Pregnant and Parenting Youth in Care and Their Children: A Literature Review

  • Andrea Lane Eastman
  • Lindsey Palmer
  • Eunhye Ahn


While general U.S. rates of adolescent pregnancy and childbirth have declined over the past four decades, the rate among adolescents in foster care has not reflected this same drop. Decades of research has indicated negative outcomes for both parenting adolescents and their children compared to their non-parenting peers, however, less is understood about the risks, outcomes and needs specific to adolescents who give birth while in foster care. This comprehensive literature review adds to the knowledge of pregnant and parenting mothers in foster care and their children by identifying and summarizing all relevant studies published between 2011 and 2017. Findings indicate that youth in care have high rates of pregnancy and childbirth, experience multiple risks and negative outcomes, and are in need of various supportive services. Implications for research, practice and policy (need to reduce unintended pregnancy and improve circumstances, identifying successful interventions, expanding knowledge of these youth and their children, and developing two-generation interventions) were also explored.


Mothers in foster care Child maltreatment Pregnant and parenting 



The Doris Duke Fellowship for the Promotion of Child Well-Being provided dissertation support and funding for 2 years, without which this paper could not have been completed. The authors would like to thank Deb Daro for investments in generating new knowledge for children at risk for maltreatment.


This study was funded by the Doris Duke Fellowship for the Promotion of Child Well Being.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Aparicio, E. M. (2017). ‘I want to be better than you:’ Lived experiences of intergenerational child maltreatment prevention among teenage mothers in and beyond foster care. Child & Family Social Work, 22, 607–616. Scholar
  2. Aparicio, E. M., Pecukonis, E. V., & O’Neale, S. (2015). ‘The love that I was missing’: Exploring the lived experience of motherhood among teen mothers in foster care. Children and Youth Services Review, 51, 44–54. Scholar
  3. Boonstra, H. D. (2011). Teen pregnancy among young women in foster care: A primer. Guttmacher Policy Review, 14, 8–19.Google Scholar
  4. Boyer, D., & Fine, D. (1992). Sexual abuse as a factor in adolescent pregnancy and child maltreatment. Family Planning Perspectives, 24, 4. Scholar
  5. Carpenter, S. C., Clyman, R. B., Davidson, A. J., & Steiner, J. F. (2001). The association of foster care or kinship care with adolescent sexual behavior and first pregnancy. Pediatrics. Scholar
  6. Coleman-Cowger, V. H., Green, B. A., & Clark, T. T. (2011). The impact of mental health issues, substance use, and exposure to victimization on pregnancy rates among a sample of youth with past-year foster care placement. Children and Youth Services Review, 33, 2207–2212. Scholar
  7. Combs, K. M., Begun, S., Rinehart, D. J., & Taussig, H. (2018). Pregnancy and childbearing among young adults who experienced foster care. Child Maltreatment, 23, 166–174. Scholar
  8. Connolly, J., Heifetz, M., & Bohr, Y. (2012). Pregnancy and motherhood among adolescent girls in child protective services: A meta-synthesis of qualitative research. Journal of Public Child Welfare, 6, 614–635. Scholar
  9. Courtney, M. E., Dworsky, A. L., Cusick, G. R., Havlicek, J., Perez, A., & Keller, T. E. (2007). Midwest evaluation of the adult functioning of former foster youth: Outcomes at age 21. Chicago: Chapin Hall Center at the University of Chicago.Google Scholar
  10. Courtney, M. E., Hook, J. L., & Lee, J. S. (2012). Distinct subgroups of former foster youth during young adulthood: Implications for policy and practice. Child Care in Practice, 18, 409–418. Scholar
  11. Courtney, M. E., Okpych, N. J., Charles, P., Mikell, D., Stevenson, B., Park, K., … Feng, H. (2016). Findings from the California youth transitions to adulthood study (CalYOUTH): Conditions of youth at age 19. Chicago: Chapin Hall at the University of Chicago.Google Scholar
  12. Dworsky, A. (2015). Child welfare services involvement among the children of young parents in foster care. Child Abuse & Neglect, 45, 68–79. Scholar
  13. Dworsky, A., & Courtney, M. E. (2010). The risk of teenage pregnancy among transitioning foster youth: Implications for extending state care beyond age 18. Children and Youth Services Review, 32, 1351–1356. Scholar
  14. Dworsky, A., & Gitlow, E. (2017). Employment outcomes of parenting foster youth. Children and Youth Services Review, 72, 133–140.CrossRefGoogle Scholar
  15. Eastman, A. L., Putnam-Hornstein, E., Magruder, J., Mitchell, M. N., & Courtney, M. E. (2017). Characteristics of youth remaining in foster care through age 19: A pre-and post-policy cohort analysis of California data. Journal of Public Child Welfare, 11, 40–57. Scholar
  16. Hamilton, B. E., & Mathews, T. J. (2016). Continued declines in teen births in the United States, 2015 (NCHS data brief, 259). Hyattsville: National Center for Health Statistics.Google Scholar
  17. Holtrop, K., Canto, A. I., Schelbe, L., Mcwey, L. M., Radey, M., & Montgomery, J. E. (2018). Adapting a parenting intervention for parents aging out of the child welfare system: A systematic approach to expand the reach of an evidence-based intervention. American Journal of Orthopsychiatry, 88, 386–398. Scholar
  18. King, B., & Van Wert, M. (2017). Predictors of early childbirth among female adolescents in foster care. Journal of Adolescent Health, 61, 226–232. Scholar
  19. Leve, L. D., Kerr, D. C., & Harold, G. T. (2013). Young adult outcomes associated with teen pregnancy among high-risk girls in a randomized controlled trial of multidimensional treatment foster care. Journal of Child & Adolescent Substance Abuse, 22, 421–434. Scholar
  20. Lieberman, L. D., Bryant, L. L., & Boyce, K. (2015). Family preservation and healthy outcomes for pregnant and parenting teens in foster care: The Inwood House theory of change. Journal of Family Social Work, 18, 21–39. Scholar
  21. Milbrook, N. (2012). Factors contributing to subsequent pregnancies among teen parents in child welfare (Doctoral dissertation). Retrieved from ProQuest Dissertations and Theses Database. (UMI No. 3533388).Google Scholar
  22. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G., The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097. Scholar
  23. Narendorf, S. C., Munson, M. R., & Levingston, F. (2013). Managing moods and parenting: Perspectives of former system youth who struggle with emotional challenges. Children and Youth Services Review, 35, 1979–1987. Scholar
  24. Oshima, K. M. M., Narendorf, S. C., & McMillen, J. C. (2013). Pregnancy risk among older youth transitioning out of foster care. Children and Youth Services Review, 35, 1760–1765. Scholar
  25. Oswald, S. H., Heil, K., & Goldbeck, L. (2010). History of maltreatment and mental health problems in foster children: A review of the literature. Journal of Pediatric Psychology, 35, 462–472. Scholar
  26. Putnam-Hornstein, E., Cederbaum, J. A., King, B., Eastman, A. L., & Trickett, P. K. (2015). A population-level and longitudinal study of adolescent mothers and intergenerational maltreatment. American Journal of Epidemiology, 181, 496–503. Scholar
  27. Putnam-Hornstein, E., Hammond, I., Eastman, A. L., McCroskey, J., & Webster, D. (2016). Extended foster care for transition-age youth: An opportunity for pregnancy prevention and parenting support. Journal of Adolescent Health, 58, 485–487. Scholar
  28. Putnam-Hornstein, E., & King, B. (2014). Cumulative teen birth rates among girls in foster care at age 17: An analysis of linked birth and child protection records from California. Child Abuse & Neglect, 38, 698–705. Scholar
  29. Radey, M., Schelbe, L., McWey, L. M., Holtrop, K., & Canto, A. I. (2016). “It’s really overwhelming”: Parent and service provider perspectives of parents aging out of foster care. Children and Youth Services Review, 67, 1–10. Scholar
  30. Schelbe, L., & Geiger, J. M. (2017). Parenting under pressure: Experiences of parenting while aging out of foster care. Child and Adolescent Social Work Journal, 34, 51–64. Scholar
  31. Shpiegel, S., Cascardi, M., & Dineen, M. (2017). A social ecology analysis of childbirth among females emancipating from foster care. Journal of Adolescent Health, 60, 563–569. Scholar
  32. Stevens-Simon, C., & Mcanarney, E. R. (1994). Childhood victimization: Relationship to adolescent pregnancy outcome. Child Abuse & Neglect, 18, 569–575. Scholar
  33. Svoboda, D. V., Shaw, T. V., Barth, R. P., & Bright, C. L. (2012). Pregnancy and parenting among youth in foster care: A review. Children and Youth Services Review, 34, 867–875. Scholar
  34. Taussig, H. N., Culhane, S. E., Garrido, E. F., & Raviv, T. (2010). Cumulative risk exposure and mental health symptoms among maltreated youth placed in out-of-home care. Child Abuse & Neglect, 34, 742–751. Scholar
  35. Turpel-Lafond, M., & Kendall, P. (2009). Kids, crime and care Kendall, P. (2009). Mental health symptoms among maltreated youth placed in out-of-home care. Victoria: Representative for Child and Youth Care and Office of the Provincial Health Officer.Google Scholar
  36. Winter, V. R., Brandon-Friedman, R. A., & Ely, G. E. (2016). Sexual health behaviors and outcomes among current and former foster youth: A review of the literature. Children and Youth Services Review, 64, 1–14. Scholar
  37. Zhan, W., Smith, S. R., Warner, L. C., North, F., Wilhelm, S., & Nowak, A. (2017). Sexual behavior and pregnancy among adolescents in foster family homes. International Journal of Adolescent Medicine and Health. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Children’s Data Network, School of Social Work, School of Social WorkUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations