She was 11 years old and pregnant. A preteen herself, the girl delivered the baby while under the supervision of child protective services, a clear sign of serious issues in her young life. The medical, psychological, social and emotional support she received, however, came by way of the Teen Alliance for Prepared Parenting (TAPP), a privately funded program created by the Washington Hospital Center to address a teen pregnancy problem that the District has been slow to confront.

Loral Patchen, director of the program, does not bury her head in the sand when it comes to teen pregnancies. Instead, she and her staff of social workers, youth development specialists and health counselors have buried themselves in the problem. I learned more about their work from Patchen and Washington Hospital Center Foundation officials this week.

Since 2001, the TAPP program has served 1,356 pregnant D.C. teens and teen mothers. These days, TAPP serves more than 300 new teen mothers and teen fathers each year - that is, if the latter get involved, which is rare. TAPP support includes helping the girls through their pregnancies with counseling, psychosocial and youth development services designed to prevent subsequent pregnancies, dropping out of school and a future of dependency.

Most of the girls TAPP serves are 16 or 17 years old (45 percent and 29 percent, respectively), when they enroll in the program, though 13 percent were 15 years old and 6 percent were 14 or younger. The program started enrolling 18-year-olds last fall as well.

Patchen estimates that 70 percent of the pregnant girls and teen mothers are students in D.C. public schools.

What else is known about these girls? More than 90 percent are African American or Latina. They live in wards of the city where poverty, drugs, guns, unemployment, incarceration and teen parenting are prevalent. The average age at which the girls reported first having intercourse was 14.6 years, and they averaged one sexual partner within the year before contacting TAPP.

One-fifth of the girls had been diagnosed with one or more sexually transmitted infections. One fifth also had been pregnant two or more times before enrollment, and 6 percent already had at least one child when they started with TAPP.

About 56 percent of them live in single-parent homes, 52 percent were born to teen mothers, and 40 percent have siblings who were also teen parents.

TAPP, which focuses on preventing additional pregnancies, appears to be making a dent in the problem. Only 8 percent of TAPP girls had another birth within 24 months after the first child, according to a study by the Office of Population Affairs in the U.S. Department of Health and Human Services. Citywide, almost 18 percent of 15-to-18-year-old mothers had another child in 2007.

Let's be clear. TAPP provides a small window on the problem. Most pregnant D.C. teens don't use TAPP services. No one knows the full dimensions of the teen pregnancy problem - not the D.C. Health Department, the D.C. Public School system, the mayor or the D.C. Council. Not even the mothers and fathers of the girls and boys who are making the babies. The city's faith leaders also seem clueless.

We do know the consequences many of these young mothers and their children will face. Without an education and strong family support, low-income D.C. teens and their babies will confront a bleak future filled with barely the minimum to support their lives.

And we know of the other costs. Taxpayers must pick up the tab for food stamps, welfare, medical care, cribs, day-care vouchers, diapers and the like.

The city does manage a program for teen parents at Anacostia and Cardozo senior high schools that aims to influence graduation and attendance rates and prevent repeat pregnancies. But otherwise the District, as usual, is playing catch-up. A federal grant awarded to the city last fall will soon provide programming for pregnant and parenting students age 21 and younger. And the D.C. Health Department is establishing school-based health facilities at Anacostia, Ballou and Coolidge high schools, where care for students and their children are most needed.

But wait. Should the city's goal be to make pregnant teens better mothers? Or should it be to prevent teen pregnancy? Remember the 11-year-old mother.