In the United States today, teens in foster care give birth at twice the rate of teens in traditional homes. Whether they enter foster care already pregnant—many are kicked out of their homes—or conceive while they are in the system, teenage mothers in foster care face distinct challenges. Because the foster care system was designed to protect children from abuse and neglect but not to raise them, the kinds of services required by teens who are pregnant or new mothers are not readily available.
Historically, girls who became pregnant would be moved to a congregate care facility, in which groups of girls who are pregnant or new mothers live together in housing designed to meet their specific needs, a model that many viewed as a warehousing approach. Some specially trained families offer mother-baby foster homes, but those are limited in number. For many, the biggest concern is intergenerational foster care, meaning that their infants might end up in the system themselves.
Best Approaches for Congregate Care
Lisa Lieberman, Ph.D., and her coauthors examined best approaches to the provision of services for teens and their babies in two articles—"Pregnant Teens in Foster Care," in the June 2014 issue of Journal of Public Child Welfare, and “Family Preservation and Healthy Outcomes for Pregnant and Parenting Teens in Foster Care,” in the January 2015 issue of Journal of Family Social Work. Dr. Lieberman, associate professor of public health at Montclair State University and research consultant to New York City’s Inwood House, says that the studies were meant to compare Inwood House’s "theory of change" to an unrelated congregate care site in New York City. However, the authors found that girls at both locations fared better over time than those who weren’t in congregate care settings.
Inwood House was founded in 1830 to help young New Yorkers find a way out of poverty and, in particular, prostitution. Today it continues to serve teens at multiple facilities in New York City and Atlantic County, New Jersey, with a specific focus on teen pregnancy prevention and family services for teens who are in foster care, experiencing homelessness, or adjudicated. Inwood House offers blended facilities, in which girls who have given birth return to live at least temporarily with their infants, staying until they are emancipated or other arrangements are made for them. In the meantime, they take full advantage of educational support and services, medical care, parenting classes, and childcare. They also serve as role models and informal peer mentors for the pregnant residents.
Interventions and Services
The Inwood House "theory of change" provides a nonjudgmental approach through interventions and services that focus on financial stability; encouraging relationships with fathers, biological parents, and other young mothers; mental health services and counseling; information about birth control and reproductive health; and parenting skills.
The study was not designed to advocate for congregate care, says Dr. Lieberman, although that was a useful byproduct. Instead, the goal was to demonstrate that “facilities like Inwood House that really thought long and hard, theoretically and practically, about what young people needed to have better outcomes—not just to keep them safe and off the streets, but in fact to be able to grow healthy and strong—was an extensive set of services,” says Dr. Lieberman. “The ability to provide those in the congregate care facility existed in some ways more readily than catch-as-catch-can services someone might receive if they live with a family,” she adds. “In a facility like [Inwood House], there is a set of services that has the potential to make them more successful as parents.”
That may include both parents—some Inwood House programs involve fathers, with or without the mothers. There are other factors involved in the model. For example, young women and their children who have lived in congregate care facilities have higher rates of immunizations, receive better medical care overall, and learn better job skills. They also have better access to mental health services—essential given that so many come to Inwood House after having suffered a high degree of trauma.
“Whether they’re in foster care or they’re homeless for other reasons, the challenges that they face are not just about their home, particularly if they become parents,” says Dr. Lieberman. “They don’t typically have strong models of good parenting, and many of them come into foster care having been traumatized in some way.” The real goal of programs like those at Inwood House is to create healthy young families, she says, whatever form that may take, and to help the young parents embrace their new life circumstances.
“Can you take young mothers and young fathers and enable them to have the resources, the skills, the education, and the jobs to be good parents?” asks Dr. Lieberman, noting that there isn’t much longitudinal data on outcomes, nor a data system to track pregnancy in foster care or among youth who experience homelessness. She’s currently in the middle of another study, this one following 20 girls over the course of 2 years, up through their child’s second birthday, to chronicle their outcomes beyond foster care.
This article was originally published to highlight the March 2015 theme of Youth Homelessness.
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