Context: The personal and social costs associated with teenage pregnancy in
the United States concern many policymakers and researchers, yet the role
of contraception in preventing these pregnancies has not been adequately qu
antified.
Methods: Published estimates of contraceptive effectiveness were applied to
1995 National Survey of Family Growth data on sexual and contraceptive pra
ctices in order to estimate the number of pregnancies averted through the u
se of contraceptives by U.S. teenagers. Four scenarios of contraceptive acc
ess-from current levels of access to highly restricted access-and teenagers
' sexual and contraceptive practices in response to such restrictions are u
sed to project the potential impact on pregnancies among teenagers.
Results: Current levels of contraceptive use averted an estimated 1.65 mill
ion pregnancies among 15-19-year-old women in the United States during 1995
. If these young women had been denied access to both prescription and over
-the-counter contraceptive methods, an estimated one million additional pre
gnancies (ranging from 750,000 to 1.25 million) would have occurred, assumi
ng some decrease in sexual activity. These pregnancies would have led to 48
0, 000 live births, 390, 000 abortions, 120, 000 miscarriages, 10,000 ectop
ic pregnancies and 37 maternal deaths.
Conclusions: Contraceptive use by teenage women prevents pregnancies and ne
gative pregnancy-related health consequences that can disrupt the lives of
adolescent women and that have substantial societal costs. Continued and ex
panded access to contraceptives for adolescents is a critically important p
ublic health strategy.