“We know from previous studies that the decline in the U.S. teen abortion rate has been driven by increased contraceptive use and the use of more effective methods by American teens, which has decreased unintended pregnancy within this group,” says Susan Cohen, director of government affairs at the Guttmacher Institute. “By improving coverage and eliminating cost barriers, the Affordable Care Act should help accelerate this positive trend, allowing American women, including teens, greater access to the most effective contraceptive methods.”

Despite these improvements, the teen abortion rate in the United States remains roughly three times that in the Netherlands or Germany (6–7 per 1,000). The authors attribute this difference to a number of factors, including that, compared with the United States, many European countries provide better access to contraceptive services and comprehensive sex education and have a more pragmatic approach to adolescent sexuality.