The risk of teenage pregnancy among transitioning foster youth: Implications for extending state care beyond age 18

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Abstract

The purpose of this study is to examine how common teenage pregnancy is among young women in and aging out of foster care and to determine whether the risk of becoming pregnant can be reduced by extending foster care beyond age 18. The study used data from the first two waves of the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study of foster youth making the transition to adulthood in three Midwestern states, as well as the National Longitudinal Study of Adolescent Health. Cox proportional hazard models were estimated to examine the relationship between care status and the risk of teenage pregnancy. Foster youth are more likely to experience teenage pregnancy than their peers in the general population but staying in care seems to mitigate their risk of becoming pregnant even after the effects of other factors are taken into account. Our findings provide additional evidence of the need for a more concerted effort by child welfare agencies to help youth in foster care avoid becoming pregnant and suggest that allowing young people to remain in foster care beyond age 18 may be one way to reduce teenage pregnancy among this population.

Introduction

Growing attention has been paid in recent years to the high rate of teenage pregnancy among young people in and aging out of foster care. In fact, the National Campaign to Prevent Teen and Unplanned Pregnancy has identified the reduction of teenage pregnancy among this population as one of the priorities (National Campaign to Prevent Teen and Unplanned Pregnancy, 2009).

Although young people in and aging out of foster care are believed to be at high risk of becoming pregnant (National Campaign to Prevent Teen and Unplanned Pregnancy, 2008), the number of adolescents who experience a pregnancy while they are under the care and supervision of the state is far from clear. Gotbaum (2005), who surveyed contract foster care agencies in New York City in early 2005, found that approximately 16% of their 13 to 21 year old female wards were either pregnant (4%) or parenting (12%).

Another study with a more geographically diverse sample of foster youth looked not at teenage pregnancy but at early childbearing. Pecora et al. (2003) estimated that at least 17% of the young women who had been served by Casey Family Programs, a private agency with offices in 13 different states, between 1966 and 1998 had given birth to at least one child while in foster care. Although this is more than double the 8.2% of unmarried 15 to 19 year old females in 1998 who had ever given birth (Bachu & O'Connell, 2001), the Casey Family Programs sample included young women who had been in foster care as many as three decades ago.

There is also evidence that foster youth remain at high risk of becoming pregnant even after they become too old to stay in care. Singer (2004) reported that 31% of 18 to 24 year old young women who had “aged out” of Utah's child welfare system between 1999 and 2003 had given birth within 3 years of exiting, and that their birthrate was nearly three times higher than the birthrate for this age group in the state's general population.

The present study contributes to our limited knowledge about teenage pregnancy among youth in foster care by addressing three important questions. First, how likely are young women aging out of foster care to experience a teenage pregnancy? Second, how does their likelihood of becoming pregnant compare to that of adolescents in the general population? And third, could we reduce the risk of teenage pregnancy among this population by allowing foster youth to remain in care beyond age 18?

This third and final question is particularly relevant in light the Fostering Connections to Success and Increasing Adoptions Act of 2008. Under this legislation, which amended Title IV-E of the Social Security Act, states will be able to claim federal reimbursement for the costs of caring for and supervising eligible foster youth until age 21, rather than 18, beginning in federal fiscal year 2011. This policy change makes sense developmentally given that many young adults continue to rely heavily on their families for support during the transition to adulthood (Settersten, Furstenberg, & Rumbaut, 2005).

Using data from the first two waves of the Midwest Evaluation of the Adult Functioning of Former Foster Youth (henceforth the “Midwest Study”), a longitudinal study of foster youth making the transition to adulthood in three Midwestern states, as well as the National Longitudinal Study of Adolescent Health, we find that foster youth are more likely to become pregnant than their peers in the general population but that staying in care seems to mitigate their risk of teenage pregnancy even after the effects of other factors are taken into account. The implications of our results for child welfare policy and practice are discussed.

Section snippets

Research design and methods: the Midwest and Add Health Studies

The Midwest Study is following a sample of young people from Iowa, Wisconsin and Illinois as they as they “age out” of foster care and transition to adulthood. All of these young people had been placed in out-of-home care before their 16th birthday for reasons other than delinquency and were still in out-of-home care on their 17th birthday. Baseline interviews were conducted with 732 of these young people when they were 17 or 18 years old, and all but 34 were still state wards. Those 34 had been

Results

One third of the young women in the Midwest Study had been pregnant at least once by age 17 or 18 compared with just 13.5% of their Add Health Study counterparts. That gap had widened by age 19. Half of the nineteen year olds in the Midwest Study but only 20% of their Add Health Study counterparts had been pregnant at least once (Table 1).

A potential problem with this comparison is that African-American teens are more likely to become pregnant that teens who are non-Hispanic White, and young

Discussion

Our data clearly indicate that teenage pregnancy is all too common among young women aging out of foster care and transitioning to adulthood. Not only are female foster youth more likely to become pregnant than their non-foster peers, but many of those who become pregnant experience a repeat pregnancy. Thus, our findings confirm the need for current efforts being made by the National Campaign to Prevent Teen and Unplanned Pregnancy to reduce teen pregnancy among youth in foster care (National

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