NASHVILLE, Tenn. — Cicely Wilson’s work doesn’t end when she leaves her day job as a lactation consultant, doula and child care expert.

Wilson founded a nonprofit called Sunnyside Up Youth Pregnancy Services, which connects girls ages 13 to 19 with resources they need to care for their babies. After-hours, she looks for affordable Nashville apartments, books medical appointments, tries to find strollers and other baby supplies, and hosts conversations with pregnant teens about breastfeeding and preparing mentally for childbirth.

Since the overturning of Roe v. Wade just over a year ago, Wilson said, she is confident that more Tennessee teens will carry their pregnancies to term. “Because the access isn’t there,” she said. “I do anticipate that we’re going to get a lot more teens that are wanting to parent their babies rather than going to Illinois or Georgia or Florida.”

Demand for services like Wilson’s could rise in the coming years even though the national teen birth rate has declined dramatically over the past three decades. It’s still dropping, but preliminary data released in June by the Centers for Disease Control and Prevention shows the descent may be slowing.

Doctors, service providers, and advocates say they’re worried full CDC data released later this year — which will include state-by-state numbers — could show a rise in teen births in many Southern states, where rates remain among the highest in the country. They say several factors — including the Supreme Court’s decision to strike down federal protections for abortion rights, intensifying political pushback against sex education, and the impact of the COVID-19 pandemic on youth mental health — could start to unravel decades of progress.

“It’s absolutely concerning,” said Laura Andreson, an OB-GYN in Franklin, Tennessee. The women’s health practice where she works is treating more pregnant teenagers than in recent years, which she thinks could reflect an emerging trend.

“It’s probably going to take a little bit of time,” she said. “But I would venture to say we’re going to see it every year: It’s going to go up.”

Nationally, the rate of teen births has dropped by 78% since a modern-day peak in 1991 of 61.8 births per 100,000 people, according to the CDC. Starting in 2007, the rate had consistently dropped by about 8% until 2021, when the rate of decline slowed to about 2%.

“It certainly does stand in contrast to what we’ve seen in prior years,” said CDC researcher Brady Hamilton. He is working on the updated version of the national data released in June that will break it down by state. Hamilton said that he can’t comment on the recent social and political factors at play, but that the “phenomenal decline” in the teen birth rates over more than 15 years could be reaching a natural plateau as states achieved their goals.

“There are a lot of states that have very low birth rates,” he said. “So you kind of potentially run into a situation where they’re already low and you really can’t go lower.”

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