Whose responsibility is it to assume the leadership and primary responsibility for public policy concernedwith adolescent pregnancy and too-early childbearing? Health care professionals and advocates firstalerted the public to the problems associated with adolescent pregnancy in the mid-seventies. Initially thefederal government assumed the leadership on this issue and in 1978 established the first federal programsolely and explicitly devoted to the problems of this population, a grants program administered by theOffice of Adolescent Pregnancy Programs, DHEW.By the mid-eighties however the policy initiative and leadership had largely passed to the states. Increasinglygovernor’s offices, state legislators, and state private-sector organizations studied the dimensions ofthe problem in their state and initiated a wide range of activities to reduce the rates of teenage pregnancyand the negative consequences of too-early childbearing.Several overarching themes have shaped the development of public policy at both state and federal level.They evolved in part in response to new findings from research and program experience, and in part froma vigorous public discussion about the values involved.