NASHVILLE, Tenn. 鈥 Cicely Wilson鈥檚 work doesn鈥檛 end when she leaves her day job as a lactation consultant, doula, and child care expert.
Wilson founded a nonprofit called Sunnyside Up Youth Pregnancy Services, which connects girls ages 13 to 19 with resources they need to care for their babies. After-hours, she looks for affordable Nashville apartments, books medical appointments, tries to find strollers and other baby supplies, and hosts conversations with pregnant teens about breastfeeding and preparing mentally for childbirth.
Since the overturning of Roe v. Wade just over a year ago, Wilson said, she is confident that more Tennessee teens will carry their pregnancies to term. 鈥淏ecause the access isn’t there,鈥 she said. 鈥淚 do anticipate that we’re going to get a lot more teens that are wanting to parent their babies rather than going to Illinois or Georgia or Florida.鈥
Demand for services like Wilson鈥檚 could rise in the coming years even though the national teen birth rate has declined dramatically over the past three decades. It鈥檚 still dropping, but preliminary data released in June by the Centers for Disease Control and Prevention shows the descent may be slowing.
Doctors, service providers, and advocates say they鈥檙e worried full CDC data released later this year 鈥 which will include state-by-state numbers 鈥 could show a rise in teen births in many , where rates remain among the highest in the country. They say several factors 鈥 including the to strike down federal protections for abortion rights, intensifying political pushback against sex education, and on youth mental health 鈥 could start to unravel decades of progress.
鈥淚t鈥檚 absolutely concerning,鈥 said Laura Andreson, an OB-GYN in Franklin, Tennessee. The women鈥檚 health practice where she works is treating more pregnant teenagers than in recent years, which she thinks could reflect an emerging trend.
鈥淚t’s probably going to take a little bit of time,鈥 she said. 鈥淏ut I would venture to say we’re going to see it every year: It’s going to go up.鈥
Nationally, the rate of teen births has dropped by 78% since a modern-day peak in 1991 of 61.8 births per 100,000 people, according to the CDC. Starting in 2007, the rate had consistently dropped by about 8% until 2021, when the rate of decline slowed to about 2%.
鈥淚t certainly does stand in contrast to what we’ve seen in prior years,鈥 said CDC researcher Brady Hamilton. He is working on the updated version of the national data released in June that will break it down by state. Hamilton said that he can鈥檛 comment on the recent social and political factors at play, but that the 鈥減henomenal decline鈥 in the teen birth rates over more than 15 years could be reaching a natural plateau as states achieved their goals.
鈥淭here are a lot of states that have very low birth rates,鈥 he said. 鈥淪o you kind of potentially run into a situation where they’re already low and you really can’t go lower.鈥
But advocates say this leveling off could be the writing on the wall, signaling the start of a rise in teen births.
鈥淲e know that young people came back from the pandemic with record levels of mental health struggles, which can be very tied to things like teen pregnancy,鈥 said Jen Biundo, senior director of research and policy at Healthy Futures of Texas, a nonprofit that advocates for science-based education to curb teen pregnancy. A person with mental health issues may be more likely to form unhealthy relationships and engage in riskier sexual behaviors, she said.
And the unleashed a sea change of legislation across the nation affecting reproductive health and options for women. States like Tennessee enacted so-called trigger laws, overturning the right to most abortions. In August, an all-male South Carolina Supreme Court upheld what abortion opponents sometimes call a 鈥,鈥 which bans most abortions after about six weeks of pregnancy. The term is a misnomer because a fetus鈥 heart is not fully developed in the early stages of pregnancy.
The sudden shift in the reproductive health landscape concerns Hannah Lantos, a researcher who specializes in maternal and adolescent health for Child Trends, a nonprofit research center. She said changes in abortion policy likely won鈥檛 have major effects on teen birth statistics because most abortion patients aren鈥檛 teenagers. Teenagers account for only 9% of abortions and 6% of all pregnancies reported in the U.S. each year, according to a . Yet who do get pregnant in the U.S. will opt for an abortion, according to the Department of Health and Human Services.
Previous declines in the teen birth rate weren鈥檛 driven by access to abortions alone, Lantos said. Other factors like increased access to and more effective contraceptive methods and sex education contributed. Now, those tools also are under siege in many states.
In Texas, some school boards have amid backlash from parents. In New Hampshire, Republican state officials in federal sex ed funding, and officials in Miami-Dade County, Florida, banned new sex ed books. In Idaho, lawmakers told the state鈥檚 health departments the state would no longer fund adolescent pregnancy prevention programs.
Parents who oppose abortion could prevent their children from getting one. Even if the parents acquiesce, incentive for a teen is low, said Wilson of Sunnyside Up. People might need to for abortion care now. That鈥檚 particularly tricky for teenagers, who may be too young to make decisions independently.
鈥淭hat car ride can be very excruciating,鈥 Wilson said, noting that the drive from Nashville to the nearest abortion clinic 鈥 in Carbondale, Illinois 鈥 can take seven hours. 鈥淭hat’s seven hours of potential silence. That’s seven hours of tension. That’s seven hours of thinking about what’s next. And that is a long time to process something so difficult.鈥
The fear of a disapproving parent might also prevent a teenager who decides to keep the baby from revealing the pregnancy early on, Andreson said. That could lead to a lack of prenatal care, which is concerning for teens, given they are more likely to have complications than other expectant mothers.
鈥淭heir bodies aren’t designed to have babies yet,鈥 she said. 鈥淎nd this doesn’t even go into all the issues that go on once the baby’s born.鈥
Wilson, from Sunnyside Up, noted that teenage parents face unique challenges taking care of newborns. 鈥淚t’s a lot for them,鈥 Wilson said of the teens who seek her help. 鈥淭hey need that hands-on, in-person support.鈥
And one of the greatest challenges is housing. Teenagers need a co-signer on a lease. Even when they find a place, the median rent in Nashville , and Tennessee observes the federal minimum wage of $7.25 an hour. Sunnyside Up has persuaded clients to become roommates.
鈥淚t’s like we’re literally having to stack families together in the same household for them to be able to pay basic living expenses,鈥 Wilson said.
This story is part of a partnership that includes , , and .
