What strategies support pregnant and parenting teens in foster care?

Pregnant and parenting teenagers need strong support networks and resources to navigate adolescence and successfully transition to parenthood. Teenagers experience significant cognitive, emotional, and physical changes as the brain continues to develop into their mid-20s. For pregnant and parenting teens in foster care, an already difficult transition from adolescence to adulthood is exacerbated by the stresses of adjusting to life in the child welfare system as a young parent, often with limited or no family connections and often lacking resources to meet basic needs. As a result, pregnant and parenting teens in foster care need targeted, equitable, and easy-to-access services from competent child welfare professionals (and other caring adults) in order to thrive as young adults and parent effectively.

The Family First Prevention Services Act of 2018 makes federal funding available for specialized prevention and support services for pregnant and parenting youth in foster care, including in-home parent education, individual and family counseling, mental health services, and substance use prevention and treatment. Keeping pregnant and parenting foster youth and their children together should be prioritized by placing them with kin or in family setting. If a higher level of care is required, federal reimbursement is available for specialized group care settings where pregnant and parenting foster youth can receive treatment while caring for their child. To prevent separation and support teens’ successful transition to parenthood, child welfare professionals must have the knowledge, skills, and competencies to serve this population’s unique needs and challenges.

This brief highlights various strategies — including using data to inform policies and practices, partnering effectively with teen parents, and essential programming goals and components — to help agency leaders, caseworkers, and other youth-serving professionals better support pregnant and parenting youth and their children.¹ For information specific to pregnancy prevention, see: What strategies can help prevent unintended pregnancy for youth in foster care?

Unique needs of pregnant and parenting teens

Pregnant and parenting teens in foster care are more likely to experience lower educational attainment, mental health challenges (such as depression and anxiety), unemployment, and homelessness than their peers not in foster care.² In addition to experiencing maltreatment, many teen parents in foster care have had to endure multiple placements and disruptions in relationships with parents and other important adults. These experiences result in significant trauma that, if left untreated, can impact their mental health and their ability to form lasting relationships with caring adults and even their own child.

Teens in foster care have a higher risk for pregnancy and multiple pregnancies than teens not in foster care. Research indicates they receive limited information about and access to contraceptives, are more likely to have sex as teenagers, and have more sexual partners. Teens in foster care who already have had one child are at increased risk of having another child prior to age 21.^3,4

Children born to teen parents in foster care also present a unique set of needs. They are more likely to be born premature or with a low birth weight due to teen mothers receiving inadequate nutrition or using drugs and alcohol while pregnant.⁵ Additionally, many young parents may have limited knowledge of parenting skills and child development, which can make it difficult to recognize and respond to their child’s developmental needs. Teen parents in foster care are likely to be reported for abuse or neglect and have their children placed in foster care, which creates an intergenerational cycle of child welfare involvement that can perpetuate poor outcomes for the child.⁶

Despite their unique challenges, pregnant and parenting teens in foster care can thrive in early adulthood and new parenthood. With the support of child welfare professionals and caring adults (including parents, relatives, fictive kin, and foster caregivers), young parents can access comprehensive resources and services to increase stability and improve life outcomes for themselves and their children.

Barriers to providing effective services

Agency leaders face several barriers to providing effective and equitable services to pregnant and parenting teens in foster care. Young parents called out these barriers powerfully in a May 2023 report. Some of these barriers include:

• Insufficient data. Access to information about pregnant and parenting youth in foster care varies across jurisdictions, which can lead to inaccurate and inconsistent data. To create a comprehensive view of this population’s strengths, needs, and challenges, it is essential to improve data collection, sharing, and utilization across systems that interact with teen parents (such as education, health care, child support, early childhood education). System leaders can use resources such as The Annie Casey Foundation’s Expectant and Parenting Youth in Foster Care: Systems Leaders Data Tool Kit as a guide to gather, share, and use data to help inform policies and practices that can improve outcomes for pregnant and parenting teens. At the same time, “child welfare professionals cannot allow data to shape their view of young parents in foster care,” says Roger De Leon Jr., a father in California with lived experience in the child welfare system. “We need data for information, but data should not determine how we label young parents. We must see them for who they are, not just the labels that data says they are.”
• Insufficient sex education. Many child welfare agencies lack policies and practices for sexual and reproductive health education and services for youth in foster care. Without clear practices, differing opinions or confusion regarding who is responsible for having “the talk” with teens in foster care results in youth being ill-informed and unprepared to make sexually responsible decisions. Resource parents, caseworkers, and other trusted adults who work with youth should be equipped with skills and strategies to facilitate informed, yet sensitive discussions about sex and refer youth to available resources (such as contraceptives) to prepare them to make well-informed decisions regarding their sexual and reproductive health and development.
• Stigmas and stereotypes. Stigmatizing labels and descriptions (such as irresponsible, sexually promiscuous, bad influence, poor choices, and unmotivated) can influence how child welfare professionals and other service providers view and engage pregnant and parenting teens. An awareness of negative perceptions also can impact young parents’ willingness to seek help, even when it may be in their best interest. To successfully engage and improve outcomes for young parents in foster care, child welfare professionals, resource parents, and other individuals working with this population must intentionally challenge and eliminate the entrenched stigmas associated with teen pregnancy and parenting.
• Limited placement options. Placement stability for older youth in foster care is an ongoing issue, especially for pregnant and parenting teens. While placing teen parents and their babies together is paramount, finding resource families willing to support a pregnant teenager or a teenager with a new baby is often challenging. Agencies must continually implement strategies to identify and engage relatives and fictive kin as placement options for young parents and their children. It is equally important to consider ways to increase recruitment and training of resource caregivers who can provide a loving and safe environment where teens can parent their child with support from trusted adults.

Partnering with pregnant and parenting teens

Despite their many unique needs and life challenges, pregnant and parenting teens in foster care are resilient and determined to create positive and healthy experiences and outcomes for their children. Having guidance from trusted and supportive adults can better prepare teen parents to assume their parental responsibilities. When working with pregnant and parenting youth, caseworkers and other professionals should:

• Support their dual realities. Being both a teenager and parent can create emotional, psychological, and social challenges.⁷ Teens may believe they are too young to be a parent, feel judged by adults and peers, and experience social isolation. Caseworkers must remain cognizant of the duality of teens’ identities and find the right balance in addressing their needs as young people, while respecting them as parents and emerging adults. 
• Recognize their diverse identities. Youth of color and LGBTQ+ youth are disproportionately represented in the child welfare system. Challenges that young parents face while in foster care may be exacerbated when intersected with their social identities (such as race, gender identity, sexual orientation, physical and mental abilities, and immigration status). To provide holistic support to pregnant and parenting youth, caseworkers must recognize and support teens’ diverse identities and discern potential strengths, barriers, and vulnerabilities that may result from their intersecting identities.
• Center young parents’ voices. Supporting pregnant and parenting youth requires caseworkers to prioritize teen voices and choices related to their parenting, placement, and needed supports while in foster care and after transitioning out. It is also important to center teens’ views regarding their pregnancy confidentially and offer them mental and emotional space to determine when to disclose pregnancy details on their own timing. This helps demonstrate respect for young parents’ emerging autonomy in a manner that empowers them to take the lead in decision-making and advocacy for themselves and their child.
• Ensure youth understand their parental rights. Pregnant and parenting teens in foster care should be informed of their parental rights, options, and opportunities to help them decide the best plan of care for themselves and their child. Information related to family planning, parenting education, paternal role and engagement, and placement and permanency options prepares parenting youth to make informed decisions about their future.
• Improve two-generational outcomes. Pregnant and parenting youth in foster care are more likely to have their children placed in out-of-home care than parenting youth outside of the child welfare system.⁸ In order to break the intergenerational cycle within system-involved families, agencies must provide services with a two-generation approach that simultaneously focus on the holistic well-being of young parents and their children to improve outcomes for the family.
• Provide unbiased guidance and support. Teens need support from trusted, non-judgmental adults. Caseworkers and other adult figures (such as parents, relatives, fictive kin, and foster caregivers) should manage personal biases and avoid imposing personal beliefs when sharing options and resources with teen parents. Taking a neutral stance enables supportive adult figures to offer factual, unbiased guidance while empowering pregnant and parenting teens with the information they need to make decisions, without pressure to conform or align with certain expectations.

Goals of effective programs for teen parents in foster care

Providing a comprehensive range of services can reduce the risk of negative educational, relational, health, and economic outcomes. According to the Center for the Study of Social Policy, programs that address teen parent’s holistic needs should focus on the following goals:⁹

Ensure healthy development of the teen parent by:

• Ensuring the parent receives consistent medical attention, including prenatal and postnatal care.
• Providing supports that promote age-appropriate developmental goals and address relevant mental health issues, including the impacts of trauma.
• Providing education related to substance use (specifically the risks that substance use poses to the developing child), sexual health, the prevention of second pregnancies, and sexually transmitted infections (STIs).
• Encouraging healthy relationships with partners, peers, family members, and other supportive people.
• Promoting self-sufficiency and independent living outcomes for pregnant and parenting teens by helping them obtain high school diplomas/GEDs and pursue additional education and employment opportunities or job training, depending on their interests.

Ensure healthy development of the child by:

• Ensuring the parent receives consistent medical attention, including prenatal care, to increase the likelihood of a healthy birth.
• Assisting the parent in registering for other supports such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP) so the child receives regular medical care, including developmental screenings, and healthy food.
• Connecting the children of teen mothers and fathers with developmentally appropriate resources, childcare, and services for the child, including transportation and educational opportunities.

Develop strong parent-child relationships that promote attachment and bonding by:

• Providing access to programs that promote positive parenting and emphasize nurturing as well as age-appropriate discipline.
• Connecting teens to models of good parenting practices and programs that provide education about essential parenting skills and the importance of responsive parenting.
• Offering opportunities to practice parenting skills in a supportive environment.

Effective programs for parenting teens in foster care

Addressing this population’s unique needs, preventing child maltreatment, and reducing outcome disparities requires child welfare systems to provide equitable access to a wide range of developmentally appropriate, evidence-informed, and trauma-informed clinical and parenting interventions and services.

Several programs across the country offer high-quality support to pregnant and parenting teens while in foster care and after transitioning out. A few examples:

The California Department of Social Services provides pregnant and parenting youth in foster care with a wide range of services to address concrete needs such as financial support, food assistance, and subsidized childcare. Other services include access to home visiting programs that begins during pregnancy until the child turns age 5, and a public health nurse to assist with appointments, health records, and referrals for prenatal and postnatal care.

In Colorado, Denver’s Florence Crittenton Services resource center provides pregnant and parenting teens and their extended families access to a range of wraparound services, including year-round early childhood education, parenting and child development education, and family-focused case management. The organization’s two-generation approach includes an Early Childhood Education Center serving children from 6 weeks old through pre-K, and a high school it operates affords parenting students the opportunity to earn a Denver Public Schools diploma. According to its annual report, Florence Crittenton Services served 125 high school students and 135 infants and toddlers in 2022, with 79% of its high school seniors graduating and nine more completing a GED. The agency’s Student and Family Support Program connects young parents to family advocates who provide social-emotional education and support, as well as a transition advocate to help seniors and new graduates develop postsecondary plans. In 2022, 90% of graduating seniors completed a postsecondary plan, and 17 teen mothers were placed in long-term or permanent housing.

Inwood House, a service of The Children’s Village in New York City, provides education and support to pregnant and parenting teens in foster care. Inwood’s continuum of care model is designed to help teens become independent, increase their sense of self-worth, complete school, and enter the workforce. It also aims to reduce additional pregnancies, enhance parenting skills, and improve the health of mothers and their babies. One study found significantly better outcomes among teen parents in foster care receiving services through Inwood House than local and national norms for teen parents. For example, at the six-month point of the study, nearly all of the teen mothers at Inwood had retained custody of their baby, and the child had regular contact with the father. Other findings indicated that 89% of teen mothers were utilizing appropriate health care for their baby and 86% were in school and/or employed. Follow-up at 12 months revealed nearly identical outcomes for teen mothers who participated in the study.

St. Anne’s Family Services in Los Angeles serves pregnant and parenting teens who are currently in foster care or transitioning out of the child welfare system. The program’s goal is to build safe, nurturing, and resilient families by supporting mothers while they pursue educational opportunities and develop job skills. This support ideally leads to increased self-sufficiency, permanent employment, and stable housing. St. Anne’s operates a short term residential therapeutic program for system involved youth (i.e., child welfare and/or juvenile justice systems), ages 13 to 18 years and a transitional housing program for youth ages 18 to 24 who were formerly in foster care or the probation system, and their children. St. Anne’s also offers a workforce development program designed to help youth acquire essential professional skills (such as interviewing, assertive communication, and career exploration) to secure and sustain meaningful employment. In support of healthy child development, St. Anne’s has multiple early childhood education centers throughout Los Angeles County that serve program participants and the broader community promoting developmental and school readiness for low-income children ages 4 months to 5-years. The agency provides mental health services including individual, family, and group therapy as well as other wraparound support to help strengthen families.¹⁰

1 Content of this brief was informed through ongoing consultation with members of the Knowledge Management Lived Experience Advisory Board. This team includes youth, parents, kinship caregivers, and foster parents with lived experience of the child welfare system who serve as strategic partners with Family Voices United, a collaboration between FosterClub, Generations United, the Children’s Trust Fund Alliance, and Casey Family Programs. Members who contributed to this brief include: Genia Newark; Lisa Myles; and Roger De Leon Jr.

2 Eastman, A. L., Palmer, L., & Ahn, E. (2019). Pregnant and parenting youth in care and their children: A literature review. Child and Adolescent Social Work Journal, 36(6), 571-581.

3 Shpiegel, S., Fleming, T., Mishraky, L., VanWert, S., Goetz, B., Aparicio, E. M., & King, B. (2021). Factors associated with first and repeat births among females emancipating from foster care. Children and Youth Services Review, 125.

4 Combs, K.M., Begun S., Rinehart D.J., & Taussig H (2018). Pregnancy and childbearing among young adults who experienced foster care. Child Maltreat, 23(2), 166-174.

5Lieberman, L. D., Bryant, L. L., Boyce, K., & Beresford, P. (2014). Pregnant teens in foster care: Concepts, issues, and challenges in conducting research on vulnerable populations. Journal of Public Child Welfare, 8(2), 143-163.

6 Dworsky, A. (2014). Child welfare services involvement among the children of young parents in foster care. Chicago: Chapin Hall at the University of Chicago.

7 Child Welfare Information Gateway. (2023). Improving services for expectant and parenting youth in care. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. Retrieved from

8 Wall-Wieler, E., Brownell, M., Singal, D., Nickel, N., & Roos, L. (2018). The cycle of child protection services involvement: A cohort study of adolescent mothers. Pediatrics, 141(6).

9 Center for the Study of Social Policy (CSSP). (n.d.). Pregnant and parenting youth in foster care. Part I: A guide to service improvements.

10 Content informed by conversations with Gina Peck-Sobolewski, St Anne’s Family Services, Chief Program Officer on March 15, 2024.