One recent day at Dr. Natalie Carroll's OB-GYN practice, located inside a low-income apartment complex tucked between a gas station and a freeway, 12 pregnant black women come for consultations. Some bring their children or their mothers. Only one brings a husband.

Things move slowly here. Women sit shoulder-to-shoulder in the narrow waiting room, sometimes for more than an hour. Carroll does not rush her mothers in and out. She wants her babies born as healthy as possible, so Carroll spends time talking to the mothers about how they should care for themselves, what she expects them to do — and why they need to get married.

Seventy-two percent of black babies are born to unmarried mothers today, according to government statistics. This number is inseparable from the work of Carroll, an obstetrician who has dedicated her 40-year career to helping black women.

"The girls don't think they have to get married. I tell them children deserve a mama and a daddy. They really do," Carroll says from behind the desk of her office, which has cushioned pink-and-green armchairs, bars on the windows, and a wooden "LOVE" carving between two African figurines. Diamonds circle Carroll's ring finger.

As the issue of black unwed parenthood inches into public discourse, Carroll is among the few speaking boldly about it. And as a black woman who has brought thousands of babies into the world, who has sacrificed income to serve Houston's poor, Carroll is among the few whom black women will actually listen to.

"A mama can't give it all. And neither can a daddy, not by themselves," Carroll says. "Part of the reason is because you can only give that which you have. A mother cannot give all that a man can give. A truly involved father figure offers more fullness to a child's life."

Statistics show just what that fullness means. Children of unmarried mothers of any race are more likely to perform poorly in school, go to prison, use drugs, be poor as adults, and have their own children out of wedlock.

Dr. Natalie Carroll, an obstetrician practicing in Houston, encourages her patients to get married. "The girls don't think they have to get married. I tell them children deserve a mama and a daddy. They really do," Carroll says.

The black community's 72 percent rate eclipses that of most other groups: 17 percent of Asians, 29 percent of whites, 53 percent of Hispanics and 66 percent of Native Americans were born to unwed mothers in 2008, the most recent year for which government figures are available. The rate for the overall U.S. population was 41 percent.

This issue entered the public consciousness in 1965, when a now famous government report by future senator Daniel Patrick Moynihan described a "tangle of pathology" among blacks that fed a 24 percent black "illegitimacy" rate. The white rate then was 4 percent.

Many accused Moynihan, who was white, of "blaming the victim:" of saying that black behavior, not racism, was the main cause of black problems. That dynamic persists. Most talk about the 72 percent has come from conservative circles; when influential blacks like Bill Cosby have spoken out about it, they have been all but shouted down by liberals saying that a lack of equal education and opportunity are the true root of the problem.

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'Nobody talks about it'

Even in black churches, "nobody talks about it," Carroll says. "It's like some big secret." But there are signs of change, of discussion and debate within and outside the black community on how to address the growing problem.

Research has increased into links between behavior and poverty, scholars say. Historically black Hampton University recently launched a National Center on African American Marriages and Parenting. There is a Marry Your Baby Daddy Day, founded by a black woman who was left at the altar, and a Black Marriage Day, which aims "to make healthy marriages the norm rather than the exception."

In September, Princeton University and the liberal Brookings Institution released a collection of "Fragile Families" reports on unwed parents. And an online movement called "No Wedding No Womb" ignited a fierce debate that included strong opposition from many black women.

"There are a lot of sides to this," Carroll says. "Part of our community has lost its way."

There are simple arguments for why so many black women have children without marriage.

The legacy of segregation, the logic goes, means blacks are more likely to attend inferior schools. This creates a high proportion of blacks unprepared to compete for jobs in today's economy, where middle-class industrial work for unskilled laborers has largely disappeared.

The drug epidemic sent disproportionate numbers of black men to prison, and crushed the job opportunities for those who served their time. Women don't want to marry men who can't provide for their families, and welfare laws created a financial incentive for poor mothers to stay single.

If you remove these inequalities, some say, the 72 percent will decrease.

"It's all connected. The question should be, how has the black family survived at all?" says Maria Kefalas, co-author of "Promises I Can Keep: Why Poor Women Put Motherhood Before Marriage."

The book is based on interviews with 162 low-income single mothers. One of its conclusions is that these women see motherhood as one of life's most fulfilling roles — a rare opportunity for love and joy, husband or no husband.

'My children are what keep me going'

Sitting in Carroll's waiting room, Sherhonda Mouton watches all the babies with the tender expression of a first-time mother, even though she's about to have her fourth child. Inside her purse is a datebook containing a handwritten ode to her children, titled "One and Only." It concludes:

"You make the hardest tasks seem light with everything you do.

"How blessed I am, how thankful for my one and only you."

Mouton, 30, works full time as a fast-food manager on the 3 p.m. to 1 a.m. shift. She's starting classes to become a food inspector.

"My children are what keep me going, every day," she says. "They give me a lot of hope and encouragement." Her plans for them? "College, college, college."