Children Having Children

Before the baby came, her bedroom was a dimly lighted chapel dedicated to the idols of rock ‘n’ roll. Now the posters of Duran Duran and Ozzy Osbourne have been swept away and the walls painted white. Angela Helton’s room has become a nursery for six-week-old Corey Allen. Angie, who just turned 15, finds it hard to think of herself as a mother. “I’m still just as young as I was,” she insists. “I haven’t grown up any faster.” Indeed, sitting in her parents’ Louisville living room, she is the prototypical adolescent, lobbying her mother for permission to attend a rock concert, asking if she can have a pet dog and complaining she is not allowed to do anything. The weight of her new responsibilities is just beginning to sink in. “Last night I couldn’t get my homework done,” she laments with a toss of her blond curls. “I kept feeding him and feeding him. Whenever you lay him down, he wants to get picked up.” In retrospect she admits: “Babies are a big step. I should have thought more about it.”

The rhythm of her typing is like a fox trot, steady and deliberate. It is a hot summer day in San Francisco, and Michelle, a chubby black 14-year-old, is practicing her office skills with great fervor, beads of sweat trickling down her brow. She is worried about the future. “I have to get my money together,” she frets. “I have to think ahead.” Indeed she must. In three weeks this tenth-grader with her hair in braids is going to have a baby. “I have to stop doing all the childish things I’ve done before,” she gravely resolves. “I used to think, ten years from now I’ll be 24. Now I think, I’ll be 24, and my child will be ten.”

It is early afternoon, and the smells of dirty diapers and grease mingle in the bleak Minneapolis apartment. The TV is tuned to All My Children, and Stephanie Charette, 17, has collapsed on the sofa. Her rest is brief. Above the babble of the actors’ voices comes a piercing wail. Larissa, her three-week-old daughter, is hungry. In an adjacent bedroom, Joey, l l/2 years old and recovering from the flu, starts to stir. Stephanie, who is an American Indian and one of ten children herself, first became pregnant at 15. It was an “accident,” she explains. So too was her second baby. “I’m always tired,” she laments, “and I can’t eat.” Before Joey’s birth, before she dropped out of school, Stephanie dreamed of being a stewardess. Now her aspirations are more down-to-earth. “I want to pay my bills, buy groceries and have a house and furniture. I want to feel good about myself so my kids can be proud of me.” It has been a long, long while, she confides, “since I had a good time.”

They are of different races, from different places, but their tales and laments have a haunting sameness. Each year more than a million American teenagers will become pregnant, four out of five of them unmarried. Together they represent a distressing flaw in the social fabric of America. Like Angela, Michelle and Stephanie, many become pregnant in their early or mid-teens, some 30,000 of them under age 15. If present trends continue, researchers estimate, fully 40% of today’s 14-year-old girls will be pregnant at least once before the age of 20. Says Sally, 17, who is struggling to raise a two-year-old son in Los Angeles: “We are children ourselves having children.”

Teenage pregnancy has been around as long as there have been teenagers, but its pervasiveness in this country, the dimensions of its social costs and the urgent need to attack the problem are just beginning to be widely appreciated. According to a Harris poll released in November, 84% of American adults regard teenage pregnancy as a serious national problem. The news in recent weeks illustrates the growing concern:

In Wisconsin last month, Governor Anthony Earl signed landmark legislation designed to combat unwanted teen pregnancies and, as he put it, to “limit thousands of personal tragedies that are played out in our state every day.” The law, which won unanimous approval in the state legislature, provides funding for sex education in public schools, repeals restrictions on the sale of nonprescription contraceptives and provides $1 million for counseling pregnant adolescents. It also takes the unusual step of making grandparents of babies born to teenagers legally responsible for the babies’ financial support. “All of us,” said Earl, “young people and parents of young people, have a responsibility for our actions.”

At Chicago’s DuSable High School, controversy erupted when school officials decided to establish an on-campus health clinic, authorized to dispense contraceptives to students who have parental permission. The school, which serves one of the nation’s poorest neighborhoods, is battling a veritable epidemic: each year about one-third of its 1,000 female students are pregnant. The clinic has elicited picketing and protest, mostly by religious and antiabortion groups, but the school has refused to back down. Says Principal Judith Steinhagen: “All I can say is, we’re trying to keep some young ladies in school and off welfare.”

The school board in Los Angeles announced that it too plans to open a health clinic offering contraceptives to high school students. So far, nine schools around the U.S. have taken this step, and others are expected to follow suit. Says School Board Member Jackie Goldberg: “There’s an appalling number of teen pregnancies. I hope to upgrade the quality of teen medical care, and I hope that young men and women will consider the ramifications of being sexually active.”

Such strong and controversial measures reflect the magnitude of the problem and its consequences. Teen pregnancy imposes lasting hardships on two generations: parent and child. Teen mothers are, for instance, many times as likely as other women with young children to live below the poverty level. According to one study, only half of those who give birth before age 18 complete high school (as compared with 96% of those who postpone childbearing). On average, they earn half as much money and are far more likely to be dependent on welfare: 71% of females under 30 who receive Aid to Families with Dependent Children had their first child as a teenager.

As infants, the offspring of teen mothers have high rates of illness and mortality. Later in life, they often experience educational and emotional problems. Many are victims of child abuse at the hands of parents too immature to understand why their baby is crying or how their doll-like plaything has suddenly developed a will of its own. Finally, these children of children are prone to dropping out and becoming teenage parents themselves. According to one study, 82% of girls who give birth at age 15 or younger were daughters of teenage mothers.

With disadvantage creating disadvantage, it is no wonder that teen pregnancy is widely viewed as the very hub of the U.S. poverty cycle. “A lot of the so-called feminization of poverty starts off with teenagers’ having babies,” says Lucile Dismukes of the Council on Maternal and Infant Health in Atlanta, a state advisory group. “So many can’t rise above it to go back to school or get job skills.”

Among the underclass in America’s urban ghettos, the trends are especially disturbing. Nearly half of black females in the U.S. are pregnant by age 20. The pregnancy rate among those ages 15 to 19 is almost twice what it is among whites. Worse still, nearly 90% of the babies born to blacks in this age group are born out of wedlock; most are raised in fatherless homes with little economic opportunity. “When you look at the numbers, teenage pregnancies are of cosmic danger to the black community,” declares Eleanor Holmes Norton, law professor at Georgetown University and a leading black scholar. “Teenage pregnancy ranks near the very top of issues facing black people.”

The shocking prevalence of teenage pregnancy among white as well as black Americans was brought to light earlier this year, when the Alan Guttmacher Institute, a nonprofit research center in New York City, released the results of a 37-country study. Its findings: the U.S. leads nearly all other developed nations in its incidence of pregnancy among girls ages 15 through 19. As a point of comparison, AGI investigators looked at five other Western countries in detail: Sweden, Holland, France, Canada and Britain (see chart). Though American adolescents were no more sexually active than their counterparts in these countries, they were found to be many times as likely to become pregnant. And while black teenagers in the U.S. have a higher pregnancy rate than whites, whites alone had nearly double the rate of their British and French peers and six times the rate of the Dutch. Observes AGI President Jeannie Rosoff: “It’s not a black problem. It’s not just an East Coast problem. It’s a problem for all of us.”

It is also a complex problem, one that strikes many sensitive nerves. The subject of teenage pregnancy seems to raise almost every politically explosive social issue facing the American public: the battle over abortion rights; contraceptives and the ticklish question of whether adolescents should have easy access to them; the perennially touchy subject of sex education in public schools; controversies about welfare programs; and the precarious state of the black family in America. Indeed, even the basic issue of adolescent sexuality is a subject that makes many Americans squirm.

To understand the nature of the problem, one must look beyond statistics and examine the dramatic changes in attitudes and social mores that have swept through American culture over the past 30 years. The teenage birth rate was actually higher in 1957 than it is today, but that was an era of early marriage, when nearly a quarter of 18-and 19-year-old females were wedded. The overwhelming majority of teen births in the ’50s thus occurred in a connubial context, and mainly to girls 17 and over. Twenty and 30 years ago, if an unwed teenager should, heaven forbid, become pregnant, chances are her parents would see that she was swiftly married off in a shotgun wedding. Or, if marriage was impractical, the girl would discreetly disappear during her confinement, the child would be given up for adoption, and the matter would never be discussed again in polite company. Abortion, of course, was not a real option for most until 1973, when the Supreme Court ruled it could not be outlawed.

All this has changed. Today if a girl does not choose to abort her pregnancy (and some 45% of teenagers do), chances are she will keep the baby and raise it without the traditional blessings of marriage. “The shotgun marriage is a relic of the past,” observes Mark Testa, of Chicago’s National Opinion Research Center. With teen marriages two to three times as likely to end in divorce, he explains, “parents figure, why compound their mistake?” In 1950 fewer than 15% of teen births were illegitimate. By 1983 more than half were, and in some regions of the country, the figure exceeds 75%. Unwed motherhood has become so pervasive that “we don’t use the term illegitimate anymore,” notes Sister Bertille Prus, executive director of Holy Family Services, a Los Angeles adoption agency for pregnant teens.

With the stigma of illegitimacy largely removed, girls are less inclined to surrender their babies for adoption. In fact, fewer than 5% do (compared with roughly 35% in the early 1960s). “In earlier times if a girl kept her child, society would treat her like an outcast,” reflects Sister Bertille. “The fear and guilt are not the same as before.”

Unwed motherhood may even seem glamorous to impressionable teens. “They see Jerry Hall on TV, flinging back her hair, talking about having Mick Jagger’s second [out-of-wedlock] child, and saying what a wonderful life she has,” bristles Daphne Busby of Brooklyn, founder of the Sisterhood of Black Single Mothers. A succession of attractive stars, including Farrah Fawcett and Jessica Lange, have joined Hall in making a trend of extramarital pregnancy, something that 35 years ago helped get Actress Ingrid Bergman blackballed in Hollywood.

But if unwed motherhood has lost much of its notoriety, premarital sex has over the same period become positively conventional. Like it or not, American adolescents are far more sexually active than they used to be. Guttmacher statistics show that the incidence of sexual intercourse among unmarried teenage women increased by two-thirds during the 1970s. Moreover, the sexual revolution seems to have moved from the college campus to the high school and now into the junior high and grade school.[*] A 1982 survey conducted by Johns Hopkins Researchers John Kantner and Melvin Zelnick found that nearly one out of five 15-year-old girls admitted that she had already had intercourse, as did nearly a third of 16-year-olds and 43% of 17-year-olds. “In the eyes of their peers, it is important for kids to be sexually active. No one wants to be a virgin,” observes Amy Williams, director of San Francisco’s Teenage Pregnancy and Parenting Project (TAPP). The social pressure even on the youngest adolescents can be daunting. Says Stephanie, 14, of suburban Chicago, now the mother of a four-month-old, “Everyone is, like, ‘Did you lose your virginity yet?’ “

Social workers are almost unanimous in citing the influence of the popular media–television, rock music, videos, movies–in propelling the trend toward precocious sexuality. One survey has shown that in the course of a year the average viewer sees more than 9,000 scenes of suggested sexual intercourse or innuendo on prime-time TV. “Our young people are barraged by the message that to be sophisticated they must be sexually hip,” says Williams. “They don’t even buy toothpaste to clean their teeth. They buy it to be sexually attractive.”

And yet, for all their early experimentation with sex, their immersion in heavy-breathing rock music and the erotic fantasies on MTV, one thing about American teenagers has not changed: they are in many ways just as ignorant about the scientific facts of reproduction as they were in the days when Doris Day, not Madonna, was their idol. In a study funded by the Rockefeller Foundation, Demographer Ellen Kisker of Princeton University found that teenage girls are awash in misinformation. Among the commonest myths: that they could not become pregnant the first time they had sex, if they had it only occasionally or if they had it standing up. Adolescents are especially foggy on the subject of contraception. A National Opinion Research Center survey of teenage mothers found that few were familiar with the IUD, and most, says Researcher Pat Mosena, “didn’t even know what the diaphragm was.” Mistaken notions about the health risks of the birth control pill are rampant. All this may help explain why, according to John Hopkins researchers, only about one in three sexually active American girls between ages 15 and 19 uses contraceptives at all. And many who do use them have a rather weak grasp of the methodology: one-quarter of the girls in the NORC survey said they were using birth control at the time they became pregnant.

It is this naiveté and ineptitude coupled with less openness in American society generally about birth control that, according to Guttmacher researchers, constitute one of the most striking differences between American adolescents and their European peers. In Sweden teenagers are sexually active even earlier than they are in the U.S., and they are exposed to even more explicit television. However, the Swedish National Board of Education has provided curriculum guidelines that ensure that, starting at age seven, every child in the country receives a thorough grounding in reproductive biology and by age ten or twelve has been introduced to the various types of contraceptives. “Teachers are expected to deal with the subject whenever it becomes relevant, irrespective of the subject they are teaching,” says Annika Strandell, the board’s specialist in sex education. “The idea is to dedramatize and demystify sex so that familiarity will make the child less likely to fall prey to unwanted pregnancy and venereal disease.”

In Holland, sex is similarly demystified. While the country has no mandated sex-education program, teens can obtain contraceptive counseling at government-sponsored clinics for a minimal fee. In addition, the Dutch media have played an important role in educating the public, says Dr. Evert Ketting of the Dutch Mental Health Center, citing frequent broadcasts on birth control, abortion and related issues. “We’ve been told that no Dutch teenager would consider having sex without birth control,” says Guttmacher Spokeswoman Jane Murray. “It would be like running a red light.”

The signals are quite different for American teenagers. Last summer, when the American College of Obstetricians and Gynecologists unveiled a new public service announcement designed to combat teenage pregnancy, all three major TV networks balked. The reason: the announcement included the word contraceptives. These are the same networks that, as one ABC official put it, routinely depict intercourse to “the point of physical motion under the covers of a bed.” Network officials have since relented, but the offending word has been dropped.

How to explain this skittishness? “We are still very much governed by our puritanical heritage,” answers Faye Wattleton, president of the New York-based Planned Parenthood Federation. “While European societies have chosen to recognize sexual development as a normal part of human development, we have chosen to repress it. At the same time, we behave as if we’re not repressing it.” In studying various cultures, the Guttmacher researchers found that the highest teen-pregnancy rates were in countries with the least open attitudes toward sex. “The ambivalence our society is projecting about sex is costing us a lot,” concludes Institute President Rosoff.

People who work directly with teenagers agree. “We maintain this incredible double standard with teenagers about sex,” says Alice Radosh, coordinator of pregnancy and parenting services in the New York City mayor’s office. “If you’re swept away by passion, then you didn’t do anything wrong. But if you went on a date after taking the Pill or with a diaphragm, then you’re bad. You were looking for sex, and that’s not permitted.”

The message that contraception is bad is often reinforced by parents, who are loath to admit that their children are sexually experienced. “I went to my mom five different times to see if she could at least get me to a doctor to get me on birth control,” recounts Nancee Mason, 19, from Pontiac, Mich., who has a nine-month-old son. “But my mom is the kind of person who, if you mention sex, she turns all red and clams up.”

The Reagan Administration has taken steps to make it difficult for teenagers to obtain contraceptives. Since taking office, the President has repeatedly tried to restrict the availability of family-planning services. One-third of the women who seek such services at federally funded clinics are teenagers. In 1983 the Administration further attempted to control teenage access to contraceptives by issuing what quickly became known as the “squeal rule.” The regulation required federally funded clinics to notify parents within ten days of prescribing contraceptives to minors. However, the squeal rule was squelched in the courts on the ground that it would have increased unwanted pregnancies and abortions.

Even without the risk of being squealed on, many young girls are embarrassed about going to a public clinic. “I chickened out,” confesses Debra Stinnett, 18. “I just never went back to Planned Parenthood for the pills.” She now has a one-year-old daughter. Studies show that, on the average, teens wait twelve months after first becoming sexually active before they seek contraception. By then it is often too late. “When you’re young,” says Kim Adalid, 19, of Lawndale, Calif, a wise old mother of two, “all you think about is the weekend.”

When they do become pregnant, many girls simply hide the fact, denying it even to themselves. For Angela Spencer, 16, of Lawndale, reality did not hit home until five months into her pregnancy, when she entered a special school for young mothers. “A lot of the girls had already had their babies,” she relates. “When I walked in that classroom, it was like the first time I realized what was happening to me.” Unable to grasp their situation, adolescents frequently wait too long even to consider having an abortion. The gravity of such a decision often eludes them. “I was going to have an abortion, but I spent the money on clothes,” confesses Sonya Lyde, 18, of Chicago, now the mother of a seven-month-old boy.

According to the most recent statistics, almost 30% of U.S. abortions are performed on teenagers. Abortions seem to be commonest among the affluent. “Upper-middle-class girls look at abortion as a means of birth control,” says Myra Wood Bennett, a county health official in southern Illinois. The poorer girls, she notes, simply cannot afford it. Federal funding of most abortions for low-income women was barred by Congress in 1976; only nine states have stepped into the breach, providing for abortions without restrictions.

There is for many young girls another, less tangible factor in the sequence of events leading to parenthood: a sense of fatalism, passivity and, in some cases, even a certain pleasure at the prospect of motherhood. Such attitudes are especially prevalent among the poor. Take Zuleyma, 16, of Los Angeles, who gave birth last May: “I thought I might want to have a baby,” she says. “I was thinking more in the future, but things happen.” Or Derdra Jones of Chicago, who gave birth at 15: “Part of me wanted to get pregnant,” she confesses. “I liked the boy a lot, and he used to say he wanted a baby.” Or Marquel, 17, of Hawthorne, Calif.: “I had birth control pills in my drawer. I just didn’t take them,” she says. “My life was getting boring. I wanted a baby.”

For young girls trapped in poverty, life offers few opportunities apart from getting pregnant. High school may seem pointless. Even graduation is little guarantee of a job. Their lives are circumscribed in every sense. Says Social Worker Lisa Rost, who counsels such youngsters at Project Hope in Chicago: “Some of these kids have never seen Lake Michigan.” Pregnancy becomes one of the few accessible means of fulfillment. “Nobody gets more attention than a little girl who’s pregnant,” observes Bishop Earl Paulk of Chapel Hill Harvester Church, a Protestant church in Atlanta that sponsors a program for pregnant teens. “It feels good to be the center of things.”

Youngsters who get pregnant often have a history of feeling deprived and neglected. Many have been abused or raped. “Their getting pregnant has nothing to do with sex,” observes Pat Berg, director of a Chicago program for homeless youth. “It’s attempting in a perverse sense to get some security and nurturing needs met . . . It’s like when kids get puppies.” Finally, there is little social pressure to persuade them to postpone childbearing, notes Joy Dryfoos, who has conducted research for the Rockefeller Foundation. Middle-class girls tend not to have babies, she says, “because Mother would kill them if they did.” For the lower socioeconomic groups, she says, “it’s the big shoulder shrug. They don’t get abortions. They don’t use contraception. It’s just not that important; they don’t have a sense of the future.”

No wonder teenage pregnancies have reached epidemic proportions in some ghetto areas. According to Guttmacher statistics, black American teenagers have the highest fertility rate of any teenage population group in the entire world. (Israeli Arabs come in a distant second.) One in four black babies in the U.S. is born to a teen mother, most of them unwed. “In the black community, the phenomenon of teen marriage is almost gone,” observes Mark Testa of NORC. “Eventually these girls get married, but it might be years later and not to the father of the child.” Young black women under age 24 are facing “a shrinking pool of marriageable–that is, economically stable–young men,” explains Sociologist William Julius Wilson of the University of Chicago, who coauthored a 1985 study titled Poverty and Family Structure. The reasons he cites for the dearth of eligible candidates: unemployment, incarceration and an appalling rate of murder, the leading cause of death of black males age 15 to 44.

Wilson is part of a new breed of black academicians and leaders who have begun to acknowledge teenage pregnancy as a major issue for the black community. The National Urban League has declared it its No. 1 concern and last spring, on Father’s Day, launched a program aimed at teenage boys, the often forgotten partners in the problem of teen pregnancy (see box). Says League President John Jacob: “We cannot talk about strengthening the black community and family without facing up to the fact that teenage pregnancy is a major factor in high unemployment, the numbers of high school dropouts and the numbers of blacks below the poverty line.”

This public recognition from black leaders is a significant departure from the past. Back in 1965 when New York Senator Daniel Patrick Moynihan, then Assistant Secretary of Labor, released a study depicting instability in the black family and stressing the problem of the absentee father, he was roundly accused of racism for ignoring the economic basis of the situation. In the heyday of the civil rights movement, admits Jacob, “teenage pregnancy was not the kind of subject we were willing to deal with publicly. We felt the black community would be blamed.” That lack of attention was unfortunate, as black leaders now acknowledge. In the years since the Moynihan report, observes Eleanor Holmes Norton, the status of the black family has deteriorated. In 1965, she points out, only about one-third of black children were born to single mothers. Now more than half are. She insists that the black family remains strong, but admits “there have been important structural changes that will be hard to reverse.”

Some blame the welfare system for contributing to the disintegration of the black family by providing an incentive for young women to have babies. While rules vary from state to state, indigent girls generally become eligible for public assistance in their third trimester of pregnancy. Most social-service workers argue, however, that the welfare system is at most a minor factor in teenage pregnancy. “It’s possible that with no assistance, we would see fewer kids going to term,” says Radosh of New York City’s mayor’s office. “But I don’t think you’d see fewer getting pregnant.”

Guttmacher researchers concur, pointing out that countries like Holland, Sweden and France provide far more generously for indigent young mothers, yet have low pregnancy rates. Research by Sociologist Frank Furstenberg of the University of Pennsylvania further refutes the notion that teenagers who become pregnant are simply looking for a handout. In following 400 young black mothers in Baltimore, Furstenberg discovered that most were “surprisingly motivated to get off welfare.” In fact, 17 years after bearing a first child, only one-quarter were receiving public assistance.

Despite the discrepancy in statistics, teen pregnancy, as black leaders are quick to point out, should not be seen as a specifically black problem. Rather, says Jacob, it is a poverty-related problem. “It has a greater impact on the black community because it is a poor community.” Indeed, poor whites as well as blacks tend to have high rates of teenage pregnancy. In the largely white community of North Adams, Mass., an old mill town where unemployment has been high, teen pregnancy is reaching epidemic levels. One out of five births at North Adams Regional Hospital is to an adolescent, and 90% of the young mothers wind up on welfare. “I’m seeing a world where kids feel being pregnant is a viable option,” sighs Maggie Bitman, who runs a parenting program in North Adams. “They feel their lives are in disarray.” The situation is similar in the mostly white, down-at-the-heels southern counties of Illinois, and in white, working-class areas where the work has disappeared. The underlying reasons for the pregnancies are no different from those in urban ghettos: lack of opportunity, absence of interesting alternatives to childbearing. The girls feel “locked into their stations in life,” says Health Official Wood Bennett of southern Illinois. “They’re not motivated to break out.”

Needy girls who imagine that having a baby will fill the void in their lives are usually in for a rude shock. Hopes of escaping a dreary existence, of finding direction and purpose, generally sink in a sea of responsibility. With no one to watch the child, school becomes impossible, if not irrelevant. And despite the harsh lessons of experience, many remain careless or indifferent about birth control. About 15% of pregnant teens become pregnant again within one year; 30% do so within two years. “You ask, ‘Why didn’t you come in for the Pill?’ and they say, ‘I didn’t have time,’ ” says an exasperated Kay Bard of Planned Parenthood in Atlanta. “Their lives begin to spiral out of control.”

The problems faced by children of such parents begin before they are even born. Only one in five girls under age 15 receives any prenatal care at all during the vital first three months of pregnancy. The combination of inadequate medical care and poor diet contributes to a number of problems during pregnancy, says Dr. John Niles of Columbia Hospital for Women in Washington: “Teenagers are 92% more likely to have anemia, and 23% more likely to have complications related to prematurity, than mothers aged 20 to 24.” All of this adds up to twice the normal risk of delivering a low-birth-weight baby (one that weighs under 5.5 lbs.), a category that puts an infant in danger of serious mental, physical and developmental problems that may require costly and possibly even lifelong medical care.

Infants that escape the medical hazards of having a teenage mother do not always manage to negotiate the psychological and social perils. Desirée Bell, 19, of New York City, had her first son at age 15 and her second the following year. Her elder son Eddie has a learning disability and was almost autistic as an infant. Bell, who has managed heroically to complete high school and secure a good job with the city, blames herself for his problems. “I hated the fact that I was pregnant,” she recalls. “I was resentful of my unborn child. I used to punch myself in the stomach. Poor Eddie,” she muses, “the first year I wouldn’t play with him. He didn’t talk until he was nearly two; he would just grunt. I would say, I traumatized my own son.”

Desirée Bell has recognized her error and tried to give her son the extra attention he needs. Not all teenagers do. According to the Children’s Aid Society in New York City, one of the oldest family agencies in the country, a large number of babies delivered to teenage mothers wind up in foster care. “Teenagers get excited about this little, adorable person that’s all theirs,” explains Barbara Emmerth of the New York City-based Citizens’ Committee for Children, “but when the kid is in the terrible twos and the mother wants to go out on dates instead of taking care of the little monster, they change their minds.”

Often the state must intervene in cases where abuse or neglect is suspected. Two-year-old Ana Marie seemed to be perpetually falling and hurting herself. “I didn’t pay her enough attention,” admits her mother Kim Adalid, 19, who also has a three-year-old son and expects a third child in January. After one of Ana Marie’s mishaps, Kim took her daughter to a doctor, who quickly discovered that the child’s arm was broken. Believing that the girl had been neglected (a charge that Kim vigorously denies), the doctor filed a report with the California courts. Ana Marie was taken away and placed with a temporary guardian.

Such interventions come at a considerable cost. In Illinois, state officials calculated that teenage pregnancy cost $853 million in medical care, day care, welfare and other social programs last year. It has been estimated that overall, the U.S. spends $8.6 billion on income support for teenagers who are pregnant or have given birth.

Most programs addressing the problem of teen pregnancy are directed at the group easiest to identify and help: adolescents who are already pregnant or have given birth. The goals: to ensure that the girls obtain adequate prenatal care, continue their education and learn how to be good parents. Providing prenatal care has become a bigger problem since 1982, when the Reagan Administration reduced the appropriation for the Feeding Program for Women, Infants and Children, which offers nutritional supplements and medical care to low-income expectant mothers. The cuts, say critics, will prove expensive in the long run, because caring for undersize, ailing infants through Medicaid is many times as costly as preventive prenatal measures. In recent years, private organizations and local governments have attempted to fill the gap left by Wiccutbacks. San Francisco’s TAPP, a model program that the state plans to extend to other cities, has helped reduce the incidence of low-birth-weight infants to about 4% among the teenagers it counsels, against a national average of 17%.

Keeping young mothers in school has proved to be a stickier problem. Among TAPP counselees, for example, nearly half who were not enrolled in school were persuaded to resume their education. Unfortunately, an additional 31% who had been attending decided to drop out. In New York City, special public high schools have been established for pregnant teenagers to encourage them to stick with it. New York has also established day-care facilities at 18 of its 117 high schools, so that mothers can continue to attend after they have given birth.

Increasingly, conservative religious organizations have got into the business of aiding pregnant teenagers as a way of discouraging abortion. Jerry Falwell’s Moral Majority has, for example, developed a nationwide $4 million program called Save-a-Baby, run in conjunction with an adoption agency. “We agree to assist girls who are fixing to have an abortion, if they will let the baby live,” says Jim Savley, the program’s executive director.

Other programs for teen mothers emphasize careful instruction in family planning to prevent more unwanted pregnancies. Some go so far as to send a social worker to the hospital shortly after the girl has given birth in order to present gifts of condoms and contraceptive foam, along with something for the baby. Increasingly, programs like the Door in New York and Crittenton Center in Los Angeles have extended their contraceptive-counseling programs to teens who have not yet become pregnant. Crittenton purposely holds discussion groups that mix young mothers with other adolescents to reinforce the lessons on birth control. “When they see how hard it is to be a mother,” says Executive Director Sharon Watson, “they don’t get pregnant.”

Many believe that such lessons should be a regular part of the curriculum in public schools. According to a TIME poll taken by the research firm of Yankelovich, Skelly & White, Inc., 78% of Americans respond yes to the question “Do you favor sex education in the schools, including information about birth control?” And yet, despite the majority opinion, the subject of sex education remains a divisive one. On one side are those like Wattleton of Planned Parenthood who argue that Americans should learn to accept adolescent sexuality and make guidance and birth control more easily available, as it is in parts of Europe. On the other side are those who contend that sex education is up to the parents, not the state, and that teaching children about birth control is tantamount to condoning promiscuity. Sex-education classes are simply “sales meetings” for abortion clinics, says Phyllis Schlafly, a leading right-to-lifer. In addition, she claims, there is simply no way to tell youngsters about contraception “without implicitly telling them that sex is O.K. You’ve put your Good Housekeeping seal on it.”

The conflict has contributed to riotous clashes at school-board meetings whenever the sex-education curriculums come up for review. Last year, for example, when New York City developed a program designed to help combat a runaway rate of teenage pregnancy, religious groups presented a list of 56 objections. In middleclass San Juan Capistrano, Calif., the fray over sex-education reform grew so heated last spring that conservative opponents showed up at a school-board meeting dressed in Revolutionary War garb and bearing a cannon.

In 1981 the Reagan Administration instituted a program to, in its words, “encourage teenagers not to engage in sexual activities” and foster “good communication between parents and child about sexual matters.” The plan has won favor with conservative church groups but has been derided by family-planning advocates as an unrealistic “chastity act.” Terrance Olson, professor of family sciences at Brigham Young University in Provo, Utah, is using funds from the new program to develop a conservative sex-education curriculum. Olson’s offering stresses abstinence, and, he says, “we try to involve teenagers with their parents in understanding the issues of marriage, family and reproduction.” The program has been tested in selected schools in Utah, California and New Mexico since 1982, but, he admits, “we don’t have a lot of evidence yet that we’ve changed behavior.”

Changing human behavior is, of course, always an elusive objective. When Researcher Douglas Kirby, head of the Washington-based Center for Population Options, studied the behavioral effects of sex education, he found them to be few and far between. Sex-education graduates certainly knew more about reproduction, but that did not significantly affect their habits. There was, however, one important exception. Kirby found that when sex-education programs are coupled with efforts to help teenagers obtain contraceptives, the pregnancy rate drops sharply.

The model for this type of program was the Mechanic Arts High School in St. Paul, which in 1973 became the first public high school in the U.S. to have its own full-service health clinic in the building. Set up by St. Paul-Ramsey Medical Center, it offered everything from immunizations to sport physicals to treatment for venereal disease. Significantly, it also advised teenagers on contraception and dispensed prescriptions for birth control devices (provided that parents had agreed beforehand to allow their children to visit the clinic).

Such clinics now exist at four other St. Paul high schools (Mechanic Arts High has been closed). The results have been dramatic. Between 1977 and 1984, births to female students fell from 59 per thousand to 26 per thousand. Even girls who did become pregnant seemed to benefit from the counseling. At Mechanic Arts High, their dropout rate fell from 45% to 10%, and only 1% had another unwanted pregnancy within two years of the first. The controversial clinic at Chicago’s DuSable High School and ones at other schools around the country were modeled after St. Paul’s pioneering program.

For all their apparent success, in-school clinics do not necessarily get at the emotional wellsprings of teenage pregnancy: the sense of hopelessness and resignation felt by many underprivileged girls. In Milwaukee, Janice Anderson, a successful black businesswoman, is trying to do something about it. Anderson, 36, was inspired to act last March when she read that her hometown led the country in birthrates among black teenagers. “I sat up in bed at 2 a.m. and wrote down the name of every black professional woman I knew,” she recalls. “I came up with a list of 42 names and wrote to each one, asking them to come help their sisters.” Anderson’s early-hour inspiration evolved into Reach for the Stars, a volunteer program that pairs inner-city adolescents with black role models who are successful achievers.

Similar groups have begun to appear around the country. In New York, the Family Life program, co-sponsored by the state and the Children’s Aid Society, is attempting to give dead-end kids a sense of self-esteem, says Michael Carrera, its energetic director. Since the program’s initiation last February, not one of the 55 participating youngsters has become pregnant or fathered a child.

These efforts are aimed at what may be the true root of the teenage pregnancy problem: not simply lack of sex education or access to birth control but a sense of worthlessness and despair. Recounts Watson of Crittenton Center: “The girls tell me, ‘Before I was pregnant, I was nothing. Now I am somebody. I’m a mother.’ ” As long as adolescents look in the mirror and see nobody there, they are likely to seek identity by becoming–ready or not–somebody’s mother. –By Claudia Wallis. Reported by Cathy Booth/New York, Melissa Ludtke/Los Angeles and Elizabeth Taylor/Chicago