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Rural Health Information Hub

Maternal Health Considerations for Adolescents

Since 1991, birth rates have declined steadily in the U.S. among teenagers aged 15-19. However, from 2007 to 2015, teen birth rates in urban counties declined 50% (from 38.1 to 18.9 births per 1,000 females aged 15-19) while these same rates only declined 37% in rural counties (49.1 to 30.9). Maryland, Montana, North Dakota, and Pennsylvania reported the smallest decreases with less than 30%.

The 2015 rate of teen births remained highest among rural counties when broken into race and Hispanic origin of mother.

  • Non-Hispanic White: 10.5 urban, 26.8 rural
  • Non-Hispanic Black: 29.1 urban, 39.6 rural
  • Hispanic: 31.4 urban, 47.0 rural

In 2015, the teen birth rate for American Indian/Alaska Natives was highest overall among all races and ethnicities, at 32.9 per 1,000 females aged 15-19.

There is strong evidence that comprehensive clinic-based programs for pregnant and parenting teens reduce teen pregnancy and rapid repeat pregnancies. Programs are more effective when clinical and social services are integrated, mother and infant care are combined, and contraceptive education is offered.

One promising program, Teen Options to Prevent Pregnancy (TOPP), is working with adolescent mothers from seven counties in central Ohio. The program's primary goal is to reduce rapid repeat pregnancy among teenagers. TOPP is implemented over an 18-month period by nurse educators and a social worker. The program includes the following components:

  • Monthly one-on-one motivational interviewing sessions with a nurse educator
  • Free transportation to a clinic for contraceptive services
  • At least one in-person visit from a nurse educator
  • Referral to services by the program social worker

For more program examples, see RHIhub's Models and Innovations Rural Project Examples: Teen Pregnancy.

Resources to Learn More

Teen Pregnancy Prevention Program (TPP)
Provides information about the evidence-based TPP grant program for organizations supporting medically accurate and age-appropriate teen pregnancy prevention in the U.S. Offers training and resources for professionals working to reduce teen pregnancy, and support pregnant and parenting teens. Profiles successful models and their strategies of implementation.
Organization(s): Office of Population Affairs (OPA), U.S. Department of Health & Human Services