Although the 1996 federal welfare reform law exhorts states to reduce teen and out-of-wedlock births, preliminary field research has found few links between welfare reform and pregnancy prevention, and the ones that do exist are often tenuous, hard to believe, and difficult to assess. States have established new and stronger connections between welfare and employment services under welfare reform, but creating welfare programs that explicitly stress pregnancy prevention has been inhibited by several factors. There is little consensus on how to prevent teen and out-of-wedlock births, not just as a practical matter but also as an ethical and political issue. This divisiveness has led most states to devolve critical questions about the design of such programs down to local and community levels. Also, the health agencies that have traditionally administered pregnancy prevention programs have usually not worked closely with welfare agencies in the past. And the federal reforms provide few incentives for states to create strong linkages. Nonetheless, there is an opportunity here for leaders and groups committed to teen pregnancy prevention, regardless of the approach they favor, to forge creative linkages to welfare/employment bureaucracies. (Author)