title: Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?
abstract: OBJECTIVE
  The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates.
  
  
  METHODS
  We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates.
  
  
  RESULTS
  The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P < .0001) and ethnic distribution of the population were the only variables associated with a difference between mean teen births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent.
  
  
  CONCLUSIONS
  While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates.
authors.affiliation: Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Marianne
authors.initials: M
authors.lastname: Chevrette
authors.affiliation: Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada. Electronic address: haim.abenhaim@gmail.com.
authors.forename: Haim Arie
authors.initials: HA
authors.lastname: Abenhaim
mesh_terms: D000028:Abortion, Induced / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D000022:Abortion, Spontaneous; D000293:Adolescent; D001723:Birth Rate; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D033282:Parental Consent; D057766:Policy; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012736:Sex Education / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D014481:United States
keywords: Abortion ban; Abstinence; Adolescent pregnancy; Minor's consent; Sex education; State-level policy; Teen abortion; Teen birth; Teen pregnancy