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Accidental Pregnancy and Why it Matters

The United States has the highest rate of teen pregnancy in the developed world,1 and Texas is fifth highest in the 50 states.2 That’s not surprising, given that 25% of Texas school districts don’t teach sex education and almost 60% teach abstinence-only.3

The figure below shows the 2012 birth rates in the various states.4 As you can see, Texas sits right in the middle of a hot-bed of teen pregnancy and births, along with New Mexico, Mississippi, Arkansas, Louisiana, Oklahoma, Kentucky and West Virginia.

2012 Birth Rates

It’s not just teens having accidental pregnancies either. In Texas, more than half of all pregnancies (54%) are accidental.6

The situation has worsened recently in Texas counties that used to be served by Planned Parenthood. In 2011, Texas defunded Planned Parenthood, leaving many counties without any services.7 A new study reports that those counties had an increase in Medicaid-covered births in the 18 months following funding removal, whereas counties with services showed a decrease in Medicaid-covered births.8

Teenage pregnancy has social consequences. Compared with women who have babies later in life, teenagers who have babies are:

  • Less likely to finish high school;
  • More likely to rely on public assistance;
  • More likely to be poor as adults; and
  • More likely to have children who have poorer educational, behavioral, and health outcomes over the course of their lives than do kids born to older parents.9

Accidental pregnancies cost the taxpayer. In 2010, more than 57%10 of all births in Texas were publicly funded at a cost of nearly 3 billion—almost a third of which was paid by Texas.11 That is our tax dollars that could be invested in education or health, paying for a preventable situation.

Our country as a whole loses out too, as each student dropping out of school represents about $260,000 in lost earnings, taxes, and productivity.12

Pregnancy is not the only unintended consequence of sex–disease is another consequence and a potentially fatal one. Texas ranked 3rd among the 50 states in the number of HIV13 diagnoses in 2013. Texas also ranks 13th in syphilis, 10th in chlamydia, and 12th gonorrhea.14 In fact, Austin has more sexually transmitted disease cases than 50 other cities surveyed, and Dallas is 9th!15

The disease risk is higher for young people too. Of the 20 million new STD16 cases every year, about half in 2000 occurred among individuals aged 15 to 24.17

This book aims to improve these statistics, providing marital education in an easy to read, non-judgmental fashion. Why “marital” education instead of “sex” education? We chose this name in the hopes of reaching parents who support abstinence-only education.

Abstinence-only education may have a positive benefit in delaying the onset of sexual activity18—but it can lead to marriage at an earlier age, and without sexual education, those young couples may not know how to plan their family. Even if they are married, young parents are still at risk for dropping out of school with all of the negative consequences mentioned above.

Further, although pregnancy is an important focus, the information presented here is also relevant for same-sex marriages, and we believe that regardless of your life choices, reproductive health care and education is important to your well-being, and that your well-being is important to everyone’s well-being.

This book thus provides a basic education in the types of family planning and disease prevention methods available, discusses their failure rates and the common reasons for failure. It makes suggestions for doubling or trebling-up (using two or three different methods) to improve your chances of avoiding accidental pregnancy and disease.

Our purpose here is not to scare young people, but to provide essential information in a balanced and nonjudgmental way. Hopefully, this book will also be able to connect with parents who have been pro-abstinence-only, and encourage them to consider marital education in their communities. In Texas, and other states with high HIV rates, it may mean the difference between a happy healthy life, and a shortened one fighting HIV.

A copy of this book for personal use can be downloaded at Read it, pass it on, and if you get the opportunity, vote for abstinence-plus-marital education being taught in your local schools.


Endnote 1

Kearney M.S. & Levine P.B., Why is the teen birth rate in the United States so high and why does it matter? J. Econ. Perspect. 26(2):141-66 (2012), abstract available online at (“Teens in the United States are far more likely to give birth than in any other industrialized country in the world. U.S. teens are two and a half times as likely to give birth as compared to teens in Canada, around four times as likely as teens in Germany or Norway, and almost 10 times as likely as teens in Switzerland. Among more developed countries, Russia has the next highest teen birth rate after the United States, but an American teenage girl is still around 25 percent more likely to give birth than her counterpart in Russia.”).


Endnote 2

According to the National Campaign to Prevent Teen and Unplanned Pregnancy, available online at The worst state is New Mexico, followed by Mississippi, Arkansas, and Louisiana. Oklahoma is tied with Texas at fifth highest in teen pregnancy rates.


Endnote 3

Conspiracy of Silence: Sexuality Education in Texas Public Schools in 2015-2016, available online at


Endnote 4

Excerpted from Sexual Health of Adolescents and Young Adults in the United States (2014), published by the Henry J. Kaiser Family Foundation, available online at


Endnote 5

From Sexual Health of Adolescents and Young Adults in the United States (2014), by the Henry J. Kaiser Family Foundation, available online at


Endnote 6

State Facts About Unintended Pregnancy: Texas, published by the Guttmacher Institute and available online at


Endnote 7

Thomson-DeVeaux A., How Defunding Planned Parenthood Could Affect Health Care, FiveThirtyEight (2017), available online at (“Texas . . . embarked on a series of efforts to divert funding away from Planned Parenthood in 2011. First, the legislature instituted broad cuts to family planning services, spurring the closure of 82 clinics, one-third of which were affiliated with Planned Parenthood.”). For more information on Texas efforts to defund reproductive healthcare, see Deteriorating Access to Women’s Health Services in Texas: Potential Effects of the Women’s Health Program Affiliate Rule, by the Department of Health Policy, School of Public Health and Health Services at George Washington University, available online at; also Charts: This Is What Happens When You Defund Planned Parenthood, MotherJones (2013), available online at


Endnote 8

Stevenson A.J., et al., Effect of Removal of Planned Parenthood from the Texas Women’s Health Program, New Engl. J. Med. 374:853-860 (2016), available online at (“The percentage of women who underwent childbirth covered by Medicaid within 18 months increased from 7.0% to 8.4% in the counties with [now closed] Planned Parenthood affiliates and decreased from 6.4% to 5.9% in the counties without Planned Parenthood affiliates (estimated difference in differences, 1.9 percentage points; P = 0.01).”).


Endnote 9

From Teen Pregnancy and Childbearing, published by the Department of Health and Human Services, available online at


Endnote 10

Selby, W.G., Democratic legislators say more than half of Texas births funded by Medicaid, PolitiFact Texas (2012), available online at (“[Texas Health and Human Services] commission spokesman Geoffrey Wool . . . add[ed] that in 2010, 56.9 percent of Texas births — or 220,899 out of 388,447 total births — were covered by Medicaid, at an average cost of $11,600.”).


Endnote 11 (“In Texas in 2010, the federal and state governments spent $2.9 billion on unintended pregnancies; of this, $2,057 million was paid by the federal government and $842.6 million was paid by the state.”).


Endnote 12

Shuger L., Teen Pregnancy and High School Dropout: What Communities Can Do to Address These Issues. Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy (2012), available online at (“Nearly one-third of teen girls who have dropped out of high school cite early pregnancy or parenthood as a key reason. […] According to the Alliance for Excellent Education, it is estimated that over the course of his or her lifetime, a single high school dropout costs the nation approximately $260,000 in lost earnings, taxes, and productivity. Put another way, if students who dropped out of the Class of 2011 had graduated from high school, the nation’s economy would likely benefit from nearly $154 billion in additional income over the course of their lifetimes.”).


Endnote 13

HIV is human immunodeficiency virus, which will eventually cause AIDS—acquired immunodeficiency syndrome, and death.


Endnote 14

Texas – 2015 State Health Profile, published by the CDC, available online at


Endnote 15

10 US Cities with Most Positive STD Tests, STDCheck (2015) available online at Cf. Different surveys include different diseases, and thus STD statistics are highly variable. This particular survey did not include HSV1 or Hepatitis A, but did include Chlamydia, gonorrhea, HSV-2, hepatitis B and C, HIV-1 and -2, and syphilis.


Endnote 16

STD is “sexually transmitted disease”, also known as “STI” for “sexually transmitted infection” or “VD” for “venereal disease.”


Endnote 17

Statistics, American Sexual Health Association, available online at (“there are 19.7 million new STIs every year in the U.S… About half of all new STDs/STIs in 2000 occurred among youth ages 15 to 24.”).


Endnote 18

Jemmott III, J.B., et al., Efficacy of a Theory-Based Abstinence-Only Intervention over 24 Months, Archives of Pediatric Adolescent Medicine 164(2): 152 (2010), available online at (“The abstinence-only intervention compared with the health promotion control intervention reduced by about 33% the percentage of students who ever reported having sexual intercourse by the time of the 24-month follow- up, controlling for grade, age, and intervention- maintenance condition.”). Most studies report, however, that overall teen pregnancies are higher with abstinence only education. Stanger-Hall, K.F. & Hall, D.W., Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S, PLoS One. 2011; 6(10): e24658, available online at (“Using the most recent national data (2005) from all U.S. states with information on sex education laws or policies (N = 48), we show that increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates. This trend remains significant after accounting for socioeconomic status, teen educational attainment, ethnic composition of the teen population, and availability of Medicaid waivers for family planning services in each state. These data show clearly that abstinence-only education as a state policy is ineffective in preventing teenage pregnancy and may actually be contributing to the high teenage pregnancy rates in the U.S.”).

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