Every year in Georgia, a small but significant number of girls gives birth before reaching their 15th birthday.

In 2006, the last year for which state data is available, 325 babies were born to girls ages 10 to 14. That's 1.5 births per 1,000 in this age group, more than twice the national rate (0.6 per 1,000).

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The number of births that are related to sexual abuse is unclear because the state does not collect that data. Also victims may choose not to disclose information or there may not be enough evidence to support those who do. Despite several layers of legal safety nets, many girls slip through them all.

"The laws [in Georgia] are very strict. Under law, any sexual act under the age of 16 is sexual abuse, but in practice, a lot of cases go unreported," said J. Tom Morgan, a former DeKalb County District Attorney, also author of the book "Ignorance Is No Defense: A Teenager's Guide to Georgia Law."

Since the legal age of consent is 16 years old, any sexual activity in a male or female under that age by definition is illegal. The age difference between the parties involved determines whether the crime is a felony or misdemeanor.

When he was a prosecutor, Morgan saw a case where a 16-year-old teen mother attempted suicide. The young woman had been pregnant three times starting when she was 12. An investigation after her attempted suicide revealed that the man who caused these pregnancies was her foster father.

The majority of sexual abuse (75 percent) is perpetrated by parents, relatives or other adults who live at home with a child, according to a 2006 DFCS report.

"The connection between child sexual abuse and teen pregnancy is very strong," said Michele Ozumba, president and CEO of Georgia Campaign for Adolescent Pregnancy Prevention (G-CAPP).

Health care workers are the first line of defense in determining whether abuse has occurred.

"Anyone younger than 15 becoming pregnant is a red flag," said Juliet Cooper, Nursing Director at the Fulton County Department of Health and Wellness. "We take the responsibility [of mandated reporting] very seriously and don't mind erring on the side of caution," she said.

In Georgia, any person can report suspected child abuse to the county Department of Family and Children Services (DFCS) or police, if a child is in immediate danger. Professionals who work closely with children are required by law to report within 24 hours anything that suggests abuse.

However, some providers may feel uncomfortable pressing the issue due to respect for patient privacy, said Pam Brown, director of programs at the nonprofit Prevent Child Abuse Georgia, which provides training on mandated reporting to hundreds of health professionals across the state. The organization also has a hotline that provides information about where to get help.

In 2006, DFCS investigated 4,602 cases of reported child sexual abuse, which includes all ages and all categories of abuse. Victims between the ages of 10 and 15 made up almost half (753) of the 1,588 cases where evidence supported the allegations.

"These are absolutely the most difficult cases of abuse to investigate. There is usually no physical evidence, and often times it is difficult for a child to talk about what has happened," said Nancy Chandler, executive director of the nonprofit Georgia Center for Child Advocacy, which conducts forensic inteviews for child sexual abuse cases in Fulton and DeKalb counties in collaboration with law enforcement and DFCS. The agency also provides preventive education programs and long-term psychological therapy for victims of sexual abuse.

In 2001, G-CAPP released an executive summary stating that many people who were mandated to report sexual abuse lacked sufficient training, especially for recognizing the signs. The report was based on interviews from Georgia professionals at DFCS, schools, medical centers and advocacy groups. Participants in the survey rated the state's overall handling of the needs of sexually abused children as "fair or poor."

Chandler said headway has been made through increased collaboration between agencies, but there is still room for improvement in training workers and increasing manpower.

"There's a lot of gray area in mandated reporting," Brown said, especially when sexual activity occurs in individuals who are close in age. "There's confusion as to how people should classify the circumstances surrounding the pregnancies of teenagers."

Of 325 live births to young girls in 2006, 78 percent (252) of mothers did not report the ages of the men who fathered their babies, according to the Georgia Department of Human Resources (DHR). Of those who did (73 total), 27 percent of the fathers were over the age of 20. The ages of all reported fathers ranged from 13 to 26.

Despite the information available on birth records, cases of statutory rape are not investigated or prosecuted unless they are reported as such.

From 2004 to 2006 in Georgia, there were 507 legal abortions for girls ages 10 to 14 years old, according to DHR. The agency does not track whether those abortions are related to sexual abuse. Late-term abortions (16 to 26 weeks) accounted for 14.6 percent of these abortions, compared with 4.5 percent of abortions in all age groups.

At the Atlanta SurgiCenter, about 1 in 10 abortions performed in girls younger than 15 at the facility are from known cases of sexual abuse, a spokeswoman said. In these cases, the center works closely with law enforcement and government agencies, she said.

"To prevent sexual abuse, we need to teach young people about healthy relationships so they don't become abusers or aren't as vulnerable to being abused," said Dr. Elizabeth Saewyc, associate professor at University of British Columbia's School of Nursing.

Saewyc authored a paper that found that young people of both sexes with a history of abuse were two to four times more likely to be later involved in pregnancy before age 19 — just one of many long-term consequences.