“My Body Is Strong and Amazing:” an Interpretative Phenomenological Analysis of Embodied Experiences of Pregnancy and Birth Among Foster Youth

Background. Staggeringly high rates of teenage pregnancy among U.S. foster youth have prompted great concern. Previous studies suggest there is immense meaning in becoming a mother to young women in foster care, offering a source of unconditional love and anticipated stability. The current study employed an innovative phenomenological method and adds to the growing body of literature on teenage pregnancy and parenting among foster youth by specifically examining experiences of pregnancy and birth itself among young women who became pregnant as teenagers while living in foster care.

Method. Eighteen phenomenological interviews were collected from 6 young women (interviewed three times each) in or transitioning from foster care who gave birth at least once while in care. In-depth, community-based interviews explored how these young women experienced their pregnancy (or pregnancies) while in foster care, including their relational context prior to and during pregnancy, health system access, and health outcomes. Women in the study were 19-22 years old, were majority African American, and had between 1-3 children. Half of the women in the study had experienced an abortion at some point during adolescence. Interpretative phenomenological analysis (IPA) proceeded through six steps, including in-depth, case-based analysis followed by examining patterns of convergence and divergence across cases.

Results. Study findings suggest the meaning and experience of pregnancy among foster youth is inextricably and dialectically tied up with immense personal pain and personal renewal. All of participants’ pregnancies were unintended, which created a great deal of initial heartache, sometimes leading to an abortion. Although all of the pregnancies resulting in a live birth had been initially unintended, they were all spoken of as intentionally continued, and none of the women had considered formal adoption. The young women described their pregnancy and birth as an empowering experience, reflecting on their bodies as sources of strength, which was especially meaningful having experienced disempowerment and oppression of their bodies due to child maltreatment. Navigating the complexities of their sexual relationships was typically described as a lonely experience for these foster youth, who largely felt separated from their families and communities of origin due to being in foster care.

Implications. This study reveals critical information about the embodied experience of pregnancy and birth among foster youth. Young women in care need youth development opportunities to experience their bodies as “strong and amazing” prior to pregnancy and birth. They further require trauma-informed sexual health education and services in order to address pregnancy intentionality, family planning, and pregnancy and birth in the wake of experiences of child maltreatment. Young women in care also need trusted adults and peers to help them with their romantic relationships and their sexual health more broadly in the context of having experienced child abuse and neglect, separation from their families of origin and foster care, and, relatedly, immense experiences of absence and loss that may create risk for early sex and pregnancy. Studies on experiences of a partner’s pregnancy and birth from the perspective of male foster youth would be particularly helpful in the future.