Fertility of Men and Women Aged 15-49 in the United States: National Survey of Family Growth,2015-2019.

Objective-This report presents national estimates of selected fertility measures for men and women aged 15-49 in the United States in 2015-2019, based on data from the National Survey of Family Growth (NSFG). Overall estimates for 2015-2019 are compared with those for 2011-2015.

Teenagers in the United States: Sexual Activity,Contraceptive Use, and Childbearing, 2015-2019.

Objective-This report presents national estimates of sexual activity and contraceptive use among males and females ages 15-19 in the United States, based on data from the National Survey of Family Growth (NSFG). Methods-NSFG data were collected through in-person interviews with nationally representative samples of males and females ages 15-49 in the household population of the United States. NSFG 2015-2019 interviews were conducted between September 2015 and September 2019 with 21,441 males and females, including 3,812 teenagers (1,894 females and 1,918 males ages 15-19). Estimates include measures of sexual experience and contraceptive use as well as circumstances of first sexual intercourse (sex), attitudes, and probability of a birth during the teen years. Estimates are shown overall and by Hispanic origin and race, age group, parental living arrangements, and maternal characteristics. The report focuses on the period 2015-2019, with trends shown for selected measures for time points 2002, 2006-2010, 2011-2015, and 2015-2019. Results-In 2015-2019, 40.5% of never-married female teenagers (3.8 million), and 38.7% of never-married male teenagers (3.8 million) had ever had vaginal intercourse with an opposite-sex partner. For females this percentage was stable across the four time points, but for males this percentage decreased from the 2002 (45.7%) and 2011-2015 (44.2%) time points. For teen males, use of any contraception at first sex increased across the four time points, from 82.0% in 2002 to 92.1% in 2015-2019, while no consistent trend was seen for teen females. Nearly four out of five female teenagers (77.3%) in 2015-2019 used a method of contraception at first sex. Among female teenagers, ever-use of long-acting reversible contraception, which includes intrauterine devices and contraceptive implants, increased from 5.8% to 19.2% from 2011-2015 to 2015-2019.

Trends and Patterns in Menarche in the United States: 1995 through 2013-2017.

Objective-This report presents national estimates of age at first menstrual period for women aged 15-44 in the United States in 2013-2017 based on data from the National Survey of Family Growth (NSFG). Estimates for 2013-2017 are compared with those from previous NSFG survey periods (1995, 2002, and 2006-2010). Methods-Data for all survey periods analyzed are based on in-person interviews with nationally representative samples of women in the household population aged 15-44 in the United States. For the 2013-2017 survey period, interviews were conducted with 10,590 female respondents aged 15-44. In 2015-2017, the age range of the NSFG included women aged 15-49, but only those aged 15-44 were included in this analysis. The response rate for the 2013-2017 NSFG was 67.4% for women. Measures of menarche in this report include average age at first menstrual period, probability of first menstrual period at each age, and the relationship between age at menarche and age at first sexual intercourse. Results-The median age at menarche decreased from 1995 (12.1) to 2013-2017 (11.9). The cumulative probability of menarche at young ages was higher in 2013-2017 compared with 1995. Differences in age at menarche exist by Hispanic origin and race, mother's education, and living arrangement at age 14. A decreasing linear trend in the probability of age at first sexual intercourse by age at menarche was seen.

Sexual Activity and Contraceptive Use Among Teenagers Aged 15-19 in the United States, 2015-2017.

Monitoring sexual activity and contraceptive use among teenagers aged 15-19 in the United States informs understanding of the risk of pregnancy. By 2018, the U.S. birth rate for teenagers dropped 72% from its peak in 1991 (1), paralleling a decline in the teen pregnancy rate (1,2). While this represents progress toward national goals, these rates are still higher than those in other developed countries (3,4). Using data from the 2002 through 2015-2017 National Survey of Family Growth (NSFG), this report provides trends and national estimates of sexual activity and contraceptive use among teenagers.

Receipt of Pelvic Examinations Among Women Aged 15-44 in the United States, 1988-2017.

Pelvic examination has been commonly performed as part of a physical examination for women in the United States. However, the value of routine pelvic examinations has been questioned recently (1,2). In 2012, the American College of Obstetricians and Gynecologists (ACOG) recommended annual pelvic examinations for women aged 21 and over as part of the well-woman visit (3). In 2018, ACOG advised that pelvic examinations be performed when indicated by medical history or symptoms (4). Using National Survey of Family Growth (NSFG) data through 2017 for women aged 15-44, this report describes trends overall and by age since 1988 in the receipt of pelvic examinations in the past year, and differences by Hispanic origin and race, education, poverty status, and health insurance status for 2015-2017.

Fertility of Men and Women Aged 15-44 in the United States: National Survey of Family Growth, 2011-2015.

This report presents national estimates of selected fertility measures for men and women aged 15-44 in the United States in 2011-2015 based on data from the National Survey of Family Growth (NSFG). Estimates for 2011-2015 are compared with those for 2006-2010.

Provider communication with adolescent and young females during sexual and reproductive health visits: findings from the 2011-2015 National Survey of Family Growth.

OBJECTIVE: This study assesses provider communication with adolescent and young women about birth control, emergency contraception and condoms during sexual and reproductive health visits. STUDY DESIGN: Using data from sexually active 15-24-year-old women in the 2011-2015 National Survey of Family Growth, we examined provider communication about contraception and condoms at sexual and reproductive health services in the past year and assessed differences by demographics, sexual behavior and source of care. RESULTS: Approximately two thirds of women received provider communication about condoms (65.0%) and birth control (64.0%-66.8%). Communication was higher among Title-X-funded clinic vs. private providers. Differences by age, race/ethnicity, mother's education, number of partners and condom use were also found. CONCLUSION: Most sexually active young women attending sexual and reproductive health visits received provider communication about condoms and birth control, but communication is not universal and varies by source of care, demographics and sexual behavior.

Sexual Activity and Contraceptive Use Among Teenagers in the United States, 2011-2015.

Objective-This report presents national estimates of sexual activity and contraceptive use among males and females aged 15-19 in the United States in 2011-2015, based on data from the National Survey of Family Growth (NSFG). For selected indicators, data are also presented from the 1988, 1995, 2002, and 2006-2010 NSFGs, and from the 1988 and 1995 National Survey of Adolescent Males, which was conducted by the Urban Institute. Methods-NSFG data were collected through in-person interviews with nationally representative samples of men and women aged 15-44 in the household population of the United States. NSFG 2011-2015 interviews were conducted between September 2011 and September 2015 with 20,621 men and women, including 4,134 teenagers (2,047 females and 2,087 males). The response rate was 72.5% for male teenagers and 73.0% for female teenagers. Results-In 2011-2015, 42.4% of never-married female teenagers (4.0 million) and 44.2% of never-married male teenagers (4.4 million) had had sexual intercourse at least once by the time of the interview (were sexually experienced). These levels of sexual experience among teenagers are similar to those seen in 2002 and 2006-2010 data. Longer-term trends, from 1988 to 2011-2015, show declines in the percentage of teenagers who were sexually experienced. Female teenagers' use of a method of contraception at first sex increased from 74.5% in 2002 to 81.0% in 2011-2015. Male teenagers' use of a condom at first sex increased from 70.9% in 2002 to 79.6% in 2006-2010 and remained stable at 76.8% in 2011-2015. Overall, in 2011-2015, 5.8% of female teenagers had used a long-acting reversible method (intrauterine device or implant).

Urban and Rural Variation in Fertility-related Behavior Among U.S. Women, 2011-2015.

In 2010, one-fifth of the U.S. population lived in rural areas (1). There is known variation in social, demographic, and health characteristics across urban and rural residence (1­3). Recent National Center for Health Statistics (NCHS) reports show higher teen birth and infant mortality rates in rural counties than in urban counties (4,5). Less is known about urban and rural variation in fertility-related behavior, such as sexual activity and contraceptive use. Using National Survey of Family Growth (NSFG) data from 2011 through 2015 for women aged 18­44, this report describes urban-rural differences in first sexual intercourse, marital and cohabitation status, number of births, and contraceptive use based on residence at the time of interview.

Sexual Activity, Contraceptive Use, and Childbearing of Teenagers Aged 15-19 in the United States.

KEY FINDINGS: Monitoring sexual activity and contraceptive use among U.S. adolescents is important for understanding differences in their risk of pregnancy. In 2013, the U.S. birth rate for teenagers aged 15-19 dropped 57% from its peak in 1991 (1), paralleling a decline in the teen pregnancy rate (1-2). But these rates are still higher than those in other developed countries (3-4). Using data from the 1988 to 2011-2013 National Survey of Family Growth (NSFG), this report provides trends and recent national estimates of sexual activity, contraceptive use, and childbearing among teenagers aged 15-19.

Three Decades of Nonmarital First Births Among Fathers Aged 15-44 in the United States.

KEY FINDINGS: The percentage of fathers aged 15-44 whose first births were nonmarital was lower in the 2000s (36%) than in the previous 2 decades. Fathers with first births in the 2000s were more likely to be in a nonmarital cohabiting union (24%) than those in the 1980s (19%). The percentage of fathers with a nonmarital first birth over the past 3 decades has remained similar for Hispanic and non-Hispanic white men, but has declined for non-Hispanic black men (1980s, 77%; 2000s, 66%). Fathers with nonmarital first births in the 2000s were less likely to be non-Hispanic black men (21%) than Hispanic (33%) or non-Hispanic white (39%) men. Fathers with nonmarital first births in the 2000s were more likely to be older at the time of the birth (33%) than those in the previous 2 decades.

Recent declines in nonmarital childbearing in the United States.

There were sharp increases in nonmarital childbearing from 2002 to 2007, following the steady increases beginning in the 1980s. The upward trends have mainly reversed since 2007-2008. In addition, the nature of nonmarital childbearing may be changing as cohabiting unions have increased over the last few decades in the United States along with pregnancies within those unions. Births to unmarried women are at greater risk for adverse outcomes, including low birth weight, preterm birth, and infant mortality. Social and financial supports for unmarried mothers may be limited. This report describes recent trends in nonmarital births from the National Vital Statistics System (NVSS) and in cohabitation for unmarried mothers using data from the National Survey of Family Growth (NSFG).

Teenagers in the United States: sexual activity, contraceptive use, and childbearing, national survey of family growth 2006-2008.

OBJECTIVE: This report presents national estimates of sexual activity, contraceptive use, and births among males and females 15-19 years of age in the United States in 2006-2008 from the National Survey of Family Growth (NSFG). Selected data are also presented from the 1988, 1995, and 2002 NSFGs, and from the 1988 and 1995 National Survey of Adolescent Males (NSAM), conducted by the Urban Institute. METHODS: Descriptive tables of numbers and percents are presented and discussed. Data were collected through in-person interviews of the household population in the United States, conducted between July 2006 and December 2008. Interviews were conducted with 7,356 females-1,381 of whom were teenagers--and 6,140 males--1,386 of whom were teenagers-for a total of 2,767 teenagers. The overall response rate for the 2006-2008 NSFG was 75%. The response rate for female teenagers was 77% and for male teenagers 75%. RESULTS: In 2006-2008, about 42% of never-married female teenagers (4.3 million), and about 43% of never-married male teenagers (4.5 million) had had sexual intercourse at least once. These levels of sexual experience have not changed significantly from 2002, the last time the NSFG collected these data. Among never-married teenagers, 79% of females and 87% of males used a method of contraception at first sex. With a few exceptions, teenagers' use of contraceptives has changed little since 2002, and the condom remained the most commonly used method. One exception was an increase in the use of condoms and the use of a condom combined with a hormonal contraceptive (dual method use) among males. Another exception was a significant increase in the percent of female teenagers who had ever used periodic abstinence, or the "calendar rhythm" method. This method had been used by 17% of female teenagers in 2006-2008.

Fertility, contraception, and fatherhood: data on men and women from cycle 6 (2002) of the 2002 National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of fertility, family formation, contraceptive use, and father involvement indicators among males 15-44 years of age in the United States in 2002 from Cycle 6 of the National Survey of Family Growth (NSFG). Data are also shown for women for purposes of comparison. METHODS: Descriptive tables of numbers and percentages are presented. Data were collected through in-person interviews of the household population 15-44 years of age in the United States between March 2002 and March 2003. The sample included 7,643 females and 4,928 males. This report focuses primarily on data from the male sample, but compares findings with the female data whenever appropriate. The overall response rate for Cycle 6 of the NSFG was 79 percent, and the response rate for men was 78 percent. RESULTS: This report covers a wide range of topics including first sexual intercourse and its timing in relation to marriage; contraceptive use; wantedness of births in the past 5 years; marital and cohabiting status at first birth; living arrangement of fathers with their children; father's activities with children they live with and those they do not live with; HIV-risk related behaviors; and infertility services. CONCLUSION: The reproductive experiences of men and women 15-44 years of age in the United States vary significantly, and often sharply, by demographic characteristics such as education, income, and Hispanic origin and race.

Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth.

OBJECTIVE: This report presents national estimates of fertility, family planning, and reproductive health indicators among females 15-44 years of age in the United States in 2002 from Cycle 6 of the National Survey of Family Growth (NSFG). For selected indicators, data are also compared with earlier cycles of the NSFG. METHODS: Descriptive tables of numbers and percentages are presented and interpreted. Data were collected through in-person interviews of the household population 15-44 years of age in the United States between March 2002 and March 2003. The sample included 7,643 females and 4,928 males, and this report focuses on data from the female sample. The overall response rate for the Cycle 6 NSFG was 79 percent, and the response rate for women was 80 percent. RESULTS: Given the range of topics covered in the report, only selected findings are listed here. About 14 percent of recent births to women 15-44 years of age in 2002 were unwanted at time of conception, an increase from the 9 percent seen for recent births in 1995. Among recent births, 64 percent occurred within marriage, 14 percent within cohabiting unions, and 21 percent to women who were neither married nor cohabiting. The overall rate of breastfeeding initiation among recent births increased from 55 to 67 percent between 1995 and 2002. About 50 percent of women 15-44 had ever cohabited compared with 41 percent of women in the 1995 survey; the percentage of women currently cohabiting also increased, from 7 to 9 percent between 1995 and 2002.

Use of contraception and use of family planning services in the United States: 1982-2002.

OBJECTIVE: This report presents national estimates of contraceptive use and method choice based on the 1982, 1995, and 2002 National Surveys of Family Growth (NSFG). It also presents data on where women obtained family planning and medical services, and some of the services that they received. METHODS: Data were collected through in-person interviews with 12,571 men and women 15-44 years of age in the civilian noninstitutional population of the United States in 2002. This report is based on the sample of 7,643 women interviewed in 2002. The response rate for women in the study was about 80 percent. RESULTS: The leading method of contraception in the United States in 2002 was the oral contraceptive pill, used by 11.6 million women; the second leading method was female sterilization, used by 10.3 million women. The condom was the third-leading method, used by about 9 million women and their partners. The condom is the leading method at first intercourse; the pill is the leading method among women under 30; and female sterilization is the leading method among women 35 and older. More than 98 percent of women 15-44 years of age who have ever had sexual intercourse with a male (referred to as "sexually experienced women") have used at least one contraceptive method. Over the 20 years from 1982 to 2002, the percent who had ever had a partner who used the male condom increased from 52 to 90 percent. The proportion who had ever had a partner who used withdrawal increased from 25 percent in 1982 to 56 percent in 2002. Another important measure of contraceptive use is use at the first premarital intercourse: before 1980, only 43 percent of women (or their partner) used a method of birth control at their first premarital intercourse. By 1999-2002, the proportion using a method at first premarital intercourse had risen to 79 percent.

Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002.

OBJECTIVE: This report presents national estimates of sexual activity, contraceptive use, and births among males and females 15-19 years of age in the United States in 2002 from the National Survey of Family Growth (NSFG). Data are also presented from the 1988 and 1995 NSFGs, and from the 1988 and 1995 National Survey of Adolescent Males (NSAM). METHODS: Descriptive tables of numbers and percents are presented and interpreted. Data were collected through in-person interviews of the civilian noninstitutionalized population in the United States. Interviews were conducted with 7,643 females, 1,150 of whom were teenagers, and 4,928 males, 1,121 of whom were teenagers. RESULTS: In 2002, about 47 percent of female teenagers (4.6 million), and about 46 percent of male teenagers (4.7 million) had had sexual intercourse at least once. For never-married males, there was a significant decline from 55 percent in 1995 to 46 percent in 2002. Among never-married females, for those aged 15-17 there was a significant decline in the percent sexually experienced, and for those aged 18-19 there was no significant change. Teenagers showed increases in the use of contraceptives. About 3 out of 4 teens used a method of contraception at their first intercourse. About 91 percent of males and 83 percent of females used a method at their last (most recent) sex. Hispanic teens are most likely to have a birth before age 20 and non-Hispanic whites are least likely, with non-Hispanic black teens in the middle. CONCLUSION: This report documents findings that may be helpful in understanding trends in teen birth and pregnancy, and STD rates.