Despite a 39 percent decrease in the teen pregnancy rate and a one-third reduction in the teen birth rate since the early 1990s, recent data suggest that prog- ress has stalled. Between 2005 and 2006 both the teen pregnancy and teen birth rate increased for the first time since the early 1990s [1, 2]. Teen birth rates continued to increase in 2007 (data on teen pregnancy rates are not available beyond 2006) before declining slightly in 2008. Teen birth and pregnancy rates in the United States remain among the highest of all indus- trialized countries and it remains the case that three in 10 girls in the United States get pregnant by age 20. These trends are worrisome because the majority of teen pregnancies in this country are unplanned, are to unmarried mothers, and are associated with serious hardship for both child and parent.
Older teens (ages 18–19) account for the vast majority of teen pregnancies and births, and their trends have been more discouraging than for younger teens overall. Compared to their younger peers, older teens experienced smaller declines in teen pregnancy and birth rates through 2005, and recent increases in their teen birth rates are larger. Yet, few efforts have addressed teen pregnancy pre- vention specifically among this age group. This lack of attention may be due to the challenges reaching this group, lack of political and/or community will to address pregnancy prevention among this age group, and limited evidence of effective programs for teens in this age group.