The United States has seen a welcome fall in teen pregnancies and a leveling off of out-of-wedlock births, but the rates remain at crisis levels in many cities.
In eight of America's 40 largest cities, unmarried women give birth to more than 3 out of every 5 children - roughly twice the national average. And it's happening in poor urban areas already struggling with other social and economic problems.
Researchers have gained some insight into what helps reduce teen pregnancy, but they don't yet know what programs, if any, can influence women in their twenties. These older women, recent census figures show, account for two-thirds of out-of-wedlock births.
But time is running out to find out. Next year, Congress must reauthorize the 1996 welfare-reform act that made reducing nonmarital births a top priority. While several experiments are under way, they're barely old enough to evaluate properly.
"I don't think there's a lot of known information about what works," says Andrea Kane, outreach coordinator for the Brookings Institution's welfare-reform initiative in Washington.
The attention is long overdue. Out-of-wedlock births have skyrocketed in the past half-century. In 1940, only 3.8 percent of American women were not married when they gave birth. By 1994, that rate had climbed to 32.6 percent. Since then, the rate has hovered around 33 percent, although it remains alarmingly high in some cities, according to census data released last month.
Take Baltimore. More than 3 out of 4 residents who gave birth there in the past 12 months were unmarried, according to census estimates. That was tops among America's 40 largest cities and three times the rate of Austin, Texas, and San Francisco, which ranked near the bottom of the list.
Income and education levels probably explain much of the difference, experts suggest. For example, Baltimore ranks among the 10 large cities with the lowest median household incomes and the smallest share of residents with college degrees, according to census estimates. Austin and San Francisco rank near the top in both categories.
Baltimore also has one of the highest proportions of African-American residents. Historically, unmarried black women have given birth at much higher rates than unmarried whites, demographers point out. While that rate has fallen dramatically since 1970 - and risen even more dramatically for whites - African-American women are still twice as likely to give birth out of wedlock than are their white counterparts, according to a study last year for the National Center for Health Statistics.
In all, 7 of the top 10 cities for out-of-wedlock births also rank in the 10 cities with the highest percentages of black residents, according to census data.
Poor job prospects among black men may partially explain the higher out-of-wedlock births among African-American women, observers say.
"People feel very strongly that a man needs to be able to support a family if he's going to get married," says Christine Bachrach, chief of the demographic and behavioral sciences branch at the National Institute of Child Health and Human Development in Rockville, Md. "Marriage in many of these urban poor areas is really not seen as an option."
The central question is: Are there ways that cities can reduce the number of births to unwed women?
Convinced that welfare was encouraging out-of-wedlock births, Congress overhauled welfare programs in 1996 and mandated several provisions to reduce the problem, which is closely linked with child poverty. Among them, a $100 million-a-year bonus for five states that showed success in combating out-of-wedlock births.
But results have been mixed. This fall, for example, the US Department of Health and Human Services found only three winners it could give money to: the District of Columbia (down 4 percent), Alabama, and Michigan (both down only a fraction of 1 percent).
Except for a measure to beef up enforcement of child support, researchers have not yet found a direct link between welfare reform and the leveling off of unwed motherhood, argues Isabel Sawhill, president of the National Campaign to Prevent Teen Pregnancy.
Experts are divided over whether programs should urge abstinence alone or also discuss contraception and abortion.
Still, some policies aimed at teenagers do seem to have worked. Births to girls 15 to 19 have fallen by one-fifth since 1991. Experts point to several factors, including teens' more conservative attitudes, fear of sexually transmitted diseases, and contraception. Studies also credit the growth of public and private efforts to prevent teen pregnancy. For example, between 1997 and 1999, more than twice as many states had begun media campaigns to combat out-of-wedlock births, according to research by Child Trends.
But few states or cities have focused on women in their twenties. One entity trying to address the 20-somethings is Hamilton County, Tenn., which includes Chattanooga.
Four years into its comprehensive family and marriage-strengthening program, the First Things First initiative has helped reduce divorce filings by 20 percent and out-of-wedlock pregnancies by 16 percent.