Teen pregnancy and birth rate statistics: the long decline and the gaps that remain

She was 17, eight weeks pregnant by ultrasound, and had already decided she was going to parent. What she wanted from me was not a moral assessment. She wanted to know whether she could finish junior year, whether Medicaid would cover the birth in her state, and whether the implant she had never been offered after her older sister's pregnancy was still an option for later. Her mother sat quietly with a work badge still clipped to her shirt. Nobody in the room treated this as an abstract public health chart.

It is easy, reading national data, to forget those rooms. The U.S. teen birth rate is at a historic low. That is real, well documented, and worth saying without hedging. It is also uneven. A teenager in New Hampshire and a teenager in Mississippi live in different statistical worlds, and so do teenagers of different racial and ethnic groups in the same county.

According to the National Center for Health Statistics final birth data for 2023, the birth rate for females ages 15-19 was 13.1 live births per 1,000. That is down 4% from 13.6 in 2022 and 79% below the modern peak of 61.8 in 1991. Provisional 2024 data pushed the rate lower still, to 12.7. This article lays out the trend line, the age bands, the state and race gaps, repeat births, and what research attributes the decline to. Primary sources sit next to the numbers.

Year	Births per 1,000
2010	34.2
2012	29.4
2014	24.2
2016	20.3
2018	17.4
2020	15.0
2022	13.6
2023	13.1

Source: NCHS, Births: Final Data for 2023, Table 2. Rates are live births per 1,000 females ages 15-19.

The long decline

If you work in adolescent or obstetric care long enough, you have watched this number fall almost every year of your career. NCHS final data put the 2023 rate for females ages 15-19 at 13.1 births per 1,000. That is another record low. The agency notes that since 2009 the teen birth rate has fallen to a new low each year. The number of births to that age group was 140,977 in 2023, down 2% from 143,789 in 2022.

The longer view is starker. The same NCHS report places the 1991 peak at 61.8 and the most recent high, in 2007, at 41.5. From 1991 to 2023 the rate fell 79%. From 2007 to 2023 it fell 68%. Provisional 2024 data, released by NCHS in April 2025, put the rate at 12.7 (another 3% drop) and 137,020 births to females ages 15-19.

A few caveats keep this from turning into a victory lap. First, birth rates are not pregnancy rates. Abortions and fetal losses sit outside the birth certificate system, so a falling birth rate can reflect fewer conceptions, more pregnancy endings, or both. Second, the United States still has a higher teen birth rate than many other high-income countries, a point the CDC continues to flag even while celebrating the domestic decline. Third, national averages hide the state and race gaps discussed below; progress and remaining burden are both true.

Still, the direction is not ambiguous. A rate near 13 per 1,000 means roughly 1.3% of females ages 15-19 gave birth in 2023. In 1991 the corresponding figure was closer to 6%. That is one of the clearer multi-decade public health trend lines in U.S. reproductive health.

Group	Births per 1,000
Non-Hispanic Asian	1.8
Non-Hispanic White	8.4
All races and origins	13.1
Non-Hispanic Black	19.3
Hispanic (any race)	20.8
Non-Hispanic American Indian and Alaska Native	20.9
Non-Hispanic Native Hawaiian and Other Pacific Islander	21.2

Source: NCHS, Births: Final Data for 2023, Table 2. Race groups are non-Hispanic single race unless noted; Hispanic includes any race.

Younger teens and older teens

Aggregating ages 15-19 is useful for headlines and bad for clinical planning. Most teen births are to older teens. In 2023, NCHS reported a birth rate of 5.5 per 1,000 for ages 15-17 and 24.6 for ages 18-19. Both were record lows. Rates for those groups have fallen 75% and 66%, respectively, since 2007, and 86% and 74% since 1991. The birth rate for females ages 10-14 was unchanged at 0.2 per 1,000.

Count the births and the skew is obvious. Of 140,977 births to females ages 15-19 in 2023, 105,263 (about 75%) were to 18- and 19-year-olds, and 35,714 (about 25%) were to 15- to 17-year-olds. The HHS Office of Population Affairs, summarizing 2022 final data, reported the same pattern: three-quarters of teen births were to mothers ages 18-19.

That matters for counseling and for school-based services. An 18-year-old finishing high school or already in the workforce has a different set of barriers, and a different legal capacity to consent to contraception in many states, than a 15-year-old. Both groups have shared in the decline. Neither group has closed the geographic or racial gaps that still define risk.

Race and ethnicity gaps

Every major race and Hispanic-origin group has lower teen birth rates than a decade ago. The absolute levels remain far apart. NCHS final 2023 rates for females ages 15-19 were 1.8 for non-Hispanic Asian teens, 8.4 for non-Hispanic White teens, 19.3 for non-Hispanic Black teens, 20.8 for Hispanic teens, 20.9 for non-Hispanic American Indian and Alaska Native teens, and 21.2 for non-Hispanic Native Hawaiian and Other Pacific Islander teens.

Put differently: Black, Hispanic, American Indian and Alaska Native, and Native Hawaiian and Other Pacific Islander teens each had rates more than double the non-Hispanic White rate, and more than ten times the non-Hispanic Asian rate. That pattern matches what the Office of Population Affairs summarized for 2022 and what the CDC has described for earlier years.

Year-to-year movement in 2023 still favored decline for most groups. NCHS reported decreases of 8% for White, 7% for American Indian and Alaska Native, 5% for Black, and 2% for Hispanic teens ages 15-19 from 2022 to 2023. Changes for Asian and Native Hawaiian and Other Pacific Islander teens were not statistically significant that year.

These are not biological differences. They track the same structural gradients that show up in prenatal care timing, preterm birth, and maternal mortality: neighborhood opportunity, school quality, insurance continuity, clinic density, and how quickly a young person can get a confidential contraceptive visit. Our reviews of Black maternal health disparities and contraception access and unintended pregnancy describe pieces of that same architecture.

State and geographic variation

State lines redraw the teen birth rate more aggressively than almost any other demographic cut. In 2023, according to NCHS Table 8, New Hampshire's rate for ages 15-19 was 4.6 births per 1,000. Mississippi's was 24.9. Same country, same birth certificate system, and more than five times the rate depending on where a teenager lives.

Other 2023 state rates illustrate the spread rather than a simple red-blue map: Massachusetts 5.8, Vermont 5.7, Connecticut and Minnesota in the high single digits, while Arkansas, Louisiana, and Oklahoma sat above 20, as did Tennessee. Rates among territories ranged from 11.6 in the U.S. Virgin Islands to 23.5 in Guam.

Rural-urban gaps sit inside those state numbers. Earlier NCHS analyses have consistently found higher teen birth rates in rural counties than in large metro areas, even as both declined. The mechanisms are not mysterious: fewer Title X and family planning sites, longer travel for LARC placement, weaker school-based health infrastructure, and less private insurance depth in many rural labor markets. If you are counseling a teen in a maternity care desert, the national rate of 13.1 is not the number that governs her options.

State	Births per 1,000
New Hampshire	4.6
Massachusetts	5.8
California	9.1
United States	13.1
Texas	19.4
Oklahoma	20.6
Louisiana	23.1
Mississippi	24.9

Source: NCHS, Births: Final Data for 2023, Table 8 (state of residence). National rate from Table 2.

Repeat teen births

First births dominate teen fertility, but second and higher-order births while a mother is still a teenager carry outsized educational and economic consequences. NCHS analyzed first and second births to U.S. teenagers from 2000 to 2022 and found that the second and higher-order birth rate for ages 15-19 fell 80%, from 10.2 to 2.0 per 1,000. First-birth rates fell 69%, from 37.5 to 11.7. Among births to teenagers younger than 20, the share that were second or higher declined from about one in five (21.1%) in 2000 to about one in seven (14.3%) in 2022.

Congressional Research Service summaries of NCHS data place the second-and-higher birth rate for teens at 1.8 in 2023, a historical low, down roughly 78% from its recent high of 8.1 in 2006-2007. Roughly 14% of 2023 teen births were second or higher-order, in line with the Office of Population Affairs figure of about 14% for 2022.

Clinically, that 14% is where postpartum contraception either works or fails. A teen who leaves the hospital without a plan, or with a plan that requires a separate clinic visit she cannot attend, is the patient most likely to return pregnant before finishing school. Same-day LARC eligibility after delivery and Medicaid coverage of devices are not side issues. They are the mechanism by which the second-birth rate keeps falling.

What drove the decline

Reporters ask this every year, and the honest answer is multi-factor with a clear primary proximal driver: contraception.

Lindberg and colleagues, writing in the Journal of Adolescent Health in 2016, examined National Survey of Family Growth data for 2007-2012, the early years of the steepest recent drop. Sexual activity in the past three months did not change significantly. Among sexually active adolescent women, use of any contraceptive method at last sex rose from 78% to 86%, and multiple-method use rose from 26% to 37%. Highly effective method use (IUD, implant, injectable, pill, patch, ring) increased from 38% to 51% between 2007 and 2009. Their decomposition estimated that the entire decline in the pregnancy risk index over the period was attributable to improved contraceptive use.

An earlier analysis by Santelli and colleagues in the American Journal of Public Health (2007) reached a related conclusion for 1995-2002: about 86% of the decline in teen pregnancy risk was linked to improved contraceptive use, and about 14% to delayed sexual activity. For younger teens 15-17, the contraceptive share was about 77%. The CDC's teen pregnancy page cites the Lindberg work when it discusses drivers of the long decline.

What that research does not claim is that abstinence education, reality television, or any single federal program can take sole credit. Broader social conditions (educational expectations, labor-market prospects, the cost of raising a child, online information about contraception) almost certainly shape behavior. The data simply say that among sexually active teens, method use and method effectiveness improved enough to move the pregnancy risk curve. That is why access questions still matter even as rates fall: the mechanism that lowered the rate is the same mechanism clinics and insurers can strengthen or weaken. For related national patterns on method mix and deserts, see our contraception access statistics; for concurrent STI risk among adolescents and young adults, see STI statistics in women.

Parents and clinicians sometimes over-read "less sex" into the charts. For the 2007-2012 window that produced a large share of the modern decline, that reading is not what the NSFG-based research found. Teens who were sexually active used contraception more often and used more effective methods. That is a less moralized story than some public debates prefer, and a more practical one for clinics.

Pregnancy rates versus birth rates

Birth certificates count live births. Pregnancy rates try to add estimated abortions and fetal losses, so they arrive later and with more uncertainty. Using updated NCHS methods, the teen pregnancy rate for females ages 15-19 was 29.4 pregnancies per 1,000 in 2019, down from 60.8 in 2010. The Office of Population Affairs highlights that drop alongside birth-rate trends.

Even at 29.4, pregnancy risk remains more than double the 2023 birth rate of 13.1. That gap is expected: not every pregnancy ends in a live birth. It is also a reminder that "teen birth rate" understates how many adolescents experience a pregnancy each year. Policy debates that focus only on births miss abortions and miscarriages, plus contraceptive failures that never appear in the natality file.

For adolescents who do continue a pregnancy, clinical risk is not theoretical. Teen pregnancies are associated with higher rates of preterm birth and other complications relative to births in the mid-20s, and the social consequences (interrupted schooling, higher poverty risk for mother and child) are well documented in the child-development literature. Our overview of pregnancy complications statistics covers the obstetric side of that risk for readers who need complication rates rather than fertility rates.

If you are a clinician, the practical takeaway is unglamorous. Offer the full method mix, including LARC, at the visit when a teen is ready, not at a follow-up she may not attend. Know your state's minor consent rules. Ask about a prior birth, because that is where repeat risk concentrates. And when a teen is tracking cycles or trying to understand fertility windows for any reason, tools such as our ovulation calculator and period calculator are adjuncts to counseling, not substitutes for a method she can actually use.

The 17-year-old in my exam room did finish junior year. She left with a prenatal referral, a social-work contact, and a clear plan for postpartum contraception. The national rate of 13.1 did not write that plan. A system that still makes method access depend on ZIP code and insurance continuity, and that still tracks along racial lines, did write the risk she carried into the room. The long decline is real. The remaining work is in the gaps the average no longer shows.

Frequently asked questions about teen pregnancy and birth rates

What is the current U.S. teen birth rate?

According to NCHS final data, the 2023 birth rate for females ages 15-19 was 13.1 live births per 1,000, a record low. Provisional 2024 data put the rate at 12.7. Those figures count live births only, not pregnancies that ended in abortion or fetal loss.

How much have teen birth rates fallen since the 1990s?

NCHS reports a 79% decline from the 1991 peak of 61.8 births per 1,000 females ages 15-19 to 13.1 in 2023. From the more recent high of 41.5 in 2007, the rate fell 68% by 2023 and about 69% by provisional 2024 data (12.7).

Do younger and older teens have the same rates?

No. In 2023 the rate was 5.5 per 1,000 for ages 15-17 and 24.6 for ages 18-19, both record lows per NCHS. About three-quarters of births to females ages 15-19 were to 18- and 19-year-olds. The rate for ages 10-14 remained 0.2 per 1,000.

Which states have the highest and lowest teen birth rates?

In 2023, New Hampshire had the lowest state rate at 4.6 births per 1,000 females ages 15-19, and Mississippi had the highest at 24.9, according to NCHS. Southern states generally cluster higher; several Northeastern and Western states cluster lower.

Why did the teen birth rate decline?

For 2007-2012, Lindberg and colleagues estimated that improved contraceptive use, not a large drop in sexual activity, accounted for the entire decline in adolescent pregnancy risk. An earlier Santelli analysis attributed about 86% of the 1995-2002 decline to better contraception. Broader social factors likely shape those behaviors.

How common are second births to teens?

NCHS data show the second and higher-order birth rate for ages 15-19 fell from 10.2 per 1,000 in 2000 to 2.0 in 2022, an 80% decline. Among births to teenagers younger than 20, about 14.3% in 2022 were second or higher, down from 21.1% in 2000; roughly 14% of 2022-2023 births to ages 15-19 were second or higher by order counts.