Births to Adolescent Girls Involved in the Child Welfare System: Differences Associated with Remaining at Home Vs. Entering Foster Care
Research has consistently documented an association between giving birth as an adolescent and a history of childhood maltreatment. Studies have also found higher rates of childbirth among teens who have been in foster care compared to teens in the general population. Few studies have examined this phenomenon among all girls receiving child welfare services or disentangled the relationship between maltreatment, out-of-home placement, and adolescent childbirth. This study seeks to answer the following questions: Among girls who are maltreated and receive child welfare services, is placement in out-of-home care associated with a higher likelihood of giving birth as an adolescent? Does the likelihood vary by the timing, type, and frequency of maltreatment?
METHODS:
This analysis is based on a unique dataset constructed by probabilistically matching California child protection records for all adolescent girls with substantiated allegations of maltreatment to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among the population of adolescent girls who received child welfare services were generated and differences were assessed using chi-square test statistics. Generalized linear models were specified to assess the likelihood of childbearing depending on whether or not there was an entry into foster care and adjusting for demographic characteristics and maltreatment-related experiences. Findings are reported as both crude and adjusted measures of relative risk (RR) with corresponding 95% confidence intervals.
RESULTS:
Of the 81,078 adolescent girls who had substantiated allegations of maltreatment in California between 1999 and 2010, just over 18% subsequently gave birth. Among girls who entered foster care, the proportion was higher (22%) than among those who remained at home (17%). Significant variations (p<.001) were observed in the rate of childbirth across demographic characteristics and maltreatment-related experiences. On a crude basis, entry into foster care was associated with a moderately higher likelihood of a first birth (RR: 1.25; 95% CI: 1.21-1.29), but in the adjusted model, even this small effect was substantially reduced (RR: 1.05; 95% CI: 1.02-1.09). When simultaneously modeling for all covariates, race/ethnicity (Latina), age at first substantiated allegation (early adolescence), recurrence of maltreatment, and maltreatment type (sexual and physical abuse) emerged as more prominent explanatory factors for giving birth as an adolescent than foster care placement.
CONCLUSIONS AND IMPLICATIONS:
In this study, foster care placement is associated with only a slight increase in the likelihood of early parenting. This suggests that higher rates of childbirth among adolescents that have been in foster care may be driven more by the circumstances that brought them into care rather than foster care itself. The high rate of childbirth among adolescents substantiated for maltreatment (1 in 5) warrants increased efforts to promote reproductive health and prevent unintended pregnancy for this population. Such interventions should be targeted to those girls who have experienced severe and repeated episodes of maltreatment and focus on mitigating the impact of these events.