The National Campaign to Prevent Teen and Unplanned Pregnancy is excited to join with Planned Parenthood Federation of America, the Congressional Coalition on Adoption Institute, and the National Foster Care Coalition in a partnership to focus on reducing the disproportionately high teen pregnancy rate among youth in and aging out of foster care. Since 2005, this population has been a major focus of the Campaign’s work, both because this is a group of young people with high rates, and because it’s an area where more attention and research is needed to make progress and improve child well-being.

As a first step, our newly formed working group sponsored a briefing on Thursday entitled, “Preventing Teen Pregnancy and Promoting Health Relationships among Youth in Foster Care.” Senator Mary Landrieu (D-LA) was part of the Congressional Roundtable Discussion at which the announcement of the new working group was made. She pointed out that the government has a special obligation to take care of the children in its custody, and given some of the reproductive health outcomes of this group, we all could be doing a better job of making sure this happens.

Amy Dworsky, a panelist from Chapin Hall at the University of Chicago, a independent policy research center, is the co-investigator for a longitudinal study of young people making the transition from foster care to adulthood in three Midwestern states. During the Roundtable, she discussed her research and noted there are currently 200,000 adolescents in foster care who are at high risk of getting pregnant or getting someone pregnant.  According to the study, by age 17, one-third of young women in foster care themselves reported having been pregnant at least once.  By age 19, that proportion had risen to nearly one half, compared to three in ten of all teen girls in this country.   In addition, at age 17 or 18, only 45 percent of the study participants reported that they had received information about birth control and only 15 percent reported that they had received family planning services during the past year.  New findings from an analysis by Child Trends reveal a few more sobering statistics: almost half of youth who have ever lived in foster care had sex for the first time before age 16, compared to one third of other youth; they are less likely to use contraception the first time they have sex, and are twice as likely to have a baby as a teen; and they are also more likely to have experienced forced sex.

We were reminded by the dozens of foster care alumni present at the briefing – many of whom attested to having successfully made the transition from care to living independently – that they are young people with the same dreams and aspirations as their non-foster peers.  Put simply, youth in foster care want what any young person wants – to finish school, go to college, perhaps to start a family, to have successful careers, and more. The differences lie in the unique challenges that youth in foster care face, which require us to think creatively and sensitively about the way in which messages about sexual health, prevention, and healthy relationships are delivered to them.

Some of the specific challenges this population faces were cited by experts and youth themselves at the briefing.  Youth in foster care are highly mobile, often moving between group homes, foster families, and biological families, one consequence of which can be irregular or interrupted school attendance.  As panelist Representative Jim Cooper (D-TN) pointed out, even if a particular public school is providing what passes for decent sex education (which he suspects most don’t), the chances are greater that these youth could simply miss receiving the information either because it was offered at a point in the semester before that teen enrolled, or because it’s offered only once in four years in an earlier grade (think Coach Bob’s ninth grade health class presentation, complete with super-scary STI slides).  Combine less-than-adequate or non-existent sex education and information on how to avoid teen pregnancy with the fact that many of these youth have a history of trauma, abuse, and even coerced sex, and you can imagine how simply relying on what these young people may or may not get in school is problematic.

In the absence of program interventions in school or community programs, many pointed out that the lack of strong relationships with trusted adults who might otherwise be a source for information about pregnancy planning and prevention is a significant challenge.  As several youth pointed out, the social workers who often serve as the gateway to knowledge about many aspects of their lives are often uncomfortable and unprepared to provide information about this issue, nor do they have time given their high caseloads.  And often the level of trust between the youth and their foster parents isn’t sufficient to have frank conversations about what for many can be an uncomfortable topic. Focus group findings from The National Campaign support the sentiment that even where young people lack these important relationships, the need and desire for more information about sex and pregnancy remains.  

There are, of course, exceptions to this, including foster parents such as Susan Badeau who has helped so many teens understand they have opportunities and reasons to delay parenting.  And, the Pregnancy Prevention and Empowerment Program developed by Rachel Winston with the Richmond City Department of Social Services is providing young people in foster care with vital information and support.  Also, Planned Parenthood’s peer educators – who were present in full force and outfitted in their trademark pink shirts – are working hard to fill this gap, including some who have aged out of the foster care system.  Recognizing that most young adults feel much more comfortable asking someone their age the tough questions about their health, they volunteer to become knowledgeable about sexual and reproductive health and to spread the word to their peers.

The briefing is only the first step in what will be a continuing effort to bring awareness to this issue, brainstorm strategies that might make a difference, and to make recommendations on common sense solutions that will help reduce the pregnancy rate among these youth.  The National Campaign has some policy ideas for moving this work forward, including taking advantage of opportunities during the implementation of the recently passed Fostering Connections to Success Act. We also know of states and communities that have made working with this population a priority and are working with teams in eight states to do even more to help young people in foster care avoid early pregnancy.   

We look forward to making progress and to working with leaders in fields of both teen pregnancy prevention/reproductive health and child welfare to confront this most important issue.