Hispanics (16.8%), and whites (13.9%). By age, declines in the percentage of teen births that were repeat births occurred both among teens aged 15–17 years (23.8%) and 18–19 years (19.7%). From 2004 to 2015, 35 states experienced a significant decline in the percentage of teen births that were repeat births; of the 35 states, 12 experienced declines of >20%, and none experienced a significant increase (Figure 1).

(Enlarge Image)

Figure 1.

Percent change in repeat teen births* —United States, 2004–2015
*Repeat teen births are two or more live births to a mother aged <20 years (Vital Statistics).
^† Data for 2004 and 2015 downloaded from CDC WONDER (https://wonder.cdc.gov).

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Abstract and Introduction
Repeat Teen Births: 2015 and Change From 2004 to 2015
Current Postpartum Contraceptive use — 31 States, 2013
Trends in Postpartum Contraceptive use Among Teens in Five States During 2004–2013
Discussion
References
Sidebar

Table. Postpartum contraceptive use among teens,* by selected characteristics — Pregnancy Risk Assessment Monitoring System, 31 states, ^† 2013
Characteristic (No.)	Overall		Postpartum contraceptive use								Chi-squared p-value
	Overall		Most effective^§		Moderately effective^§		Least effective^§		No contraceptive use^§
	No.	% (95% CI)^¶	No.	% (95% CI)^¶	No.	% (95% CI)^¶	No.	% (95% CI)^¶	No	% (95% CI) ^¶
Total (2,518)	—	100 (–)	652	26.9 (23.8–30.2)	984	40.2 (36.7–43.9)	415	15.7 (13.3–18.5)	467	17.2 (14.7–20.0)	—
Maternal age (yrs) (2,518)											0.5964
≤17	744	29.0 (25.8–32.5)	204	25.4 (20.0–31.6)	309	43.9 (37.2–50.8)	101	13.8 (9.7–19.3)	130	16.9 (12.4–22.6)
18–19	1,774	71.0 (67.5–74.2)	448	27.5 (23.8–31.5)	675	38.7 (34.6–43.1)	314	16.5 (13.6–19.8)	337	17.3 (14.4–20.6)
Previous live birth (2,499)											0.8867
No	2,135	86.1 (83.5–88.4)	546	26.5 (23.2–30.2)	849	40.7 (36.8–44.6)	343	15.7 (13.1–18.8)	397	17.1 (14.4–20.2)
Yes	364	13.9 (11.6–16.5)	102	29.5 (21.8–38.6)	126	36.9 (28.2–46.6)	67	15.6 (10.2–23.1)	69	17.9 (12.1–25.8)
Race/Ethnicity (2,455)											0.0003
White, non-Hispanic	839	45.9 (42.2–49.6)	193	26.9 (22.1–32.3)	362	40.2 (34.8–45.9)	154	18.5 (14.6–23.1)	130	14.4 (11.0–18.7)
Black, non-Hispanic	598	21.9 (19.0–25.2)	115	15.1 (10.2–21.6)	281	50.1 (42.0–58.2)	88	12.6 (8.1–18.9)	114	22.3 (16.0–30.2)
Hispanic	656	23.6 (20.9–26.7)	223	36.1 (29.9–42.7)	206	34.6 (28.1–41.7)	101	13.0 (9.4–17.8)	126	16.3 (12.2–21.5)
Marital status (2,518)											0.0627
Married	276	10.9 (9.0–13.2)	69	19.7 (14.0–27.0)	86	35.8 (26.2–46.6)	67	21.8 (15.0–30.6)	54	22.7 (15.1–32.5)
Other	2,242	89.1 (86.8–91.0)	583	27.8 (24.4–31.4)	898	40.8 (37.0–44.7)	348	15.0 (12.4–17.9)	413	16.5 (13.9–19.5)
State^† (2,518)											<0.0001
Alaska	92	1.0 (0.7–1.2)	31	32.6 (22.1–45.2)	18	22.7 (13.6–35.5)	20	21.9 (13.2–34.2)	23	22.8 (13.9–35.0)
Arkansas	98	2.4 (1.7–3.5)	9	13.7 (4.4–35.1)	52	53.1 (34.4–71.0)	17	17.8 (7.1–38.0)	20	15.4 (6.6–32.0)
Colorado	90	3.8 (2.8–5.2)	37	51.5 (36.1–66.6)	24	29.7 (17.4–45.9)	15	11.1 (5.4–21.4)	14	7.7 (3.5–16.2)
Delaware	49	0.6 (0.5–0.8)	7	15.3 (7.4–29.0)	30	63.5 (48.9–76.1)	4	6.1 (2.1–16.2)	8	15.1 (7.5–28.0)
Georgia	50	5.4 (3.6–8.1)	13	39.9 (21.0–62.3)	23	31.9 (15.7–54.2)	7	13.4 (3.9–36.7)	7	14.8 (4.8–37.4)
Hawaii	73	1.0 (0.7–1.4)	13	15.8 (7.4–30.6)	30	36.6 (23.4–52.3)	14	18.2 (9.2–32.7)	16	29.4 (16.6–46.5)
Illinois	71	11.3 (8.8–14.3)	16	19.7 (10.8–33.0)	33	52.7 (39.3–65.8)	13	12.6 (6.6–23.0)	9	15.0 (7.5–27.5)
Iowa	95	2.3 (1.6–3.3)	27	13.7 (6.4–26.8)	32	47.0 (29.6–65.2)	19	20.0 (9.0–38.7)	17	19.3 (8.5–38.2)
Maine	47	0.7 (0.5–0.9)	14	32.6 (18.5–50.6)	18	34.3 (20.0–52.1)	7	13.1 (5.1–29.5)	8	20.1 (9.4–37.9)
Maryland	35	2.3 (1.5–3.4)	4	15.8 (5.4–38.0)	14	35.0 (18.5–56.0)	8	21.7 (9.2–42.9)	9	27.6 (12.9–49.5)
Massachusetts	54	2.6 (1.8–3.7)	22	36.4 (21.9–54.0)	18	40.2 (23.7–59.4)	5	6.1 (2.4–14.6)	9	17.2 (7.0–36.4)
Michigan	141	7.7 (5.9–10.1)	31	18.6 (10.0–31.9)	73	55.8 (41.4–69.3)	23	19.2 (9.9–34.1)	14	6.4 (3.5–11.4)
Minnesota	46	2.6 (1.8–3.8)	18	28.9 (15.9–46.8)	13	30.2 (15.9–49.8)	6	17.4 (6.1–40.7)	9	23.4 (10.3–44.8)
Missouri	88	6.5 (5.2–8.2)	33	27.2 (18.2–38.6)	24	27.7 (18.1–39.9)	17	24.7 (15.5–36.9)	14	20.4 (12.1–32.2)
Nebraska	85	1.4 (1.1–1.9)	23	30.9 (20.0–44.4)	27	30.9 (20.3–44.0)	14	17.6 (9.5–30.3)	21	20.7 (12.4–32.4)
New Hampshire	36	0.9 (0.6–1.3)	13	43.0 (24.2–64.0)	13	27.7 (13.7–48.0)	6	17.6 (7.0–37.5)	4	11.7 (3.2–35.2)
New Jersey	32	2.0 (1.3–2.9)	5	20.3 (7.8–43.6)	9	25.3 (12.0–45.6)	8	20.7 (9.0–40.7)	10	33.8 (16.8–56.2)
New Mexico	148	3.0 (2.5–3.6)	50	39.3 (30.8–48.5)	54	30.5 (23.3–38.7)	18	12.3 (7.4–19.6)	26	18.0 (12.0–26.0)
New York	326	5.4 (4.0–7.4)	58	13.6 (6.3–26.7)	133	49.4 (33.8–65.2)	63	8.9 (6.0–13.1)	72	28.1 (15.8–45.0)
New York City	54	3.5 (2.4–5.1)	7	11.4 (3.8–29.3)	28	57.0 (38.4–73.8)	7	17.6 (7.3–36.8)	12	14.0 (5.7–30.6)
Oklahoma	108	4.1 (2.9–5.6)	21	32.2 (18.4–50.0)	46	39.1 (24.2–56.3)	15	14.7 (6.4–30.5)	26	14.0 (6.6–27.0)
Oregon	77	2.7 (2.0–3.7)	35	46.9 (31.7–62.7)	22	27.8 (15.4–44.7)	7	10.5 (3.7–26.0)	13	14.9(7.3–27.9)
Pennsylvania	43	6.4 (4.6–8.9)	9	23.2 (11.6–41.2)	20	41.9 (26.1–59.6)	8	17.5 (7.9–34.3)	6	17.4 (7.2–36.3)
Rhode Island	50	0.5 (0.4–0.8)	19	35.9 (22.2–52.3)	20	38.9 (24.6–55.4)	3	7.8 (2.6–21.0)	8	17.4 (8.0–33.9)
Tennessee	56	7.6 (5.6–10.3)	12	29.9 (16.8–47.5)	29	42.1 (26.9–59.0)	8	17.0 (7.6–33.8)	7	10.9 (4.0–26.4)
Utah	74	1.8 (1.4–2.3)	28	35.7 (25.0–48.0)	28	34.7 (24.1–47.0)	5	6.3 (2.6–14.7)	13	23.4 (12.7–39.1)
Vermont	43	0.3 (0.2–0.4)	17	40.3 (25.4–57.2)	15	38.0 (23.4–55.1)	8	16.9 (7.8–32.7)	3	4.9 (1.2–18.5)
Washington	41	4.0 (2.7–5.8)	13	37.8 (21.1–57.8)	11	26.1 (12.4–46.7)	7	12.8 (4.3–32.6)	10	23.4 (10.9–43.1)
West Virginia	153	2.1 (1.7–2.6)	19	11.9 (6.3–21.1)	77	50.6 (39.5–61.6)	30	18.9 (11.6–29.3)	27	18.6 (11.4–29.0)
Wisconsin	129	3.6 (2.7–4.9)	41	32.9 (20.3–48.5)	38	24.7 (14.5–38.8)	25	19.0 (9.9–33.5)	25	23.4 (13.2–37.9)
Wyoming	34	0.5 (0.4–0.8)	7	21.2 (9.0–42.4)	12	32.9 (16.7–54.4)	8	28.2 (13.2–50.4)	7	17.6 (6.7–38.8)

Abbreviation: CI = confidence interval.
*For this report, the term "teens" refers to persons aged <20 years.
^†"States" refer to 30 states (Alaska, Arkansas, Colorado, Delaware, Georgia, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, Vermont, Washington, West Virginia, Wisconsin, and Wyoming) and New York City.
^§Methods categorized by effectiveness, as determined by the percentage of females who experience pregnancy during the first year of typical use: most effective (contraceptive implant and intrauterine device) (<1%); moderately effective (oral contraceptive pill, an injectable (e.g., Depo–Provera), birth control patch, and vaginal ring) (6%–10%); and least effective (condom, diaphragm, cervical cap, contraceptive sponge, rhythm method/natural family planning, the "morning after pill," withdrawal, and "other" responses that could not be categorized to a more effective category) (>10%); also includes measure of teen mothers who report no postpartum contraceptive use.
^¶Weighted percent.