Abortion trends varied widely by state as well. "Teenage abortion rates were highest in New York (41 per 1,000), New Jersey, Nevada, Delaware and Connecticut. By contrast, teenagers in South Dakota (6 per 1,000), Utah, Kentucky, Nebraska and North Dakota all had abortion rates of eight or fewer per 1,000 women aged 15 -- 19. More than half of teenage pregnancies ended in abortion in New Jersey, New York and Connecticut" (Guttmacher, 2010). It is important to keep in mind that teenage abortion rates may reflect multiple issues. First, they may reflect that teenager's own personal beliefs and desire to raise a baby. However, they may also reflect prevailing societal norms in that geographic area, which can make it difficult, and even practically impossible, for pregnant teenagers to obtain abortions.

Portrayal in popular culture

Perhaps one of the most alarming things about teen pregnancy is that it is receiving more and more attention in popular culture, but not necessarily negative attention. For years, the trend was to stigmatize teenage mothers, which could lead to them being ostracized from society. For example, pregnant teenagers were once prohibited from attending the same schools as other children. There has been a trend towards compassion, which cannot be critiques; ostracizing teenage mothers only served to increase the negative impact of teenage pregnancy. However, there has been a trend in recent years of popular culture focusing on teen pregnancy, and many believe that this has glamorized teenage pregnancy.

The movie Juno focused on a pregnant 16-year-old and her decision to have the baby and give it up for adoption. Because the character Juno was portrayed in a positive manner, many people felt as if the movie was promoting the idea of teen pregnancy. There are some aspects in the film that certainly do not mesh with the reality for most pregnant teens. For example, the character is very self-possessed and has the support of her family (Jayson, 2008). In reality, most pregnant teenagers are members of otherwise high-risk groups and unlikely to have the self-possession of the movie's title character. Moreover, while some parents are supportive of their pregnant teenagers, the reality is that many pregnant teens get little to no support from their families. That does not mean that the movie Juno is unrealistic, but that it portrays a reality for a very small percentage of pregnant teenagers.

Even more disconcerting than the movie Juno is the popular reality TV series Teen Mom and the series it has spawned. Following teenagers who get pregnant during high school, the series does portray some of the realities for teen parents. However, despite the fact that most of these teenagers are not exemplary parents and have done literally nothing to distinguish them from the rest of society, they have been welcomed into the ranks of celebrity. The result is that teenage parenting may be portrayed as glamorous, even if the details of the show do not actually glamorize teen pregnancy. Teen pregnancy could be seen as a pathway to fame and fortune. Moreover, while most adults might dismiss this notion because of the tremendous problems portrayed on the show and in the tabloids about the mothers that have been represented, the problem is that teenagers lack adult judgment. In fact, one of the problems with teen pregnancy is that teenagers lack the mental faculty of adults; expecting them to understand messages that are clear to parents may be beyond the abilities of many teenagers.

Other figures in pop culture experience teenage pregnancy with an apparent lack of consequences. For example, when Jamie Lynn Spears became pregnant, she was a teenager. However, her similarities to the average teenager may have ended with her biological age. She certainly had the financial resources to deal with a pregnancy. Moreover, she had a family that was willing to help her raise her child. Likewise, teenage mothers like Bristol Palin, who have made a career out of being an unwed teenage mother, do not demonstrate the reality of what it will mean for most teenagers to become pregnant....

The fact is that almost anyone who is going to be a sufficiently public figure for her pregnancy to be part of popular culture is going to be so removed from the problems that plague most teenage parents that she simply will not be a realistic depiction of pregnancy for the average teenager.
Popular beliefs and opinions impact on the teen pregnancy rate

Although popular culture may be embracing unwed parenting in general and seemingly embracing teen parenting in general, it would be erroneous to assume that popular culture is the driving force behind current high teenage pregnancy rates. Instead, one must look at the belief systems that lead to the U.S.'s high rates of teen pregnancy. The biggest contributing factor to teenage pregnancy appears to be American attitudes towards sexuality, particularly female sexuality, which is compounded by American religious beliefs. It is no coincidence that teenage pregnancy rates are higher in those states that are also most highly identified as predominantly conservative and Christian. Children in those states do not have sex at lower rates than children in other areas, but they do not seem to seek access to birth control at the same rates.

In fact, the failure to use reliable and consistent contraception is the cause of the teenage pregnancy epidemic (CDC, 2012). "Nearly two-thirds of unwed teenage women report that they never practice contraception or that they use a method inconsistently" (Lachance, 2011). This is not because they are trying to get pregnant; only 9% of pregnant teenagers reported trying to get pregnant (Lachance, 2011). Instead, the girls seemed to have an embarrassing lack of knowledge about basic human reproduction. Almost half of them believed that they could not get pregnant, generally because it was the wrong time of the month for conception (Lachance, 2011). "Of those who had realized they could get pregnant, the major reason given for not using a method was that they had not expected to have intercourse. Of the 15% who did not practice contraception because they were pregnant, the overwhelming majority were pregnant unintentionally. About eight percent said that they had wanted to use a method but 'couldn't under the circumstances,' or that they did not know about contraception or where to get it" (Lachance, 2011). Understanding the circumstances that make teenage women feel as if they are unable to use contraception is a critical component of solving teen pregnancy.

What is being done to reduce teen pregnancy?

At this point, it seems ridiculous to suggest that anything is being done to reduce teen pregnancy rates in some areas. Many areas have abstinence-only-based sex education, which is an absurd approach. Only a single abstinence-only education program has been able to provide credible evidence that it has led to a reduction of teenage pregnancy rates in any age group (Kirby, 2002). There is some evidence that abstinence only education may delay initial age of sexual intercourse, but that evidence is interesting because it also shows an overall increase in teen pregnancy rates. In fact, "increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates" (Stanger-Hall & Hall, 2011). This suggests that abstinence-only approach is in many ways more concerned about the notion of preserving female virginity than in decreasing teenage pregnancy rates, which may or may not be a morally appropriate approach, but does nothing to combat the public health epidemic of teenage pregnancy.

In other areas, sex education that discusses contraception, including where to access contraception, has been shown to be effective in helping reduce teenage pregnancy rates, though it does not eliminate teenage pregnancy. This is not due simply to contraceptive failure. The problem is that, even when students are informed about contraceptives and have access to them, they may not use them. In fact, "most teenagers are sexually active for many months before ever seeking birth control help from a family planning clinic or physician (citingTeenage Pregnancy, 1981). Very few come to a clinic in anticipation of initiating sexual intercourse, and many come because they fear -- often correctly -- that they are pregnant. The major reason teenagers give for the delay is concern that their parents will find out about the visit" (Lachance, 2010). What this suggests is that real change has to go beyond schools and formal sex education and tackle the societal and family level issues that contribute to teenage pregnancy.

How can the community reduce teen pregnancy?

One of the important things that the medical community can do is to address all of the health concerns of women of reproductive age, including access to birth control. Information about contraception should be a routine part of well-woman checkups for women of any age, including teenage women, and doctors should inform patients of where to access birth control as well as the relative efficacy of different forms of birth control. This is especially critical for teenagers who have already given birth…