Ongoing progress in reducing teen pregnancy.

Author:Munoz, Jaime


Across the nation the rates of teen pregnancy are dropping at staggering rates. Between 1991 and 2015 there was a 64 percent reduction in the teen birth rate. (1) While we can celebrate this accomplishment, we know that the country still faces huge disparities between race/ethnicities, socioeconomic status, geographic locations, and ages. We also see similar disparities between youth in foster care and youth not in care.

The Midwest Study found that youth in foster care were more than twice as likely to be pregnant by age 19 as youth not in care. (2) Recent data from the Children's Data Network at University of Southern California found that almost 30 percent of California youth in foster care gave birth before age 20. (3) Births to adolescents in care were 60 percent higher than the general population.

The rate of maltreatment of children born to mothers in foster care was two times higher than children born to mothers not in care. And most recently, the CalYOUTH Study showed that half of young women in care reported being pregnant at least once by age 19. (4)

These alarming differences between youth in care and youth not in care highlight the need to continue a sharp focus on teen pregnancy prevention services for this population.

Orange County, California

With more than 3 million residents, of which 23 percent are under the age of 18, Orange County is California's third most populous county, and the sixth most populous in the United States. Orange County has California's sixth highest number of youth in foster care at about 2,200, of which 42 percent are 12 to 21 years of age; and of which 14 percent are 18 to 21 years of age in Extended Foster Care.

Two years ago, Orange County joined five other counties in an 18-month learning community to reduce the rate of pregnancy among youth in foster care--the California Foster Youth Pregnancy Prevention Institute, a project of the John Burton Foundation in partnership with the American Public Human Services Association and The National Campaign to Prevent Teen and Unplanned Pregnancy.

When we started, we did not know how many youth in foster care were pregnant or parenting and we did not have a written policy to guide

social workers. Over the next two years, Orange County obtained increasing clarity and we are pleased to share some key lessons we've learned:

  1. Contact the experts

    In addition to the John Burton Foundation's expertise in California's transition age youth in foster care, the American Public Human Services Association's expertise in organizational change and effectiveness, and The National Campaign to Prevent Teen and Unplanned Pregnancy's expertise in pregnancy prevention, the California Foster Youth Pregnancy Prevention Institute also enlisted teen reproductive health law expertise from the National Center for Youth Law, pregnancy and parenting among foster youth data expertise from the Children's Data Network, and evidence- based intervention expertise. These helped clarify urgency and authority to act and, thereby, facilitated responsibility to act.

    These were especially critical during the formative stage to inform policy development and strategic planning, and to solidify local internal and external support. For example, these helped answer questions like...

    * What is the prevalence of pregnancy and parenting among youth and young adults in care compared to their peers not in care?

    * How do we compare with other counties?

    * What is the cost of doing nothing?

    * What is the cost of doing something?

    * What are contributing factors?

    * What are tried-and-true interventions?

    * What are the rights and responsibilities of youth, their parents, and child welfare services, and under what conditions do they exist? In California, we were supported by the passage in 2014 of Senate Bill 528, which clarified child welfare social worker responsibilities and authority to support healthy sexual development of youth and young adults in foster care.

  2. Keep current with up-to-date information

    Reading about diverse perspectives helps develop a deep understanding of how mistimed pregnancies affect the multigenerational life trajectory; learn about engagement and intervention innovations; and keep informed about new data to consider for course adjustments.

    See Appendix 1 for some of our favorite sources for additional reading.

  3. Get the full picture

    At the beginning, we were so singularly focused on reducing pregnancy and sexually transmitted infection that we confused this with our end goal.

    We then realized that pregnancy prevention was a breakthrough...

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