In Post-Roe America, Comprehensive Sex Education is Necessary to Prevent Teen Pregnancy


Claire Helgerson (PPS ‘25)

Claire Helgerson (PPS ‘25)

The U.S. ranks #1 in rates of teenage pregnancy (ages 15–19) across developed nations. Teenage parents are more likely to become unemployed, pregnant teenagers have higher rates of prenatal complications, and their children are more likely to suffer from birth defects[1].

In June 2022, the Republican-majority Supreme Court overturned Roe v. Wade, allowing for states to regulate abortion. In the wake of this decision, “trigger laws” from decades past that were deemed unconstitutional by Roe came back into effect. Given the outsize number of teen pregnancies, we must consider the implications of post-Roe America for this age group, specifically in Southern states. Regulating abortion without simultaneously improving sex education will serve only to increase the rate of teen pregnancy.

The rate of teen pregnancy is decreasing, falling from 12% of all pregnancies in 2006 to 6% in 2017[2]. As teenagers made up 17% of abortions in 2006 and 9% in 2017, it is crucial to consider that this age group represents an excise amount of abortions relative to pregnancies. Further, 25% of teen pregnancies end in abortion, the highest rate of any age group. Given the inflated rate of abortion among pregnant teens, post-Roe America is likely to have a disproportionate impact upon this group. One key example of consequential laws for teen parents are emerging “heartbeat laws” that outlaw abortions after 6 weeks of pregnancy[3]. The average gestational age for receiving a positive pregnancy test is 5.9 weeks. However, the average for the teenage group is 7.4 weeks. Six-week heartbeat laws will therefore remove the possibility of abortion from the average pregnant teenager and could lead to higher birth rates as a byproduct of less abortion.

Given the state of reproductive policy post-Roe, I propose improving sex education to prevent teen pregnancy before the necessity of considering abortion.

Picture of a Map
This 2020 graph from the Centers for Disease Control shows rates of teen pregnancy by state[1]. Clearly, states in the American South have a noticeably higher burden of teen pregnancy (numbers given in instances of pregnancy per 1000 teenage women). Given the disparate impact of teenage pregnancy in the South, I looked into the prevalence and quality of sex education measures on a state-by-state, and regional, basis.
The below above shows 5 categories of sex education requirements across states[2].

Southern states are split on requiring sex education, but those that do mandate abstinence education, where educators encourage not having sex at all, as opposed to having it safely. Given that teenagers make up 6% of pregnancies nationwide, and rates in Southern states are higher by 10–15 points than any other region, it is clear that abstinence education is not convincing.

Further, abortion rates across all U.S. states have been declining over the past 15 years (CITE). This decrease is not attributed to abortion regulation, but wider access to contraceptives[1]. Therefore, instruction on contraception (moving away from abstinence-only programming) in Southern schools could help apply this trend to teenage parents and decrease the number of teenagers becoming pregnant to begin with.

Currently, only 7.8% of sex education programs are “comprehensive” or evidence-based, meaning that they use systematic, scholarly findings to drive the curriculum[2]. These programs place an emphasis on effective contraception and note its importance for preventing pregnancy and include discussion of anatomy, safe sex, and consent. Comprehensive education have been proven to decrease instances of teenage pregnancy, sexually transmitted infections, and result in a later age of having sex for the first time[3]. Though the South has already, and will continue to, regulate abortion, introducing comprehensive sex education would serve to prevent teen pregnancy before the choice to pursue abortion becomes necessary.

The argument amongst many Southern lawmakers against sex education is that it may go against cultural or religious practices of individual students or families, or that learning about sex encourages sexual activity[1]. However, a study conducted in Mobile, Alabama (highest statewide teen pregnancy rate) showed that 83% of parents support increased sex education in public schooling. When prompted, these parents condoned expanding sex education beyond current abstinence-only programs. Given the wide support for education as a preventative measure, legislators should implement comprehensive policies, while allowing for exemptions due to cultural or religious reasons on a case-by-case basis.

Abstinence-only sex education is clearly not working. If sex education policies do not change to a comprehensive method emphasizing the varieties of contraceptive devices and their correct methods of use, the burden of teen pregnancy in the American South will only increase.

[1] Franjić, S. (2018, 30 April). Adolescent Pregnancy is a Serious Social Problem. Journal of Gynecological Research and Obstetrics. Retrieved 12 April 2023, from, link.

[2] Lantos, H. (2022, 19 October). State-level Abortion Restrictions Will Negatively Impact Teens and Children. ChildTrends. Retrieved 12 April 2023, from, link.

[3] Simmons-Duffin, S. (2022, 3 May). The Texas abortion ban hinges on ‘fetal heartbeat.’ Doctors call that misleading. NPR. Retrieved 12 April 2023, from, link.

[4] National Center for Health Statistics. (2022, 25 February). Stats of the State — Teen Birth Rates. Centers for Disease Control. Retrieved 12 April 2023, from, link.

[5] Rekhter, M. (2018, 25 October). Let’s Talk About Sex … Education. HiLite. Retrieved 12 April 2023, from, link.

[6] Dreweke, J. (2019, 18 September). The U.S. Abortion Rate Continues to Drop: Once Again, State Abortion Restrictions Are Not the Main Driver. Guttmacher Policy Review. Retrieved 12 April 2023, from, link.

[7] Millner, V. (2015, 1 February). Parents’ Beliefs Regarding Sex Education for Their Children in Southern Alabama Public Schools. SpringerLink. Retrieved 12 April 2023, from, link.

[8] Mark, N. (2022, 14 February). More comprehensive sex education reduced teen births: Quasi-experimental evidence. PubMed Central. Retrieved 12 April 2023, from, link.

[4] Panjabi, C. (n.d.). The problem with sex ed is …. SIECUS. Retrieved 12 April 2023, from, link.

Claire Helgerson is from Charlottesville, VA and an Undergraduate at Duke University’s Sanford School of Public Policy. This piece was submitted as an op-ed in the Spring ‘23 PUBPOL 301 course. This content does not represent the official or unofficial views of the Sanford School, Polis, Duke University, or any entity or individual other than the author.