Editing Teenage pregnancy (section)

==Risk factors==

===Culture===
Rates of teenage pregnancies are higher in societies where it is traditional for girls to marry young and where they are encouraged to bear children as soon as they are able. For example, in some sub-Saharan African countries, early pregnancy is often seen as a blessing because it is proof of the young woman's [[fertility]].<ref name=subsahara/> Countries where [[teenage marriage]]s are common experience higher levels of teenage pregnancies. In the [[Indian subcontinent]], early marriage and pregnancy is more common in traditional rural communities than in cities.<ref name=escap/> Many teenagers are not taught about methods of birth control and how to deal with peers who pressure them into having sex before they are ready. Many pregnant teenagers do not have any cognition of the central facts of sexuality.<ref>{{cite journal | last1 = MacLeod | first1 = C. | title = The 'Causes' of Teenage Pregnancy: Review of South African Research – Part 2 | journal = South African Journal of Psychology | volume = 29 | pages = 8–16 | year = 1999 | doi = 10.1177/008124639902900102 | s2cid = 144455158 }}</ref>

[[Economic incentive]]s also influence the decision to have children. In societies where children are set to work at an early age, it is economically attractive to have many children.<ref>{{Cite book|url=https://books.google.com/books?id=Wi1PmIdkVA8C&q=having+children+to+avoid+poverty+in+old+age&pg=PA254|title=Cultural Selection|isbn=9780792355793|last1=Fog|first1=A.|year= 1999|publisher=Springer }}</ref>

In societies where adolescent marriage is less common, such as many developed countries, young age at first [[Sexual intercourse|intercourse]] and lack of use of [[contraceptive]] methods (or their inconsistent and/or incorrect use; the use of a method with a high failure rate is also a problem) may be factors in teen pregnancy.<ref name=oecd/><ref name=toosoon>[http://aspe.hhs.gov/HSP/cyp/xsteesex.htm Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy And Parenthood], US Department of Health and Human Services. Retrieved 25 January 2007.</ref> Most teenage pregnancies in the developed world appear to be unplanned.<ref name=toosoon/><ref name=psi>{{usurped|1=[https://web.archive.org/web/20170324184650/http://www.psi.org.uk/news/pressrelease.asp?news_item_id=37 Teenage Mothers: Decisions and Outcomes – Provides a unique review of how teenage mothers think]}} Policy Studies Institute, University of Westminster, 30 October 1998</ref> Many Western countries have instituted [[sex education]] programs, the main objective of which is to reduce unplanned pregnancies and [[Sexually transmitted infection|STIs]]. Countries with low levels of teenagers giving birth accept sexual relationships among teenagers and provide comprehensive and balanced information about sexuality.<ref name=guttmacher2>Guttmacher Institute. (2005). [http://www.guttmacher.org/sections/sexandrelationships.php Sex and Relationships]. Retrieved 8 August 2006.{{clarify|date=May 2011|reason=This is a long list of reports: Which one did the information actually come from?}}</ref>

Teenage pregnancies are common among [[Romani people]] because they marry earlier.<ref>{{cite journal |last1=Avci |first1=Ilknur Aydin |last2=Cavusoglu |first2=Figen |last3=Aydin |first3=Mesiya |last4=Altay |first4=Birsen |title=Attitude and practice of family planning methods among Roma women living in northern Turkey |journal=International Journal of Nursing Sciences |date=17 January 2018 |volume=5 |issue=1 |pages=33–38 |doi=10.1016/j.ijnss.2018.01.002 |pmid=31406798 |pmc=6626220 }}</ref>

===Other family members===
Teen pregnancy and motherhood can influence younger siblings. One study found that the younger sisters of teen mothers were less likely to emphasize the importance of [[education]] and [[employment]] and more likely to accept [[human sexual behavior]], [[parenting]], and [[marriage]] at younger ages. Younger brothers, too, were found to be more tolerant of [[illegitimacy|non-marital]] and early births, in addition to being more susceptible to [[Recklessness (psychology)|high-risk behavior]]s.<ref>{{cite journal | author = East PL | title = Do adolescent pregnancy and childbearing affect younger siblings? | journal = Family Planning Perspectives| volume = 28 | issue = 4 | pages = 148–153 | year = 1996 | pmid = 8853279 | doi = 10.2307/2136190 | jstor = 2136190 }}</ref> If the younger sisters of teenage parents babysit the children, they have an increased probability of getting pregnant themselves.<ref name="Jacobson"/> Once an older daughter has a child, parents often become more accepting as time goes by.<ref>{{Cite journal | doi = 10.1207/s1532480xads0202_1| title = Impact of Adolescent Childbearing on Families and Younger Sibling: Effects that Increase Younger Siblings' Risk for Early Pregnancy| journal = Applied Developmental Science| volume = 2| issue = 2| pages = 62–74| year = 1998| last1 = East | first1 = P. L. }}</ref> A 2011 study in Norway found that the probability of a younger sister having a teenage pregnancy went from 1:5 to 2:5 if the elder sister had a baby as a teenager.<ref>{{cite news| url=https://www.bbc.co.uk/news/health-14442709 | work=BBC News | title=Teenage pregnancy is 'contagious' | date=9 August 2011}}</ref>

===Sexuality===
{{See also|Adolescent sexuality}}
In most countries, most males experience sexual intercourse for the first time before their 20th birthday.<ref name=GImen>Guttmacher Institute (2003) [http://www.guttmacher.org/presentations/itor_slides_US.html ''In Their Own Right: Addressing the Sexual and Reproductive Health Needs of Men Worldwide.''] {{webarchive|url=https://web.archive.org/web/20130927100558/http://www.guttmacher.org/presentations/itor_slides_US.html |date=27 September 2013 }} pp. 19–21.</ref> Males in Western developed countries have sex for the first time sooner than in undeveloped and culturally conservative countries such as sub-Saharan Africa and much of Asia.<ref name=GImen />

In a 2005 [[Kaiser Family Foundation]] study of US teenagers, 29% of teens reported feeling pressure to have sex, 33% of sexually active teens reported "being in a relationship where they felt things were moving too fast sexually", and 24% had "done something sexual they didn't really want to do".<ref name=kaiser>{{cite web|url=http://www.kff.org/youthhivstds/upload/U-S-Teen-Sexual-Activity-Fact-Sheet.pdf |title=U.S.Teen Sexual Activity |url-status=dead |archive-url=https://web.archive.org/web/20080216015345/http://www.kff.org/youthhivstds/upload/U-S-Teen-Sexual-Activity-Fact-Sheet.pdf |archive-date=16 February 2008 }}&nbsp;{{small|(147&nbsp;KB)}} Kaiser Family Foundation, January 2005. Retrieved 23 January 2007</ref> Several polls have indicated [[peer pressure]] as a factor in encouraging both girls and boys to have sex.<ref name="pollingdata">The National Campaign to Prevent Teen Pregnancy. (1997). [https://web.archive.org/web/20070223214706/http://www.teenpregnancy.org/resources/data/polling97.asp What the Polling Data Tell Us: A Summary of Past Surveys on Teen Pregnancy]. teenpregnancy.org (April 1997).</ref><ref name=psychologytoday>Allen, Colin. (22 May 2003). "[https://archive.today/20130419001411/http://www.psychologytoday.com/articles/pto-20030522-000002.html Peer Pressure and Teen Sex]." ''Psychology Today.'' Retrieved 14 July 2006.</ref> The increased sexual activity among adolescents is manifested in increased teenage pregnancies and an increase in [[sexually transmitted diseases]].

===Role of drug and alcohol use===
Inhibition-reducing [[Drug abuse|drugs]] and [[alcohol (drug)|alcohol]] may possibly encourage unintended sexual activity.<ref>Theuri, Joseph and Nzioka, David (2021). Alcohol and drug abuse as ecological predictors of risk taking behaviour among secondary school students in Kajiado North Sub-County, Kajiado County, Kenya. African Journal of Empirical Research, 2 (1), 50–55. {{doi|10.51867/ajer.v2i1.9}}</ref> If so, it is unknown if the drugs themselves directly influence teenagers to engage in riskier behavior, or whether teenagers who engage in drug use are more likely to engage in sex. [[Correlation does not imply causation]]. The drugs with the strongest evidence linking them to teenage pregnancy are [[alcohol (drug)|alcohol]], [[cannabis (drug)|cannabis]], [[MDMA|"ecstasy"]] and other [[substituted amphetamine]]s. The drugs with the least evidence to support a link to early pregnancy are [[opioids]], such as [[heroin]], [[morphine]], and [[oxycodone]], of which a well-known effect is the significant reduction of [[libido]] – it appears that teenage [[opioid dependence|opioid]] [[recreational drug use|users]] have significantly reduced rates of conception compared to their peers who do not use opioids, and peers who do use  [[alcohol (drug)|alcohol]], [[MDMA|"ecstasy"]], cannabis, and [[amphetamine]].<ref name=oecd/><ref name="kaiser"/><ref name=Besharov/><ref>Sax, Leonard (2005) [http://www.whygendermatters.com/ ''Why Gender Matters'']. Doubleday books, p.&nbsp;128, {{ISBN|0786176814}}</ref>

===Early puberty===
{{main|Precocious puberty}}

Girls who mature early (precocious puberty) are more likely to engage in sexual intercourse at a younger age, which in turn puts them at greater risk of teenage pregnancy.<ref>{{cite journal |pmid=16322170 | doi=10.1542/peds.2005-0542 | volume=116 | issue=6 | title=Early puberty and adolescent pregnancy: the influence of alcohol use | year=2005 | journal=Pediatrics | pages=1451–6 | last1=Deardorff |first1=J |last2=Gonzales |first2=NA |last3=Christopher |first3=FS |last4=Roosa |first4=MW |last5=Millsap |first5=RE| citeseerx=10.1.1.558.9628 | s2cid=36296702 }}</ref>

===Lack of contraception===
{{main|Birth control}}

Adolescents may lack knowledge of, or access to, conventional methods of preventing pregnancy, as they may be too embarrassed or frightened to seek such information.<ref name="pollingdata"/><ref name="britsexed">Slater, Jon. (2000). "[https://web.archive.org/web/20070703000657/http://www.unesco.org/courier/2000_07/uk/apprend.htm Britain: Sex Education Under Fire]." ''The UNESCO Courier'' Retrieved 7 July 2006.</ref> Contraception for teenagers presents a huge challenge for the clinician. In 1998, the government of the UK set a target to halve the under-18 pregnancy rate by 2010. The Teenage Pregnancy Strategy (TPS) was established to achieve this. The pregnancy rate in this group, although falling, rose slightly in 2007, to 41.7 per 1,000 women.<ref>{{cite journal|author1=Adams, A. |author2=D'Souza, R.|year=2009|title= Teenage contraception|journal= General Practice Update|volume= 2|issue=6|pages= 36–39}}</ref>

Young women often think of contraception either as 'the pill' or condoms and have little knowledge about other methods. They are heavily influenced by negative, second-hand stories about methods of contraception from their friends and the media. [[Prejudice]]s are extremely difficult to overcome. Over concern about side-effects, for example [[weight gain]] and [[acne]], often affect choice. Missing up to three pills a month is common, and in this age group the figure is likely to be higher. Restarting after the pill-free week, having to hide pills, drug interactions and difficulty getting repeat prescriptions can all lead to method failure.<ref>{{cite journal|author1=Adams, A. |author2=D'Souza, R.|year=2009|title= Teenage contraception|journal= General Practice Update|volume= 2|issue=6|pages= 36–39}}</ref>

In the US, according to the 2002 [[National Survey of Family Growth]], sexually active adolescent women wishing to avoid pregnancy were less likely than older women to use contraceptives (18% of 15–19-year-olds used no contraceptives, versus 10.7% for women aged 15–44).<ref name=trusell&Wynn>National Surveys of Family Growth{{cite journal | vauthors = Trussell J, Wynn LL | title = Reducing unintended pregnancy in the United States | journal = Contraception | volume = 77 | issue = 1 | pages = 1–5 | date = January 2008 | pmid = 18082659 | doi = 10.1016/j.contraception.2007.09.001 | url = http://www.arhp.org/publications-and-resources/contraception-journal/january-2008 | access-date = 8 September 2008 | archive-date = 19 August 2018 | archive-url = https://web.archive.org/web/20180819115227/http://www.arhp.org/Publications-and-Resources/Contraception-Journal/January-2008 | url-status = dead | url-access = subscription }}</ref> More than 80% of teen pregnancies are unintended.<ref name=speidel>{{Cite journal | doi = 10.1016/j.contraception.2008.06.001| title = The potential of long-acting reversible contraception to decrease unintended pregnancy| journal = Contraception| volume = 78| issue = 3| pages = 197–200| year = 2008| last1 = Speidel | first1 = J. J. | last2 = Harper | first2 = C. C. | last3 = Shields | first3 = W. C. | pmid=18692608}}
</ref> Over half of [[unintended pregnancy|unintended pregnancies]] were to women not using [[contraceptives]],<ref name=trusell&Wynn /> most of the rest are due to inconsistent or incorrect use.<ref name=speidel /> 23% of sexually active young women in a 1996 ''[[Seventeen (American magazine)|Seventeen]]'' magazine poll admitted to having had [[Safe sex|unprotected sex]] with a partner who did not use a condom, while 70% of girls in a 1997 ''[[Parade (magazine)|PARADE]]'' poll claimed it was embarrassing to buy birth control or request information from a doctor.<ref name="pollingdata"/>

In 1995, the [[National Longitudinal Study of Adolescent Health]] surveyed 1,027 students in the US in grades 7–12 to compare the use of contraceptives among Whites, Blacks, and [[Hispanic]]s. 36.2% of Hispanics said they never used contraception during intercourse, compared to 23.3% of Black teens and 17.0% of White teens who did not use contraceptives during intercourse.<ref name="Sterling 2009 19–28"/>

In a 2012 US study, over 1,000 females were surveyed to find out factors contributing to not using contraception. Of those surveyed, almost half had been involved in unprotected sex within the previous three months. These women gave three main reasons for not using contraceptives: trouble obtaining birth control (the most frequent reason), lack of intention to have sex, and the misconception that they "could not get pregnant".<ref>{{Cite journal | pmid = 22555219| year = 2012| last1 = Biggs| first1 = M. A.| title = Unprotected intercourse among women wanting to avoid pregnancy: Attitudes, behaviors, and beliefs| journal = Women's Health Issues| volume = 22| issue = 3| pages = e311–8| last2 = Karasek| first2 = D| last3 = Foster| first3 = D. G.| doi = 10.1016/j.whi.2012.03.003}}</ref>

In a 2011 study for the [[Guttmacher Institute]], researchers found that from a comparative perspective, however, teenage pregnancy rates in the US are less nuanced than one might initially assume. "Since timing and levels of sexual activity are quite similar across [Sweden, France, Canada, Great Britain, and the US], the high U.S. rates arise primarily because of less, and possibly less-effective, contraceptive use by sexually active teenagers."<ref name="DJE">{{cite web|last=Darroch|first=Jacqueline E.|title=Teenage Sexual and Reproductive Behavior in Developed Countries: Can More Progress Be Made?|url=http://www.guttmacher.org/pubs/eurosynth_rpt.pdf|publisher=The Alan Guttmacher Institute|access-date=14 February 2011|author2=Jennifer J. Frost |author3=Susheela Singh }}</ref> Thus, the cause for the discrepancy between rich nations can be traced largely to contraceptive-based issues.

Among teens in the UK seeking an abortion, a 2007 study found that the rate of contraceptive use was roughly the same for teens as for older women.<ref>{{cite news| url=http://news.bbc.co.uk/1/hi/health/6279601.stm | work=BBC News | title=Teenage pregnancy myth dismissed | date=22 January 2007 | access-date=25 May 2010}}</ref>

In other cases, contraception is used, but proves to be inadequate. Inexperienced adolescents may use [[condom]]s incorrectly, forget to take [[combined oral contraceptive pill|oral contraceptives]], or fail to use the contraceptives they had previously chosen. [[Pearl index|Contraceptive failure rates]] are higher for teenagers, particularly poor ones, than for older users.<ref name=Besharov>{{Cite journal | doi = 10.1016/S0190-7409(97)00022-4| pmid = 12295352| title = Trends in Teen Sexual Behavior| journal = Children and Youth Services Review| volume = 19| issue = 5–6| pages = 341–367| year = 1997| last1 = Besharov | first1 = D. J. | last2 = Gardiner | first2 = K. N. | citeseerx = 10.1.1.673.5213}}</ref> Long-acting contraceptives such as [[intrauterine device]]s, subcutaneous [[contraceptive implant]]s, and contraceptive injections (such as [[Depo-Provera]] and [[combined injectable contraceptive]]), which prevent pregnancy for months or years at a time, are more effective in women who have trouble remembering to take pills or using barrier methods consistently.

According to ''Encyclopedia of Women's Health'', published in 2004, there has been an increased effort to provide contraception to adolescents via family planning services and school-based health, such as HIV prevention education.<ref name="Teen Pregnancy"/>

A 2025 study, using Swedish data, found that the introduction of the birth control pill could explain half of the decline in teenage pregnancy following its introduction.<ref>{{Cite journal |last=Ragan |first=Kelly Suzanne |date=2025 |title=The Power of The Pill: Evidence from Oral Contraceptive Sales* |url=https://academic.oup.com/ej/advance-article-abstract/doi/10.1093/ej/ueaf017/8026880?redirectedFrom=fulltext |journal=The Economic Journal |doi=10.1093/ej/ueaf017 |issn=0013-0133|url-access=subscription }}</ref>

===Sexual abuse===
{{See also|Sexual abuse}}

Studies from South Africa have found that 11–20% of pregnancies in teenagers are a direct result of rape. About 60% of teenage mothers had unwanted sexual experiences preceding their pregnancy. Before age 15, a majority of first-intercourse experiences among females are reported to be non-voluntary. The Guttmacher Institute found that 60% of girls who had sex before age 15 were coerced by males, who on average were six years their senior.<ref>{{Cite journal | pmid = 19372525| pmc = 3515795| year = 2009| last1 = Speizer| first1 = I. S.| title = Sexual violence and reproductive health outcomes among South African female youths: A contextual analysis| journal = American Journal of Public Health| volume = 99| pages = S425–31| last2 = Pettifor| first2 = A| last3 = Cummings| first3 = S| last4 = MacPhail| first4 = C| last5 = Kleinschmidt| first5 = I| last6 = Rees| first6 = H. V.| issue = Suppl 2| doi = 10.2105/AJPH.2008.136606}}</ref> In 2003, one in five teenage fathers admitted to forcing girls to have sex with them.<ref>Cullinan, Kerry [https://web.archive.org/web/20081120202426/http://www.csa.za.org/article/articleview/259/1/1/ Teen mothers often forced into sex]. www.csa.za.org. 23 November 2003</ref>

Multiple studies have indicated a strong link between early childhood sexual abuse and subsequent teenage pregnancy in industrialized countries. Up to 70% of women who gave birth in their teens were molested as young girls. By contrast, 25% of women who did not give birth as teens were molested.<ref>{{cite journal |vauthors=Saewyc EM, Magee LL, Pettingell SE | title = Teenage pregnancy and associated risk behaviors among sexually abused adolescents | journal = Perspectives on Sexual and Reproductive Health | volume = 36 | issue = 3 | pages = 98–105 | year = 2004 | pmid = 15306268 | doi = 10.1363/3609804 }}</ref><ref>{{Cite journal | last1 = Saewyc | first1 = E. M. | last2 = Magee | first2 = L. L. | last3 = Pettingell | first3 = S. E. | title = Teenage pregnancy and associated risk behaviors among sexually abused adolescents | journal = Perspectives on Sexual and Reproductive Health | volume = 36 | issue = 3 | pages = 98–105 | year = 2004 | doi = 10.1363/3609804| pmid = 15306268 }}</ref><ref>[http://www.scienceblog.com/community/older/1998/D/199803609.html Study Links Childhood Sexual Abuse, Teen Pregnancy] {{Webarchive|url=https://archive.today/20120629082937/http://www.scienceblog.com/community/older/1998/D/199803609.html |date=29 June 2012 }} University of Southern California, Science Blog, 2004</ref>

In some countries, sexual intercourse between a minor and an adult is not considered consensual under the law because a minor is believed to lack the maturity and competence to make an informed decision to engage in fully consensual sex with an adult. In those countries, sex with a minor is therefore considered [[statutory rape]]. In most European countries, by contrast, once an adolescent has reached the age of consent, he or she can legally have sexual relations with adults because it is held that in general (although certain limitations may still apply), reaching the age of consent enables a juvenile to consent to sex with any partner who has also reached that age. Therefore, the definition of statutory rape is limited to sex with a person under the minimum age of consent. What constitutes statutory rape ultimately differs by jurisdiction (see [[age of consent]]).

===Dating violence===
{{See also|Dating abuse|Teen dating violence}}

Studies have indicated that adolescent girls are often in abusive relationships at the time of their conceiving.<ref name=autogenerated1>{{cite journal |author=Rosen D |title="I Just Let Him Have His Way" Partner Violence in the Lives of Low-Income, Teenage Mothers |journal=Violence Against Women |volume=10 |issue=1 |pages=6–28|year=2004 |doi=10.1177/1077801203256069|s2cid=72957028 }}</ref><ref>{{cite journal|author=Quinlivan J |title=Teenage pregnancy |journal=O&G |volume=8 |issue=2 |pages=25–6 |date=Winter 2006 |url=http://www.ranzcog.edu.au/publications/o-g_pdfs/OG-Winter-2006/teenage-pregnancy.pdf |access-date=22 June 2009 |url-status=dead |archive-url=https://web.archive.org/web/20080720215040/http://www.ranzcog.edu.au/publications/o-g_pdfs/OG-Winter-2006/teenage-pregnancy.pdf |archive-date=20 July 2008 }}</ref> They have also reported that knowledge of their pregnancy has often intensified violent and controlling behaviors on part of their boyfriends. Girls under age 18 are twice as likely to be beaten by their child's father than women over age 18. A UK study found that 70% of women who gave birth in their teens had experienced adolescent domestic violence. Similar results have been found in studies in the US. A Washington State study found 70% of teenage mothers had been beaten by their boyfriends, 51% had experienced attempts of [[birth control sabotage]] within the last year, and 21% experienced school or work sabotage.

In a study of 379 pregnant or parenting teens and 95 teenage girls without children, 62% of girls aged 11–15 and 56% of girls aged 16–19 reported experiencing domestic violence at the hands of their partners. Moreover, 51% of the girls reported experiencing at least one instance where their boyfriend attempted to sabotage their efforts to use birth control.<ref>[http://www.cpeip.fsu.edu/resourceFiles/resourceFile_73.pdf Violence, Abuse and Adolescent Childbearing] {{webarchive|url=https://web.archive.org/web/20130927202303/http://www.cpeip.fsu.edu/resourceFiles/resourceFile_73.pdf |date=27 September 2013 }}. Florida State University Center for Prevention & Early Intervention Policy (2005)</ref>

===Socioeconomic factors===
[[File:The Child Mother.jpg|thumb|A young poverty-stricken girl clutches her child. [[Book frontispiece|Frontispiece]] illustration from ''Street Arabs and Gutter Snipes'' by George Carter Needham, Boston, 1884.]]

Teenage pregnancy has been defined predominantly within the research field and among social agencies as a social problem. [[Poverty]] is associated with increased rates of teenage pregnancy.<ref name=Besharov/> Economically poor countries such as [[Niger]] and [[Bangladesh]] have far more teenage mothers compared with economically rich countries such as [[Switzerland]] and [[Japan]].<ref name=globalis>[https://web.archive.org/web/20070713173733/http://globalis.gvu.unu.edu/indicator.cfm?IndicatorID=127 Indicator: Births per 1000 women (aged 15–19) – 2002] UNFPA, State of World Population 2003. Retrieved 22 January 2007.</ref>

In the UK in 2001, around half of all pregnancies to those under 18 were concentrated among the 30% most deprived population, with only 14% occurring among the 30% least deprived.<ref>"[http://www.statistics.gov.uk/statbase/Product.asp?vlnk=6725 Teenage Conceptions By Small Area Deprivation In England and Wales 2001–2]" (Spring 2007)''Health Statistics Quarterly Volume 33''</ref> For example, in [[Italy]] in 2001, the teenage birth rate in the well-off [[Central Italy|central regions]] is only 3.3 per 1,000, while in the poorer [[Mezzogiorno]] it is 10.0 per 1,000.<ref name=oecd/> Similarly, in the US in 2001, sociologist [[Mike A. Males]] noted that teenage birth rates closely mapped poverty rates in [[California]]:<ref>Males, Mike (2001) [http://home.earthlink.net/~mmales/yt-sex.htm America's Pointless "Teen Sex" Squabble] {{Webarchive|url=https://web.archive.org/web/20181013092427/http://home.earthlink.net/~mmales/yt-sex.htm |date=13 October 2018 }}, c Youth Today.</ref>

{| class="wikitable"
|-
!County
!Poverty rate
!Birth rate*
|-
|[[Marin County, California|Marin County]]
|5%
|5
|-
|[[Tulare County, California|Tulare County]] (Caucasians)
|18%
|50
|-
|[[Tulare County, California|Tulare County]] (Hispanics)
|40%
|100
|}
<small>* per 1,000 women aged 15–19</small>

Teen pregnancy cost the US over $9.1 billion in 2004, including $1.9 billion for health care, $2.3 billion for child welfare, $2.1 billion for incarceration, and $2.9 billion in lower tax revenue.<ref>[http://www.medicalnewstoday.com/articles/55373.php Teen Births Cost U.S. Government $9.1B In 2004 Despite Drop In Teen Birth, Pregnancy Rates, Report Says] {{webarchive|url=https://web.archive.org/web/20110512174552/http://www.medicalnewstoday.com/articles/55373.php |date=12 May 2011 }}. ''Medical News Today''. Retrieved 3 December 2011.</ref>

There is little evidence to support the common belief that teenage mothers become pregnant to get benefits, welfare, and council housing. Most knew little about housing or financial aid before they got pregnant, and what they thought they knew often turned out to be wrong.<ref name=psi/>

===Childhood environment===
Girls exposed to abuse, [[domestic violence]], and family strife in childhood are more likely to become pregnant as teenagers, and the risk of becoming pregnant as a teenager increases with the number of adverse childhood experiences.<ref>{{Cite journal | doi = 10.1093/swr/20.3.131|title=The link between childhood maltreatment and teenage pregnancy|journal= Social Work Research |year=1996|volume= 20 |issue=3|pages= 131–141|author=Smith, Carolyn }}</ref> In a 2004 study, one-third of teenage pregnancies could be prevented by eliminating exposure to abuse, violence, and family strife. The researchers note that "family dysfunction has enduring and unfavorable health consequences for women during the adolescent years, the childbearing years, and beyond." When the family environment does not include adverse childhood experiences, becoming pregnant as an adolescent does not appear to raise the likelihood of long-term, negative psychosocial consequences.<ref>Tamkins, T. (2004) [http://findarticles.com/p/articles/mi_m0NNR/is_2_36/ai_n6069104/pg_1 Teenage pregnancy risk rises with childhood exposure to family strife] {{webarchive|url=https://web.archive.org/web/20071104231437/http://findarticles.com/p/articles/mi_m0NNR/is_2_36/ai_n6069104/pg_1 |date=4 November 2007 }} Perspectives on Sexual and Reproductive Health, March–April 2004</ref> A 2001 study suggested that boys raised by mothers who experienced physical abuse, or who experienced domestic violence directly, were more likely to be involved in a teenage pregnancy.<ref>{{cite journal |vauthors=Anda RF, Felitti VJ, Chapman DP, Croft JB, Williamson DF, Santelli J, Dietz PM, Marks JS | title = Abused boys, battered mothers, and male involvement in teen pregnancy | journal = Pediatrics | volume = 107 | issue = 2 | page = E19 | year = 2001 | pmid = 11158493 | doi = 10.1542/peds.107.2.e19 }}</ref>

A 2003 study found that girls whose fathers left the family early in their lives had the highest rates of early sexual activity and adolescent pregnancy. Girls whose fathers left them at a later age had a lower rate of early sexual activity. The lowest rates are found in girls whose fathers were present throughout their childhood. Even when the researchers took into account other factors that could have contributed to early sexual activity and pregnancy, such as behavioral problems and life adversity, early father-absent girls were still about five times more likely in the US and three times more likely in New Zealand to become pregnant as adolescents than were father-present girls.<ref>{{cite journal |vauthors=Ellis BJ, Bates JE, Dodge KA, Fergusson DM, Horwood LJ, Pettit GS, Woodward L | title = Does father absence place daughters at special risk for early sexual activity and teenage pregnancy? | journal = Child Development | volume = 74 | issue = 3 | pages = 801–821 | year = 2003 | pmid = 12795391 | pmc = 2764264 | doi = 10.1111/1467-8624.00569 }}</ref><ref>Quigley, Ann (2003) [http://mentalhealth.about.com/cs/familyresources/a/teensex503_2.htm Father's Absence Increases Daughter's Risk of Teen Pregnancy] {{Webarchive|url=https://web.archive.org/web/20150906023159/http://mentalhealth.about.com/cs/familyresources/a/teensex503_2.htm |date=6 September 2015 }} Health Behavior News Service, 27 May 2003</ref>

Low [[education]]al expectations have been pinpointed as a risk factor.<ref>{{cite journal |vauthors=Allen E, Bonell C, Strange V, Copas A, Stephenson J, Johnson AM, Oakley A | title = Does the UK government's teenage pregnancy strategy deal with the correct risk factors? Findings from a secondary analysis of data from a randomised trial of sex education and their implications for policy | journal = J Epidemiol Community Health | volume = 61 | issue = 1 | pages = 20–7 | year = 2007 | pmid = 17183010 | pmc = 2465587 | doi = 10.1136/jech.2005.040865 }}</ref> A girl is more likely to become a teenage parent if her mother or older sister gave birth in her teens.<ref name="Furstenberg">{{cite journal |vauthors=Furstenberg FF, Levine JA, Brooks-Gunn J | title = The children of teenage mothers: patterns of early childbearing in two generations | journal = Fam Plann Perspect | volume = 22 | issue = 2 | pages = 54–61 | year = 1990 | pmid = 2347409 | doi = 10.2307/2135509 | jstor = 2135509 }}</ref><ref name="Jacobson">{{cite journal |vauthors=East PL, Jacobson LJ | title = The younger siblings of teenage mothers: a follow-up of their pregnancy risk | journal = Dev Psychol | volume = 37 | issue = 2 | pages = 254–64 | year = 2001 | pmid = 11269393 | pmc = 3878983 | doi = 10.1037/0012-1649.37.2.254 }}
</ref> A majority of respondents in a 1988 [[Joint Center for Political and Economic Studies]] survey attributed the occurrence of adolescent pregnancy to a breakdown of [[Interpersonal communication|communication]] between parents and child and also to inadequate [[parental supervision]].<ref name="pollingdata"/>

[[Foster care]] youth are more likely than their peers to become pregnant as teenagers. The National Casey Alumni Study, which surveyed foster care alumni from 23 communities across the US, found the birth rate for girls in foster care was more than double the rate of their peers outside the foster care system. A University of Chicago study of youth transitioning out of foster care in Illinois, Iowa, and Wisconsin found that nearly half of the females had been pregnant by age 19. The Utah Department of Human Services found that girls who had left the foster care system between 1999 and 2004 had a birth rate nearly three times the rate for girls in the general population.<ref>{{cite web|url=http://www.teenpregnancy.org/fostercare/Foster_Care_Project_FactSheet2.pdf |title=Fostering Hope: Preventing Teen Pregnancy Among Youth in Foster Care |url-status=dead |archive-url=https://web.archive.org/web/20070928011130/http://www.teenpregnancy.org/fostercare/Foster_Care_Project_FactSheet2.pdf |archive-date=28 September 2007 }}&nbsp;{{small|(42.1&nbsp;KB)}} A Joint Project of The National Campaign to Prevent Teen Pregnancy and UCAN (Uhlich Children's Advantage Network) 16 February 2006</ref>

=== Media influence ===
A 2006 study found that adolescents who were more exposed to sexuality in the media were more likely to engage in sexual activity themselves.<ref>{{cite journal | last1 = L'Engle |first1=KL |last2=Brown |first2=JD |last3=Kenneavy |first3=K | title = The mass media are an important context for adolescents' sexual behavior | journal = Journal of Adolescent Health | volume = 38 | issue = 3 | pages = 186–192 | year = 2006 | pmid = 16488814 | doi = 10.1016/j.jadohealth.2005.03.020 }}</ref> According to ''[[Time (magazine)|Time]]'', "teens exposed to the most sexual content on TV are twice as likely as teens watching less of this material to become pregnant before they reach age 20".<ref>{{cite news| url=http://www.time.com/time/nation/article/0,8599,1855842,00.html | archive-url=https://web.archive.org/web/20081106102203/http://www.time.com/time/nation/article/0,8599,1855842,00.html | url-status=dead | archive-date=6 November 2008 | magazine=Time | first=Alice | last=Park | title=Sex on TV Increases Teen Pregnancy, Says Report | date=3 November 2008}}</ref>