Teen birth rates have plummeted on Long Island and in the U.S. Here's why.

Graciela Benavides had planned to be in law school by now. But she got pregnant when she was 16 and has to focus on caring and providing for her now 5-year-old daughter.

As Tatiana quietly played Hungry Hungry Hippos at a table a few feet away, the 22-year-old Uniondale mom said she loves her daughter deeply but sometimes thinks how her life would have been different if she had waited longer to have a child.

"I do have a bit of regret because I feel like if I didn't have her, I would have been more free to do other things," she said.

Hundreds of Long Island teenagers have babies every year. But far fewer are giving birth than in the 1990s and 2000s, mirroring state and federal trends that experts said are driven primarily by greater use of effective contraception.

Sexual education programs, higher college-going rates, and what some surveys said is fewer adolescents having sex also are contributing to the sharp declines, researchers and doctors said.

The birth rate among Long Island girls 15, 16 and 17 dropped more than 75% between 1997 and 2022, according to state Health Department data for the latest and earliest years for which there are county-level records. For every 1,000 Nassau girls between 15 and 17, 8.2 gave birth in 1997, compared with 1.9 girls in 2022. In Suffolk, the rate went from 10.9 to 2.6.

Birth rates for Long Island 18- and 19-year-olds fell by about two-thirds. Rates for the small number of girls ages 10 to 14 who gave birth also declined. 

Teen birth rates have been falling nationwide since the early 1990s, when the large number of teen pregnancies led to widespread concern. Teen mothers and their children are more likely to live in poverty, and the children have a greater chance of being neglected or abused, dropping out of school, becoming teen parents themselves and living in poverty as adults, studies show.

Although the U.S. rates remain higher than in other wealthy countries, the plummeting number of teen births has quietly become a major public health success.

Nationwide, more than 25% of 15-year-old girls in 1991 gave birth at some point before they turned 20 — compared with 6% in 2021, according to estimates based on federal data by Child Trends, a Maryland-based nonprofit that researches issues affecting children, youth and families.

About three-quarters of births to teenagers are unintended, so increased access to contraception — and knowledge about it — is a key factor, said Jennifer Manlove, co-author of the report and a senior research scholar on sexual and reproductive health at Child Trends.

The seven states with the highest rates are in the South, where there’s often an abstinence-only approach in schools, which typically means no discussion of contraception, she said. The result is that when teens have sex, they’re less likely to use birth control, Manlove said. Birth control also is less available to teens in much of the South, she said.

In New York, which has the ninth lowest rate, more than 90% of high schools and more than 60% of middle schools had classes in which contraception was discussed in 2020, according to a Centers for Disease Control and Prevention survey. The other states with the lowest birth rates also are in the Northeast, plus Minnesota.

Avoiding pregnancy is not just about understanding basic sex education, but also giving teens tools, like how to say "no" if they don't want to have sex, said Dr. Allison Eliscu, chief of adolescent medicine at Stony Brook Children's Hospital and head of a program that sends health educators into Long Island schools, libraries and group homes.

“It's also how to negotiate complicated discussions with a partner, like ‘I want my partner to use a condom, but they don't want to,’ or how to understand what a safe relationship is," Eliscu said.

In New York, minors can obtain birth control without parental consent, including at clinics that offer it for free. The state also has a program that provides birth control for low-income teens. And since 2012, the Affordable Care Act has required most insurance plans to cover birth control with no copays.

The growing use of IUDs and contraceptive implants among teens has reduced the risk of pregnancy, Eliscu said. Intrauterine devices and implants are more effective than birth control pills and condoms, which often are used incorrectly or inconsistently.

Fewer than 6% of females 15 to 19 had used an IUD or implant in 2011-15, versus more than 19% in 2015-19, a federal report said.

Teenagers also may be having less sex. Two federal surveys indicate that the percentage of teenagers engaging in sexual activity has been declining, although in one of those surveys, the decline among teen girls was not considered statistically significant.

“Teens in this generation are spending time on their phones, they're doing less activities in person, and that affects their relationships and behaviors,” Manlove said.

More people attend college than in the past, and teens who go to college are less likely to get pregnant than those who don’t, in part because they usually have more long-term career goals that they don’t want parenting to interrupt, said Jennifer Barber, a sociology professor at Indiana University and a senior scientist at the university’s Kinsey Institute, which studies sex and relationships.

As the average age of a first birth has steadily risen over the past few decades, “the norm, that sense of feeling when it’s appropriate to have children, has changed over time,” Manlove said.

Abortion bans' impact

It’s still too early to fully measure the effect of abortion bans on teen birth rates, but in states that have greatly restricted or prohibited abortion since the U.S. Supreme Court's 2022 Dobbs decision allowing such bans, “there’s no way it’s not going to go up,” Barber said.

The decline in teen birth rates has not been driven by abortions, which also have declined precipitously over the past few decades, Manlove said.

Pregnancy and birth rates have fallen across all adolescent racial and ethnic groups. But they remain much higher among low-income teens, and Black, Latino and Native American teens, and in rural areas, federal data shows. In New York, rates are highest in some rural counties upstate, and they're lower on Long Island than the rest of the state.

On Long Island, the highest numbers are in communities that are majority Black and Hispanic, and that have lower median incomes and educational attainment, a Newsday analysis of state Health Department data shows. But pregnancy and birth rates have fallen — usually steeply — in almost every Long Island ZIP code between 2007-09 and 2020-2022, data shows.

ZIP code 11798, in Wyandanch, had Long Island’s highest teenage birth rate — 31 births per 1,000 teenage girls and women in 2020-22 — followed by ZIP codes centered in Riverhead, Hempstead, Central Islip and Roosevelt, state data shows.

Trust in health care

People with lower incomes have less access to health care and tend to live in areas with fewer services, and Black girls and women in particular often distrust the health care system because of past and present discrimination and less-respectful treatment from providers, Barber said.

That leads to fewer conversations about contraception with health care providers, and less trust in what they recommend, Manlove said.

In addition, in any community where teenage parenthood is more common, teens are more likely to view it as an option, Eliscu said.

Uniondale, where Benavides lives, has a birth rate more than double the rest of Nassau’s. 

Benavides said she never talked to her doctor about contraception and didn’t know that minors could obtain birth control pills. And she never talked with her boyfriend at the time about contraception.

“We were both just in love, young, stupid, I can say — like we never had the thought about taking care of ourselves while having intercourse,” Benavides said. "It's just we never talked about it.”

The effects of giving birth at 17 have rippled throughout Benavides' life. She still wants to become a lawyer — or possibly a dentist — but her priority now is caring for Tatiana.

After graduating from Uniondale High School, she earned a dental assistant certification at a trade school that she found with the help of a Nassau County-funded Family & Children’s Association program for teen moms.

The program also links young mothers with clinics where they can receive free or affordable contraception — to prevent further pregnancies — and helps them with parenting skills, said Chasity Matos, the program’s coordinator.

Benavides worked for two years as a dental assistant. She left the job in September so she could study full time at Nassau Community College in preparation for transferring to a four-year college to obtain a dental hygiene degree. She works part time at a Dunkin’ and saves money by living with her parents.

Juggling work, college and being a mom is a challenge, she said, but she wants a career that will earn her enough money to help her parents in Uniondale and her grandmother in El Salvador, and to give Tatiana the best life possible.