Teenage Pregnancy in Alabama

High teenage pregnancy rates are linked to high levels of social exclusion, mental illness and stress, lack of communication skills, and poor sexual health knowledge and practice. Becoming a teenage parent can lead to an increase in relative poverty, unemployment, poorer educational achievements, and poor health of the child.

Alabama's 2022 teen birth rate was 10.9 per 1,000 females ages 10-19. Forty-eight of Alabama's 67 counties (Barbour, Bibb, Blount, Bullock, Butler, Chambers, Cherokee, Chilton, Choctaw, Clay, Cleburne, Coffee, Conecuh, Covington, Cullman, Dale, Dallas, DeKalb, Escambia, Etowah, Fayette, Franklin, Geneva, Greene, Hale, Henry, Houston, Jackson, Lamar, Lawrence, Lowndes, Marion, Marshall, Mobile, Monroe, Montgomery, Morgan, Perry, Pickens, Randolph, Russell, Sumter, Talladega, Tallapoosa, Walker, Washington, Wilcox, and Winston) had a rate of births to teenage mothers that was higher than the state rate.

In 2022, there were 3,494 births to teenage mothers, accounting for 6 percent of all births in Alabama.

• Births to teenage mothers accounted for over 6 percent of all births in 42 Alabama counties.
• Births to teenage mothers accounted for over 10 percent of all births in Cherokee (10.5) and Marion (10.7) counties.

Beginning in 1984, Alabama's percentage of births to unmarried teenage mothers was lower than the percentage of births to unmarried teenage mothers for the U.S.

This continued until 2022, when Alabama's percentage was higher than the U.S. for the first time in almost 40 years.

In 2022, 45.3 percent of all births in Alabama were to unmarried women.

Births to unmarried mothers accounted for over 75 percent of all births in Bullock, Dallas, Greene, Lowndes, Perry, and Wilcox Counties during 2022.

In an additional 24 counties, over 50 percent of births were to unmarried mothers during this time.

Inadequate prenatal care is connected to increased risk of preterm birth, stillbirth, and infant mortality.

Early and regular prenatal care improves the chances of a healthy birth and may prevent complications during pregnancy and birth that negatively impact maternal and infant health.

The Kotelchuck Index classifies prenatal care into several categories based on the expected number of prenatal visits at the time of entry into care.

Adequate prenatal care includes the classifications of adequate and adequate plus. Other categories include intermediate and inadequate.

In 2022, 74.4 percent of all births in Alabama received adequate or adequate plus prenatal care.

• Only 62.8 percent of births to mothers under age 20 received adequate or adequate plus prenatal care.

In 2022, 17.8 percent of all births received inadequate prenatal care while 28 percent of births to mothers under 20 years received inadequate prenatal care.

• Alarmingly, 61.2 percent of births to mothers under 15 years old received inadequate prenatal care.

In 2022, Barbour, Bullock, Butler, Chambers, Coffee, Conecuh, Coosa, Crenshaw, Dale, Dallas, DeKalb, Etowah, Franklin, Greene, Hale, Limestone, Lowndes, Macon, Madison, Marshall, Montgomery, Morgan, Perry, Pickens, Pike, Randolph, Sumter, Tuscaloosa, and Wilcox had a higher percent of births receiving inadequate prenatal care than the state's 17.8 percent.

A focus on family resilience and family strengths, including parent-child communication, is an essential component when addressing teen pregnancy.

Adolescents who describe their family communication as good or their parents as supportive:

• Have a later sexual debut.
• Have fewer sex partners.
• Engage in safer sexual behaviors.
• Have increased condom use.

The Child & Adolescent Health Measurement Initiative uses responses to four survey items from the National Survey of Children’s Health to determine family resilience.

When your family faces problems, how often are you likely to do each of the following:

• Talk together about what to do.
• Work together to solve our problems.
• Know we have strengths to draw on.
• Stay hopeful even in difficult times.

The family structure of a child's household and the highest level of education of an adult in the household may be factors for increased family resilience.

Of the survey respondents demonstrating family resilience, the family structure for 68.1 percent was two parents, currently married.

The family structure of a child’s household and the highest level of education of an adult in the household may be factors for increased family resilience.

Of the survey respondents demonstrating family resilience, the family structure for 68.1 percent was two parents, currently married.

Nationwide, households with two parents, currently married, demonstrated the highest percent of family resilience at 87.6 percent.

Single parent (mother or father) households (79.2 percent) and households with two parents, not currently married (79.4 percent) were the family structures with the lowest percentages demonstrating family resilience.

Family resilience appears to increase with the highest level of education of the adult in the home.

Nationwide, 75.2 percent of families with an adult having less than a high school education demonstrated family resilience.

This increased to 82 percent for those with a high school education or equivalent and 87.7 percent with a college degree or higher.

The 2023 5-Year American Community Survey estimated 11.9 percent of the Alabama population to be 25 or older and not having a high school diploma.

Over 20 percent of adults aged 25 or older did not have a high school diploma in six Alabama counties.

It was estimated that in 26 additional counties, at least 15 percent of this population did not have a high school diploma.

Federal Funding Opportunities

• Family and Youth Services grants
• Office of Population Affairs Teen Pregnancy Prevention grants

References

• Alabama Vital Statistics 2022
• Child and Adolescent Health Measurement Initiative
• America’s Children: Special Issue 2024 Maternal and Infant Health and Well-Being
• The Protective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences
• Teenage Pregnancy: Trends, Contributing Factors and the Physician's Role
• American Community Survey 5-Year Data (2009-2024)

This website is supported by Grant Numbers 2601ALSRAE, 2501ALSRAE, 2601ALPREP, 2501ALPREP, and 2401ALPREP from the Family and Youth Services Bureau within the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Neither the Administration for Children and Families nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided). The opinions, findings, conclusions, and recommendations expressed are those of the author(s) and do not necessarily reflect the views of the Administration for Children and Families and the Family and Youth Services Bureau.