THE debate over Joycelyn Elders' nomination as surgeon general stirred an important discussion on the national epidemic of teen-age pregnancies.
But the focus on sex education, condom distribution and abortion rights has left out one critical area: the steady rise in teen-age motherhood.
Whatever the government does to attempt to prevent teen pregnancy, it must stop sending the signal that unwed teen mothers can, with a few dollars from government, both raise their children and seek a decent future for themselves.
It seems no great surprise that the number of unmarried women having children has increased. From a time not too long ago when a pregnancy without marriage was almost unthinkable and kept hush-hush, we have moved unwed motherhood to prime time and celebrate it on the covers of glossy magazines.
I hope all of us are glad to leave a past where a child was branded illegitimate or a desperate marriage ruined two or more lives.
But it strikes me as equally damaging to ignore the economic and social realities faced today by single teen-age mothers, and to avoid the policy changes that are needed to discourage unwed pregnancies and help girls who have children get their lives in order.
Mature, educated single women who make a choice for motherhood, though increasing in number, are still a small percentage of the total.
The huge increase is among young women -- who usually stop their education, have few economic opportunities and often lack support systems for parenthood. That means problems for them and their babies.
We must leave the old conservative-vs.-liberal arguments behind and discuss instead how to change a failed system. A 15-year-old girl is not a 21-year-old woman, yet we have a system that treats her as one.
Think of your own 15-year-old daughter. You find out she's pregnant. Wouldn't you do more than give her a check on the beginning of every month?
Wouldn't you be furious this had happened? Wouldn't you want to know how, when, who? Wouldn't you want to know how your child and her child will survive this trauma?
We would not treat our own daughters the way the welfare system does. Could it be that because many of America's 15-year-old mothers are children of color and are poor, too many of us believe they are not important?
Our welfare system should differentiate and separate the pregnant girl who is not yet 16. Remove her from where she is staying -- whether it is with a boyfriend, sister or parent or, too often, on the streets. We need a system that has a residential base where these young girls can stay, be protected and grow up.
Why not have supervised group housing? Why not provide counselors during the pregnancy and, in cases where the mother keeps the baby, for the first eight months of the infant's life?
Why not require school attendance and nightly check-ins? Why not create a haven where a girl can learn she is truly of value -- a place to learn about her new responsibility?
A girl in a group home can more easily get services that help her and her new child. Only half of teen mothers begin prenatal care in their first trimester. Too many continue using drugs and alcohol. Repeat pregnancies occur more often among teens. Abusive parenting is far too common.
Would group housing foreclose easy access for her boyfriend, give greater authority to the state and infringe on the young mother's right to do anything she wishes? You bet. But if we adults know better and do nothing, we are adults in name only.
Obviously this would cost money. But Washington already spends $25 billion a year for families whose first child was born to a teen-age mother. So we have an enormous economic and moral stake in ending the tragedy of childhood motherhood.
Such a program will require fundamental changes in our welfare, medical and legal systems.
But why not risk change? All we have now is failure.
Lynn Martin was secretary of labor in the Bush administration.