Continued: State abortions rates have declined; why not for teens?

Hidden within the positive news Tuesday of a decline in the state's abortion rate are some troubling numbers about teenagers.

A decline in the teen abortion rate through the 1990s has been stalled since 2003. And last year the rate actually increased among the far more sexually active 18- and 19-year-olds.

A reason for that may rest in one other finding in the annual Minnesota Department of Health report: The number of teens who had abortions and also said they had never used birth control jumped last year.

Overall, there were 222 fewer abortions among all women in 2007. The number among all teenagers -- 2,137 -- was virtually flat at just five fewer abortions than the previous year. But among 18- and 19-year-olds, the number of abortions increased by 65 in 2007.

Women who receive abortions are asked about their use of birth control. Among teenagers ages 15 to 19 who received abortions, the number who said they had never used birth control increased from 116 to 150. Though the numbers are small, they reflect similar trends in larger surveys.

"Especially with teenagers, we know that almost all induced abortions are the result of an unintended pregnancy. An important piece is contraceptives," said Wendy Hellerstedt, an associate professor at the University of Minnesota School of Public Health who studies trends in reproductive medicine.

That also may help explain some other downward trends in sexual health for teenagers that do not bode well. Between 2005 and 2006, the number of pregnancies and births among Minnesota girls ages 15 to 19 increased by about 6 percent, twice the national average. The number of sexually active high school seniors is higher, as are rates of chlamydia, gonorrhea and other sexually transmitted diseases.

The annual changes in abortion rates among teenagers may be small, said Michael Resnick, an adolescent health researcher at the university, but that doesn't mean teenagers are better off.

"It takes me to the bigger question: What do we do about a rising trend in pregnancies and births?" he said.

Advocates cite their efforts

Both sides of the abortion debate said the overall decline was good news.

A total of 13,843 abortions were performed in Minnesota in 2007, a 1.57 percent decrease over the previous year, but a slight rise compared with the two previous years. There were 17.4 abortions for every 100 live births.

Scott Fischbach, executive director for Minnesota Citizens Concerned for Life (MCCL), said the drop could in part be credited to the Positive Alternatives Act. That law, which MCCL championed, dedicates $2.5 million annually to organizations that try to help women avoid abortions by providing emotional, educational and financial support.

Planned Parenthood of Minnesota, South Dakota, North Dakota said that demand for its reproductive health services increased 13 percent in 2007, the majority of it from women who are poor or who do not have health insurance coverage.

"We've been putting the emphasis on expanding access to basic preventive services," said Sarah Stoesz, president and CEO of Planned Parenthood. "But we are not reaching all of the people who need to be reached."

Reflecting national trends

The rising number of sexually active teenagers who say they don't use birth control is of particular concern to Stoesz.

Fifteen percent of sexually active Minnesota high school seniors say they have never used contraceptives, an increase of 26 percent since 2004, according to a statewide survey of high school students by the Minnesota Department of Education. That mirrors national trends reported by the Centers for Disease Control and Prevention.

"That represents a failing on the part of adults in our community," Stoesz said. "Teenagers have a right to know how their bodies work and how they can protect themselves against unintended pregnancy and sexually transmitted infections."

Fischbach said that if access to contraception was a way to prevent abortions, "the problem would have been solved 30 years ago," he said. "It's not the solution."

Others said that in recent years the rising price of hormonal types of birth control, which have quadrupled or more in price because of changes in federal laws, is a significant barrier to teenage girls. Even if they have health insurance, many won't use if it means telling their parents that they are having sex.

"We do know some things about what increases use of contraception," said Lorie Alveshere, policy director for the Minnesota Organization on Adolescent Pregnancy, Prevention and Parenting (MOAPPP). "We know that it's confidential access, affordability, knowledge on how to use it."

That knowledge appears to have declined among teenagers as well, according to a national 2006 study on sex education among teenagers. In 2002, a third reported they had never received formal instruction on using birth control. One in five said they had received abstinence-only education without information on birth control, up from one in ten in 1995, according to the study published in the journal Perspectives on Sexual and Reproductive Health.

Resnick said that the declining economy can also have a negative impact on the choices teenagers make about risks of all kinds.

"Young people think about their future a lot," he said. "When it looks bleak and empty and the prospects for work and higher education are slim, those are the things that tend to increase the risk."

The economy seems to be an issue in the minds of many women who received abortions, according to the state's report. Most said they were undergoing the procedure because they did not want to have a child at that time. But more than 5,000 cited economic reasons, and 886 said they wanted to finish their education.

Josephine Marcotty • 612-673-7394