Reproductive and Sexual Health

Teen Pregnancy and STIs Have Long-Term Consequences

Each year, 750,000 American adolescents, aged 15-19, get pregnant.1 Although recent data show a decrease in teen births — driven by increased contraceptive use and increased use of effective contraception — there is still room for significant improvement.2 In California 32 of every 1,000 adolescent girls aged 15-19 have babies each year.3 Notably, this statistic masks persistent and troubling racial/ethnic disparities: annually, for every 1,000 adolescent girls aged 15-19 living in California, there are 51 births to Latinas, 37 to African Americans, 12 to whites, and 9 to Asians.4

Rates of the most common sexually-transmitted infections (STIs), including chlamydia and gonorrhea, peak in late adolescence. Youth aged 15-24 account for more than half of all STIs, including HIV, diagnosed annually.5

Despite their clear need for reproductive health care, adolescent girls access fewer reproductive health services, including contraception services, than young adult women.6 In fact, only 41% of adolescents have accessed reproductive health services.Research consistently shows that adolescents “face numerous barriers to accessing needed [reproductive] healthcare, including lack of familiarity with the healthcare system, limited ability to pay for services, fear of disclosure of confidential information to family and friends, and uncertainty about their ability to access [reproductive healthcare] services without the consent of a parent or guardian.”8

Recent research underscores the connection between adolescent reproductive health outcomes and educational outcomes. Nationally, while almost 90% of girls who do not give birth as teenagers earn a high school diploma by age 22, only slightly more than 50% of all girls who do give birth as teenagers achieve this milestone.9

SBHCs Provide Critical Reproductive and Sexual Health Care

Many school-based health centers (SBHCs) provide confidential, developmentally appropriate reproductive and sexual health services for adolescents. These services may include sexual health education, contraception, pregnancy and STI testing, counseling, and referrals to outside services. Research has shown that SBHCs effectively address reproductive and sexual health needs.

  • SBHCs provide STI screening/treatment to adolescents who often have no other source of care.10,11
  • SBHCs effectively deliver HPV vaccinations to adolescents, including those who are uninsured.12
  • Adolescent girls with SBHC access are more likely to get reproductive preventive care, use hormonal contraception, and to have been screened for an STI, than similar girls without an SBHC.13
  • SBHCs can reduce the unplanned pregnancy rate among adolescents.14,15

Resources for Practice

For tools to help you start and run school reproductive and sexual health programs, see Reproductive and Sexual Health Resources.

For tools on sexual health education, see this page.

(1) Ralph, L.J & Brindis, C.D. (2010). Access to Reproductive Healthcare for Adolescents: Establishing Healthy Behaviors at a Critical Juncture in the Lifecourse. Current Opinion in Obstetrics and Gynecology. 22:369-374.
(2) Guttmacher Institute. (2012). New Government Data Finds Sharp Decline in Teen Births: Increased Contraceptive Use and Shifts to More Effective Contraceptive Methods Behind This Encouraging Trend.
(3) California Adolescent Sexual Health Work Group. (2010). 2008 California Data for Adolescent Births, AIDS, STDs.
(4) Ralph et al.
(5) Ralph et al.
(6) Hall, K.S., Moreau, C., Trussell, J. (2011). Discouraging Trends in Reproductive Health Service Use Among Adolescent and Young Adult Women in the USA, 2002-2008. Human Reproduction. 0(0): 1-8.
(7) Hall et al.
(8) Ralph et al.
(9) Child Trends. Fact Sheet: Diploma Attainment Among Teen Mothers. Accessed October 2011.
(10) Braun, R.A. & Provost, J.M. (2010). Bridging the Gap: Using School-Based Health Services to Improve Chlamydia Screening Among Young Women. American Journal of Public Health. 100(9): 1624-1629.
(11) Crosby, R.A. & St. Lawrence, J. (2000). Adolescents’ Use of School-Based Health Clinics for Reproductive Health Services: Data from the National Longitudinal Study of Adolescent Health. Journal of School Health. 70(1): 22-27.
(12) Gold, R., Naleway, A.L, Jenkins, L.L., Riedlinger, K.K., et al. (2011). Completion and Timing of the Three-Dose Human Papillomavirus Vaccine Series Among Adolescents Attending School-Based Health Centers in Oregon. Preventive Medicine. 52: 456-458.
(13) Ethier, K.A., Dittus, P.J., DeRosa, C.J., Chung, E.Q., et al. (2011). School-Based Health Center Access, Reproductive Health Care, and Condom Use Among Sexually Experienced High School Students. Journal of Adolescent Health. 48: 562-565.
(14) Ricketts, S.A. & Guernsey, B.P. (2006). School-Based Health Centers and the Decline in Black Adolescent Fertility During the 1990s in Denver, Colorado. American Journal of Public Health. 96(9): 1590-1592.
(15) Koo, H.P.,  Dunteman, G.H., George, C., Green, Y., et al. (1994). Reducing Adolescent Pregnancy through a School- and Community-Based Intervention: Denmark, South Carolina, Revisited. Family Planning Perspectives. 26(5): 206-211.