# VIII. Out-of-Wedlock Pregnancies and Births

## Out-of-Wedlock Births in TANF Families

The Temporary Assistance for Needy Families (TANF) program requires that
States engage in activities that \"prevent and reduce the incidence of
out-of-wedlock pregnancies and establish annual numerical goals for
preventing and reducing the incidence of these pregnancies.\" In order
to collect data on and further emphasize this purpose, section 413(e) of
the Social Security Act (the Act) requires the Department of Health and
Human Services (DHHS) to annually rank States and review issues relating
to out-of-wedlock births.

Specifically, the statute requires DHHS to rank States on the following
factors:

1.  Absolute out-of-wedlock birth ratio, represented by the total number
    of out-of-wedlock births in families that receive TANF assistance
    for the most recent year for which information is available, over
    the total number of births in families receiving TANF assistance for
    such year; and

2.  Net change in the out-of-wedlock birth ratio, the difference between
    the ratio for the current fiscal year for which information is
    available and the immediately preceding year.

Table 8:1, the Total Number of Out-of-Wedlock Births in TANF Families,
is based on data the States reported to DHHS for FY 2000, the first year
States were required to report these data. DHHS notes that, in some
instances, e.g., some States reporting \"0\" out -of-wedlock births, the
data may be incomplete or inaccurate. DHHS will continue to work with
States to resolve these data issues.

Section 413(e) of the Act also requires DHHS to review the programs of
the five States most recently ranked highest and the five States most
recently ranked lowest.

## Out-of-Wedlock Birth Bonus

Also, in support of the purpose in the Act to reduce out-of-wedlock
pregnancies and births, Congress included a performance bonus entitled,
"Bonus to Reward Decrease in Illegitimacy Ratio," in the statute. The
bonus is intended to focus State efforts on the reduction of
out-of-wedlock births, encourage creativity in developing effective
solutions, and reward those States that achieve the largest decreases in
out-of-wedlock births without increasing the abortion rate.

The Administration for Children and Families issued final regulations on
April 14, 1999, implementing section 403(a)(2) of the Act, which
establishes the bonus. As specified in the statute, up to \$100 million
annually is available in each of fiscal years 1999 through 2002.
Potentially eligible States include the 50 States of the United States,
the District of Columbia, the Commonwealth of Puerto Rico, Guam, the
United States Virgin Islands, and American Samoa. In each year, up to
five States (including the District of Columbia and the Commonwealth of
Puerto Rico) may be eligible, in addition to Guam, the Virgin Islands,
and American Samoa. The amount of any award for Guam, the Virgin
Islands, and American Samoa will be 25 percent of their mandatory TANF
ceiling amount. The remainder of the \$100 million will be divided
equally among the other eligible States up to a maximum of \$25 million
for each eligible recipient.

On September 13, 1999, the Department announced the award of \$100
million in new bonuses to five awardees for achieving the nation's
largest decreases in out-of-wedlock births between 1994 and 1997. This
was the first award of these bonuses.

The awardees and the reductions in the proportion of out-of-wedlock
births achieved were: California (5.7%), the District of Columbia
(3.7%), Michigan (3.4%), Alabama (2.0%), and Massachusetts (1.5%). Each
jurisdiction received \$20 million. (See Tables 8:4 and 8:5.)

On September 15, 2000, the Department announced the award of \$100
million to the five States achieving the largest decreases in
out-of-wedlock births between 1995 and 1998.

The awardees and the reductions in the proportion of out-of-wedlock
births achieved were: the District of Columbia (4.13%), Arizona (1.38%),
Michigan (1.34%), Alabama (0.29%), and Illinois (0.02%). Each
jurisdiction received \$20 million. (See Tables 8:6 and 8:7.)

On September 21, 2001, the Department announced the award of \$75
million to the three States achieving the largest decreases in
out-of-wedlock births between 1996 and 1999. During this period, only
three States experienced a decrease in their out-of-wedlock birth
ratios.

The awardees and the reductions in the proportion of out-of-wedlock
births achieved were: the District of Columbia (3.97%), Alabama (0.24%),
and Michigan (0.009%). Each jurisdiction received \$25 million. (See
Tables 8.8 and 8.9.)

DHHS's final regulations specified the process used in determining bonus
awards. Briefly, the bonuses are awarded as follows:

-   The ratio of out-of-wedlock births to total births is calculated for
    each State for the most recent two-year period for which data are
    available and for the prior two-year period. To compute these
    ratios, DHHS uses the vital statistics data compiled annually by the
    National Center for Health Statistics, based on records submitted by
    the States.

-   The five States that had the largest proportionate decrease in their
    ratios between the most recent two-year period for which data are
    available and the prior two-year period are identified. These States
    are potentially eligible.

-   If Guam, the Virgin Islands, and American Samoa had a comparable
    decrease in their ratios (i.e., a decrease at least as large as the
    smallest decrease among the other qualifying States or a decrease
    that ranks among the top five decreases when all States and
    Territories are ranked together), they are identified. These
    additional States are also potentially eligible.

-   The potentially eligible States will be notified that, to be
    considered for the bonus, they need to submit data and information
    on the number of abortions performed in their State for the most
    recent year and for 1995.

-   DHHS will determine which of the potentially eligible States also
    experienced a decrease in their rate of abortions (defined for the
    purposes of this bonus to be the ratio of abortions to live births)
    for the most recent calendar year compared to 1995, the base year
    specified in the Act. These States will receive a bonus award.

-   While the criteria for determining bonus eligibility for Guam, the
    United States Virgin Islands, and American Samoa are the same as for
    the States, their eligibility is determined separately and the
    determination of their bonus amount is different, as specified in
    the statute, i.e., sections 403(a)(2)(B)(ii) (Amount of Grant) and
    403(a)(2)(C)(i)(I) (Definition of eligible State).

## Additional Data on Out-of-Wedlock and Teen Births

The birth rate for unmarried women aged 15-44 years increased slightly
in 1999 to 44.4 births per 1,000 women, compared with 44.3 in 1998. The
1999 birth rate is still five percent below the 1994 peak (46.9). The
actual number of out-of-wedlock births rose one percent in 1999, to
1,308,560, following a three-percent rise during 1997-98. Between 1994
and 1997, the number declined two percent. Most of the 1997-99 increases
are associated with the rising number of unmarried women of childbearing
age. The proportion of all births that were out-of-wedlock was unchanged
at 32.4 percent in 1996 and 1997, but increased to 32.8 percent in 1998
and 33.0 in 1999.

After several decades of sharp increases, non-marital childbearing has
leveled off during the second half of the 1990s. The birth rate among
unmarried women in 1999 remained nearly unchanged from 1998 and is five
percent lower than its peak reached in 1994, while the proportion of
births occurring outside of marriage has remained in the range of 32 to
33 percent. The 1990s have also seen dramatic declines in teen birth
rates, 20 percent since 1991. These declines have been widespread,
across age and racial groups, and across every State in the country as
well as the District of Columbia, Puerto Rico and the Virgin Islands.

## DHHS Programs to Prevent Teen Pregnancy

### National Strategy to Prevent Teen Pregnancy

In the 1996 welfare reform law (PRWORA), Congress required the
Department to issue a National Strategy to Prevent Teen Pregnancy.
Specifically, the statute requires DHHS to describe its efforts to
provide a cohesive approach to the challenges of teen pregnancy
prevention and to assure that at least 25 percent of communities in the
United States have teen pregnancy prevention programs in operation. The
Department is in its fourth year of implementing the National Strategy
to Prevent Teen Pregnancy.

The National Strategy\'s major teen pregnancy prevention initiatives
promote the postponement of sexual activity as the most effective way
for adolescents to prevent teen pregnancy and sexually transmitted
diseases, including HIV infection. States may use TANF funds for teen
pregnancy prevention activities in support of the goal of reducing and
preventing out-of-wedlock pregnancies.

In addition to the National Strategy, the Department administers a
number of major programs that address teen pregnancy.

### Abstinence Education Program

The welfare reform law enacted in 1996 created the Abstinence Education
Program, which provides Federal matching grants to States for abstinence
education activities, including mentoring and counseling, designed to
promote abstinence from sexual activity until marriage. The law provided
an annual appropriation of up to \$50 million for each fiscal year from
1998 through 2002. The Department\'s Health Resources and Services
Administration (HRSA) administers this program. A national evaluation of
these abstinence education initiatives is underway.

### Special Projects of Regional or National Significance

In FY 2001, HRSA awarded \$17.9 million and will award additional funds
in FY 2002 for grants to support community-based abstinence education
programs involving public and private entities. The grants will support
the development and implementation of abstinence-only education programs
for adolescents, ages 12 through 18, through Special Projects of
Regional or National Significance.

### The Adolescent Family Life Program

DHHSs' Office of Population Affairs (OPA) administers the Adolescent
Family Life Program, which funds demonstration projects to develop and
test abstinence-based programs designed to delay the onset of sexual
activity and prevent adolescent pregnancies, sexually transmitted
diseases, and HIV/AIDS. This program also supports demonstrations that
provide health, education, and social services to pregnant and parenting
adolescents and research into the causes and consequences of adolescent
pregnancy.

### Community Coalition Prevention Demonstrations

Since 1995, the Centers for Disease Control and Prevention (CDC) has
funded demonstrations for the prevention of teen pregnancies. These
projects support coalitions of local public and private agencies and
organizations, in communities with high rates of teen pregnancy, in
order to develop community action plans, coordinate efforts to reduce
teen pregnancy, identify gaps in current programs and services, target
existing resources, and design evaluation plans. CDC awarded
approximately \$250,000 per year for two years to 13 communities in 11
States to help these communities mobilize and organize their resources.
In FY 2000, a total of \$13.3 million was awarded to these 13 community
coalition partnerships to implement their action plans; evaluate their
impact; and support related data collection, evaluation, and
dissemination activities.

### Working with Boys and Young Men

DHHS includes boys and young men in teen pregnancy prevention efforts.
They are encouraged to prevent premature fatherhood through activities
funded by such Federal programs as the Adolescent Family Life Program;
the Abstinence Education Program, and the Adolescent Male Initiative,
which is a part of the Title X family planning program. States may also
use TANF funds to support such activities. By increasing understanding
of the motivations for abstinence and for fatherhood and by developing
effective prevention strategies, DHHS is building a variety of program
activities that promote responsible behavior among teenage boys and
young men. (See also Chapter VII of this Report, \"Formation and
Maintenance of Two-Parent Families.\")

For example, the Office of Population Affairs/Office of Family Planning
funds Adolescent Family Life projects that address family planning and
reproductive health information and services for males. While not
directly targeted to TANF recipients, many of these projects are located
in areas where there are high rates of poverty or reduced access to
health services. These projects are intended to integrate family
planning services and education into programs where young males are
already receiving other health, education, and social services.

Another example of services to boys and young men is the Abstinence
Education Program. This program provides grants to States to support
abstinence education and related services focused on groups most likely
to bear children out-of-wedlock. States contract with various
organizations to implement both statewide and local abstinence-only
education programs, including community-based organizations, schools,
youth-serving organizations, local health departments, and faith-based
organizations. States are responsible for determining the kinds of
projects that will be funded. A number of States have funded projects
that help to promote abstinence for boys and young men:

-   Florida funds community-based organizations, religious institutions,
    and public health agencies to implement programs for both boys and
    girls, including classroom instruction and after-school activities
    designed to enhance self-esteem and build life skills, counseling
    and referrals, and parent education.

-   In Mississippi, the \"Teens in Control\" program serves boys and
    girls in grades five and six. This is a two-year program that
    promotes remaining abstinent until marriage through the development
    of self-esteem, self-discipline, and self-respect.

-   New York provides funds for community-based efforts that provide
    abstinence education and other services for high-risk youth,
    including young males.

States are also using the flexibility under the TANF block grant to
develop programs to reduce out-of-wedlock childbearing, and several
States have chosen to use the TANF funds to develop programs for young
men that include pregnancy prevention efforts. For example:

-   Alabama funds a Fatherhood Initiative that will be administered by
    the State\'s Children\'s Trust Fund to establish community projects
    to prevent early and unplanned fatherhood, strengthen relationships
    between fathers and children, and increase child support payments by
    providing work and training opportunities for non-custodial parents.

-   Maryland\'s \"Young Fathers Responsible Fathers\" programs are
    located in seven sites in six counties and Baltimore City. These
    programs do not provide financial assistance but do provide services
    to custodial and non-custodial fathers, age 16 and older, who have
    one or more children. Services include parenting, education, family
    planning, GED instruction, job-training, employment-search
    assistance, and self-esteem building. These programs also encourage
    co-parenting for non-custodial fathers.

-   South Carolina uses TANF funds for three programs that deal with
    parenting and pregnancy prevention for couples. The Teen Companion
    Program helps youth who have never parented to prevent pregnancies,
    reduce the school dropout rate, and increase options for
    self-sufficiency. The Youth Parent Program is for youth who are
    pregnant or parenting. Its purpose is to prevent subsequent
    pregnancies, increase the number of students who return to school,
    increase options for self-sufficiency, reduce the need for Child
    Protective services, and reduce low birth weight and prenatal
    defects in newborns. Finally, under an Adolescent Pregnancy
    Prevention Initiative, the State makes grants to each county to
    support local efforts to prevent early sexual activity and reduce
    the rate of adolescent pregnancy in each county by emphasizing
    sexual abstinence and male responsibility.

## Appendices

Table 8:1 Total Number of Out-of-Wedlock Births in TANF Families

Table 8:2 Number, Rate, and Percentage of Births to Unmarried Women:
United States, 1980 and 1985-99

Table 8:3 Number and Percent of Births to Unmarried Women: United States
and Each State and Territory, 1999, and Percent of Births to Unmarried
Women, United States and Each State and Territory, 1992-99 By Place of
Residence

Table 8:4 Percent of Births to Unmarried Women, 1994-95 Average and
1996-97 Average, and Percent Change in the Percent of Births to
Unmarried Women, 1994-95 to 1996-97, United States and Each Territory
(alphabetically ordered) \[State Data for the FY1999 Out-of-Wedlock
Bonus Awards\]

Table 8:5 Percent of Births to Unmarried Women, 1994-95 to 1996-97,
States Potentially Eligible for the Bonus Ranked with Respect to Their
Change (In Order of the Largest to Smallest Decline), United States and
each Territory (rank ordered) \[State Rankings for the FY1999
Out-of-Wedlock Bonus Awards. States and Territories not Eligible for the
Bonus Listed in Ascending Order of Increase\]

Table 8:6 Percent Change in the Percent of Births to Unmarried Women,
1995-96 Average and 1997-98 Average, Percent Change in the Percent of
Births to Unmarried Women, 1995-96 to 1997-98, United States, each State
and Territory (alphabetical ordered) \[State Data for the FY 2000
Out-of-Wedlock Bonus Awards\]

Table 8:7 Percent Change in the Percent of Births to Unmarried Women,
1995-96 to 1997-98, States Potentially Eligible for the Bonus Ranked
with Respect to Their Change (In Order of Largest to Smallest Decline),
United States, each State and Territory (rank ordered) \[State rankings
for the FY 2000 Out-of-Wedlock Bonus awards. States and Territories not
eligible for the Bonus listed in ascending order of increase.\]

Table 8:8 Percent Change in the Percent of Births to Unmarried Women,
1996-97 Average and 1998-99 Average, Percent Change in the Percent of
Births to Unmarried Women, 1996-97 to 1998-98, United States, each State
and Territory (alphabetical ordered) \[State Data for the FY 2001
Out-of-Wedlock Bonus Awards\]

Table 8:9 Percent Change in the Percent of Births to Unmarried Women,
1996-97 to 1998-99, States Potentially Eligible for the Bonus Ranked
with Respect to Their Change (In Order of Largest to Smallest Decline),
United States, each State and Territory (rank ordered) \[State rankings
for the FY 2001 Out-of-Wedlock Bonus awards. States and Territories not
eligible for the Bonus listed in ascending order of increase.\]

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