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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.