• Preetha Nandi, Michael Kramer, and Melissa Kottke.
• Emory University School of Medicine, Atlanta, GA; Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: preetha.nandi@emory.edu.
• Contraception. 2019 Mar 1; 99 (3): 175-178.

ObjectiveTo understand teen birth trends in Georgia by racial and geographic factors.Study DesignWe analyzed overall birth and repeat teen birth rates by race, urban/rural status and adequacy of obstetric care from 2008 to 2016 using vital records from all Georgia counties.ResultsOverall birth rates among teens analyzed decreased dramatically in Georgia, from 45.63 births per 1000 teens in 2008-2010 to 26.28 per 1000 teens in 2014-2016. Repeat birth rates followed a similar decline, from 9.40 to 4.53 repeat births per 1000 teens over the same time period. These rates decreased in all subgroups of teens but to varying degrees. The difference in birth and repeat birth rates between black and white teens decreased fourfold during this time period, whereas the declines in these rates for teens living in rural versus urban counties and with inadequate versus adequate obstetric care were less pronounced.ConclusionWhile remarkable reductions in teen birth and repeat birth rates have occurred since 2008, these declines have not been equally experienced by all groups of teens.ImplicationsOur analysis suggests that persistent disparities in teen birth and repeat birth rates exist, particularly in areas with limited or threatened access to reproductive health care. Applying targeted teen pregnancy prevention initiatives to these areas could help ensure equitable health and social outcomes for teens.Copyright © 2018 Elsevier Inc. All rights reserved.

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