Many factors must be examined in addition to the obvious cause, which is that adolescents are having sexual intercourse without adequate contraception. Since no form of contraception is 100% effective, abstinence is the only sure way to prevent pregnancy.

Statistics show that 24% of girls and 27% of boys in the United States have experienced sex by age 15. That figure grows to 66% of unmarried teens having sex by the age 19. Studies have shown that by age 20, 77% of American females and 85% of American males are sexually active. Why teenagers have sex, and do so without effective methods of contraception, is a topic of heated debate. Suggested reasons follow:

• Adolescents become sexually mature (and fertile) approximately 4 to 5 years before they reach emotional maturity.
• Adolescents today are growing up in a culture in which peers, TV and motion pictures, music, and magazines often transmit either covert or overt messages that unmarried sexual relationships (specifically those involving teenagers) are common, accepted, and at times expected, behaviors.
• Education about responsible sexual behavior and specific, clear information about the consequences of sexual intercourse (including pregnancy, sexually transmitted diseases, and psychosocial effects) are frequently not offered in the home, at school, or in other community settings. Therefore, much of the "sex education" that adolescents receive filters through misinformed or uninformed peers.
• Adolescents who choose to be sexually active are frequently limited in their contraceptive options by peer, parental, financial, cultural, and political influences as well as their own developmental constraints (that is, achieving physical before emotional maturity).

The incidence of adolescent pregnancy has declined since reaching an all-time high in 1990, mostly due to an increase in the use of condoms. There were 506,800 live births to adolescent mothers in 1996 (compared to 521,826 live births in 1990). 

This corresponds to 97 pregnancies per 1,000 women aged 15-19 in 1996, compared to 117 per 1,000 in 1990.  Of those teen mothers, 25% will have a second child within 2 years of the first.

When compared to other industrialized nations, the United States has the highest rates of pregnancy, abortion, and childbirth among teenagers, despite similar or higher rates of sexual activity in the other countries.

A sexually active teenager who does not use contraception has a 90% chance of becoming pregnant within 1 year. Of those pregnancies, 78% are unplanned, accounting for 25% of all unplanned pregnancies. It is estimated in the United States that 40% of white women and 64% of black women will have experienced at least one pregnancy by age 20.

Potential risk factors for a teenage girl to become pregnant include: early dating behavior (dating at age 12 is associated with a 91% chance of being sexually involved before age 19, and dating at age 13 is associated with a 56% probability of sexual involvement during adolescence); early use of alcohol and/or other drugs, including tobacco products; dropping out of school; lack of a support group or few friends; lack of involvement in school, family, or community activities; perceiving little or no opportunities for success; living in a community or attending a school where early childbearing is common and viewed as the norm rather than as a cause for concern; growing up under impoverished conditions; having been a victim of sexual abuse or assault; or having a mother who was aged 19 or younger when she first gave birth.

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