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Key Findings:

• The county-level analysis found that teen birth rates are higher in communities with more individuals living in poverty or lacking a bachelor’s degree, or communities with a higher percentage of its population being age 17 or younger.
• Individual- and household-level analyses found that positive role-modeling and mentoring from parents; parental discussions about birth control; and having a mother who graduated from high school were associated with lower rates of teen birth among women in the rural South. In contrast, young age at sexual initiation and lack of contraceptive use at first sex were associated with a higher likelihood of having a teen pregnancy.
• Stakeholders and community members explained that many contextual factors contribute to teen pregnancy, such as discrimination based on race and class, restrictive sexuality education policies, and noncompliance with confidentiality protocols among healthcare providers.
• The systemic nature of factors influencing teen pregnancy in Phillips and Coahoma Counties requires a multipronged intervention approach in government, community, school, and clinical settings.