Teen Pregnancy Rates by State 2024

The teen pregnancy rate in the United States has been declining in the past 20 years. In 2018, the United States teen birth rate was 17.4 births per 1,000 females between the ages of 15 and 19. In 2019, it decreased to 16.9. Despite these lower rates, the U.S. continues to have the highest teen pregnancy rate of all developed nations.

Teen pregnancy has substantial health, economic, and social costs. Pregnant teenagers are more likely to experience miscarriages, maternal illness (preeclampsia, hypertension, etc.), stillbirth, and neonatal death. Teenage mothers are also more likely to drop out of school and never return to raise a child. Teen mothers, therefore, often lack a high school diploma, let alone a college degree, and will likely face unemployment and poverty. Children of teen pregnancies are sometimes forced into foster care if the mother cannot care for them. Then teenage females in foster care are twice as likely to become pregnant, creating a cycle.

One of the best ways to prevent teen pregnancies is by using birth control methods, such as condoms or oral contraceptives, and providing easy access to such things. Comprehensive sex education in and outside of schools has been proven to be very effective, and sex education courses must be given to all genders. Additionally, mentorship from peers or older teens tends to be more comfortable and impactful than from parents. Some communities have set up mentorship programs to help encourage healthy sexuality discussions among teens.

Research suggests that “U.S states whose residents have more conservative religious beliefs on average tend to have higher rates of teenagers giving birth.” Of the ten most conservatively religious states in the United States, eight are among the states with the highest teen birth rates.

Teen Birth Rates by State

Teen birth rates are measured as the number of births per 1,000 women between the ages of 15 and 19.

1. Mississippi

Mississippi has the highest teen birth rate of 27.9 births per 1,000 women. This is a decrease from 29.1 in 2019. The Arkansas-Mississippi Delta area has the highest birth rates, a study found, pointing to community norms and socioeconomic factors in the area that could compound to contribute to higher teen pregnancy rates, such as poverty, discrimination, lack of comprehensive sex education.

2. Arkansas

Arkansas has the second-highest teen birth rate of 27.8 births per 1,000 women. Arkansas is one of the most conservatively religious states in the country. Despite being one of the highest in the country, Arkansas’s birth rate has seen a significant decline in recent years, dropping from 59.1 in 2005 to 39.5 in 2014 and finally to 30.0 in 2019.

3.. Louisiana

Louisiana’s birth rate of 25.7 births per 1,000 women is the third-highest in the country. About 75% of teen births in Louisiana are to mothers in their late teens (ages 18 and 19), and 18% of teen births were to teens who already have a child. Pediatrician Scott Hamilton explained that sex education isn’t a part of school systems, and it’s not something discussed at home with parents.

4. Oklahoma

Oklahoma’s teen birth rate is 25.0 births per 1,000 women, giving it the fourth-highest teen birth rate in the United States. In Oklahoma, 1-in-5 births to girls ages 15 through 19 are not the mother’s first child. One issue seen in the state is that some of the school districts, such as the Oklahoma City Public Schools, fail to provide sex education at any grade level.

5. Alabama

Coming in fifth is Alabama, with a teen birth rate of 24.8 births per 1,000 women. About 74% of teen births in Alabama are to older teens (ages 18-19), and 16% of teen births are to teens who already have children. Like other states with high teen birth rates, Alabama has its fair share of rural areas and is also one of the country's most religious states. Alabama has seen significant improvements in its teen birth rate in past decades, which has decreased by about 63% since 1991.

6. Kentucky

Kentucky has the sixth-highest teen birth rate of 23.8 births per 1,000 women. This is a significant decrease from 27.3 in 2018. Kentucky’s urban counties have seen a larger decline in teen pregnancies than in its rural counties. This is likely because teens in rural areas have little access to health care, including access to contraceptives, are more likely to live in poverty, and have fewer educational opportunities. The disparity in these pregnancy rates is largely explained by the lack of healthcare and education in rural areas.

7. Tennessee

The state with the seventh-highest teen pregnancy rate is Tennessee with 23.3 per 1,000. This is lower than its 2018 rate of 25.3. Unsurprisingly, the rural counties in Tennessee showed higher teen birth rates. The Tennessee Department of Health has made reducing the teen birth rate a priority, and their efforts are being seen. The Tennessee Adolescent Pregnancy Prevention Program (TAPPP) is one of the programs implemented to educate and mentor young teens and adults about healthy sexual relationships.

8. West Virginia

West Virginia’s teen birth rate is 22.5 births per 1,000 women, a slight decrease from 2019. Some counties in West Virginia experience exceptionally high teen birth rates, around 48 births per 1,000 women, likely due to being in rural areas. About 79% of West Virginia’s teen births are to older teens (age 18-19), and about 19% of teen births are to teens who already have a child.

9. Texas

Texas's teen birth rate is 22.4, less than the 24.0 it was in 2019. Every year, around 35,000 women in Texas get pregnant before the age of 20. It is difficult for women to access reproductive services in Texas, which contributes to the high teen birth rate and why Texas has the highest rate of repeat-teen births. Other factors that researchers believe are contributing to this are a lack of sex education and abstinence-only programs.

10. New Mexico

New Mexico’s teen birth rate of 21.9 births per 1,000 women is the tenth-highest in the United States. 55.1% of female teens ages 15 to 19 in New Mexico are Hispanic, and 81% of the teens that gave birth in 2017 were Hispanic. New Mexico has a child poverty rate of 25.9%, which is a large contributing factor to teen pregnancies. New Mexico’s teen birth rate is still declining, however, as it was 24.4 in 2019. In 2015, the public savings due to the decline in the teen birth rate totaled $38 million.