23.12.2013

Conclusion on teenage pregnancy research paper

Unintended pregnancy is a widespread problem with far-reaching implications: almost half of all pregnancies in the United States are unintended, and the women and children involved in these pregnancies are disproportionately likely to experience a range of negative outcomes. Nearly half of all pregnancies in the United States are unintended, and the parents and children involved in these pregnancies tend to be disadvantaged in a number of ways. In addition, unintended pregnancy has important implications for public sector balance sheets.
In light of these considerations, policymakers have become increasingly interested in devising strategies for encouraging teens and young adults to take the steps necessary to avoid becoming pregnant until they are prepared to assume the responsibilities of parenthood. Since President Obama took office, lawmakers have made a number of sensible investments in evidence-based pregnancy prevention strategies. The reasons behind the high rate of unintended pregnancy can be organized into three broad categories. A second factor that contributes to unintended pregnancy is that some individuals who are motivated to avoid pregnancy are handicapped by a limited understanding of how to realize their good intentions. Insufficient knowledge about how to avoid unintended pregnancy is most commonly addressed via pregnancy prevention programs targeted on teens. Turning to the third reason for the high incidence of unintended pregnancy, there is strong evidence that expansions in access to publicly subsidized family planning services can affect rates of contraceptive use and unintended childbearing. The bottom line is that the research community has produced solid evidence that public policies can reduce rates of unintended pregnancy.
The research findings reviewed above were incorporated into a series of benefit-cost simulations of a nationally implemented mass media campaign, a nationwide teen pregnancy prevention program geared towards at-risk youth, and expansions in Medicaid-funded family planning services within states that were not granted family planning waivers by the federal government. The key message of these results is that each program would generate a substantial net savings for taxpayers at the same time that it helps to reduce child poverty and avert teen and unintended pregnancies.
Policymakers have begun to make prudent investments in effective strategies for reducing unintended pregnancy. Separate provisions in the ACA also provide $75 million in annual funding for evidence-based interventions to reduce teen pregnancy and restore $50 million in annual funding for abstinenceonly programs.
The research reviewed in this brief shows that evidence-based pregnancy prevention interventions are public policy trifectas: they generate taxpayer savings, they improve the lives of children and families, and they reduce the incidence of abortion. I review research on the causes of unintended pregnancy and the impacts of various evidence-based pregnancy prevention policies. For example, Figure 1 shows that unintended pregnancies are disproportionately concentrated among women who are unmarried, teenaged, and poor.


For instance, Emily Monea and I estimate that taxpayer spending on Medicaid-subsidized medical care related to unintended pregnancy totals more than $12 billion annually. This policy brief presents new research showing that several different evidence-based strategies have the potential to reduce unintended pregnancy. First, many young women and men lack sufficient motivation to avoid becoming pregnant until they are ready to do so.
Regarding the lack of motivation to avoid unintended pregnancy, there is a growing body of evidence suggesting that well-designed mass media campaigns can persuade some young men and women to avoid unprotected sex. The bulk of the high-quality research literature on these programs suggests that they have little effect on the behavior of the individuals who participate in them. While the teen pregnancy prevention program is estimated to have the largest effect on the pregnancy rate among teenagers, the expansion in access to subsidized family planning services is estimated to have the largest effect on unintended pregnancy rates overall.
Because of limitations in the relevant data, taxpayer savings are measured only in terms of the amount that would be saved on publicly subsidized medical care for pregnant women and on a variety of means-tested benefits provided to children under the age of five. While the latter provision has little evidentiary support, the research discussed in this brief suggests that the former provision is smart public policy. The relevant evidence suggests that state and federal lawmakers would be wise to maintain or even increase their investments in proven pregnancy prevention strategies rather than reduce their efforts in this area. In light of the prevalence of unintended pregnancy and the personal and societal costs that such pregnancies pose, policymakers would do well to invest further in these strategies. I discuss the estimated effects of mass media campaigns discouraging unprotected sex, teen pregnancy prevention programs, and expansions in publicly funded family planning services, and then present new research showing that expansions in these policies would likely lead to reductions in teen and unintended pregnancy, out-of-wedlock childbearing, and child poverty.
Some studies have used sophisticated statistical techniques in an attempt to determine the extent to which pregnancy intentions have a causal effect on maternal and child outcomes. The same research also shows that this goal can be attained in a cost-effective way: publicly financed mass media campaigns, comprehensive teen pregnancy prevention programs, and expansions in government subsidized family planning services are estimated to save taxpayers between two and six dollars for every dollar spent on them. However, their common thread is that they all focus at least in part on providing participants with information about how to protect themselves from unplanned pregnancy. Eligibility for these services has historically been limited to women who are pregnant and to mothers whose incomes place them below a very low threshold. The prevention of unintended pregnancy would probably also reduce government expenditures on the criminal justice system, on means-tested benefits for older children and adults, and on a range of other spending programs not incorporated into this analysis.
Due in large part to the fact that the Medicaid expansion and mass media campaign have lower costs per member of their target populations than does the more intensive teen pregnancy intervention, the benefit-cost ratios for the former two programs are higher than for the latter one.


The funding for evidencebased programs in the ACA complements an additional $110 million in discretionary funding for competitive grants to support both the replication of teen pregnancy prevention programs that have been shown to be effective and the implementation and evaluation of new interventions that have yet to be studied carefully.
The research also shows that each dollar spent on these policies would produce taxpayer savings of between two and six dollars. These studies generally suggest that unintended pregnancy and childbearing depress levels of educational attainment and labor force participation among mothers and lead to higher crime rates and poorer academic, economic, and health outcomes among children.
Unintended pregnancies are also much more likely than intended pregnancies to be terminated.
Motivation to avoid pregnancy is also reduced by the pervasive sense among young women in many low-income communities that there are few attractive alternatives to motherhood available to them. In other simulations whose results are documented in a longer paper but are not shown here, changes were made to some of the key assumptions underlying these analyses in order to test the sensitivity of their results. Over the last few years, prudent investments have been made in several proven pregnancy prevention policies.
Unintended pregnancies account for more than 90 percent of all abortions—and a substantial majority of Americans of all political stripes support the goal of reducing abortions. Qualitative studies have found that such women often believe their life prospects to be so limited that they anticipate facing few significant economic or social consequences as a result of becoming pregnant before they are married. Many of these programs have been evaluated using random assignment, which is the gold standard among the techniques available to policy researchers.
Although this may sound like a small effect, the results reviewed below show that a national media campaign has the potential to produce notable impacts on rates of unintended pregnancy and child poverty in a cost-effective way. The irony is that these efforts will likely lead to increases in the number of unintended pregnancies and therefore in the number of abortions.In addition, five states have thus far declined to accept federal funding for evidence-based teen pregnancy prevention programs.
Indeed, for reasons documented in this brief, these funds would likely generate taxpayer savings at both the federal and state levels even as they reduce teen pregnancy rates.



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