National Center for Youth Law


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Carla’s Story

6e9076abacThe National Center for Youth Law has launched a project looking at the reproductive health of youth in foster care. Previous articles in this series have presented data showing a higher rate of pregnancy among youth in foster care, presented some of the myriad factors that might explain this disparity, and looked at the availability of reproductive health care for youth in care. While future articles in this series will continue to explore the legislative and policy issues surrounding the delivery of reproductive health care services for youth in foster care, this article provides a glimpse into the life of one young woman who became pregnant while in foster care.

Carla1, now 25, lived with her mother and father until she was eight, when her parents divorced. Her mother had been the children’s protector against their abusive father, but her mother became abusive after the divorce. Her mother was diagnosed with breast cancer the year of the divorce and struggled financially as a single parent.

Carla first entered the child welfare system through the juvenile justice system. She was arrested trying to steal two packs of bacon and a carton of eggs. When the police called Carla’s home after the arrest, no one answered. Carla was transferred to the child welfare system and assigned to a group home for six months. She did “everything [she] was supposed to” because she wanted to go home. After six months, Carla went back to court with the hope of returning home, but her mother did not show up for court. Carla was returned to juvenile hall for another six months. She realized then that she would not be able to return home. At that point, Carla says she “stopped caring” about following the rules, believing her actions “didn’t really matter.” Carla left the group home and moved in with her boyfriend.

Carla does not remember speaking about reproductive health to any of the adults in her orbit during her adolescence in foster care. When she first began menstruating, she thought she was dying. In her first sexual experience, she “didn’t know what was happening.” Carla reports having felt “liked” by her boyfriend and doing what he told her to do. When Carla became pregnant at 16, her boyfriend knew where to take her for an abortion. The decision to abort, she says, was largely his decision. Without any other support in place or anywhere else to live, Carla had an abortion.

Two years later, Carla was living in transitional housing, working two retail jobs simultaneously, and attending life skills classes in preparation for the transition out of foster care. She then learned about The Alliance for Children’s Rights, an organization dedicated to protecting the rights of underserved children.2 Carla enrolled in the mentor program through the Alliance.

Around that time, Carla got into a fistfight and went to the hospital for treatment. The doctors called for a CT Scan, but insisted on doing a pregnancy test in advance. To her surprise, the tests revealed that she was almost four months pregnant. Carla took steps to get an abortion but then decided that the pregnancy was too far along. Carla says that she and the father thought, “Why don’t we just keep it?”

As part of NCYL’s on-going project looking at reproductive health among youth in foster care, NCYL would like to hear about your experience and perspective on reproductive health, including pregnancy and parenting, among youth in foster care. For further information or to share your story, please e-mail rgudeman(at)

Carla’s social worker at the Alliance learned of the pregnancy and brought Carla into her office to discuss the pregnancy and connect her to appropriate services. The social worker referred Carla to the Nurse Family Partnership (NFP) Program, in which registered nurses guide low-income, first-time mothers through pregnancy and the first two years of the baby’s life.3 (See sidebar for more information about the NFP Program.) The nurses discuss with the mothers a range of prenatal health issues including nutrition and smoking cessation, and continue with post-partum and baby care.4

According to Carla, her relationship with the NFP nurse started off with some difficulty; the nurse threw away all of Carla’s instant soups and cans of soda. But then, Carla recalls, she realized that the nurse “knew everything” and was “desperate to have my baby live.” With the help of the NFP nurse, Carla created a home for the baby.

The NFP nurse also encouraged Carla to resume her education. Carla decided to go to college and started school six months later. At enrollment, Carla tested at the third-grade level in math skills. She enrolled in summer school and winter school, as well as tutoring. She took many math classes, in some cases repeating a class; she took statistics three times. Years later, and after a great deal of hard work, Carla is now pursuing a graduate degree in social work with the hope of helping underserved youth.

Carla’s story presents the experience of a young woman in foster care growing up without sex education or support for her reproductive health, until she connected with the Alliance for Children’s Rights and the NFP Program. Carla attributes much of her success to the long-term support she has received from the Alliance. “I had the will,” she says, “but [The Alliance] gave me everything else.” The web of support has led her to feel that she “was never alone during any critical time” since she first joined the mentorship program. These bonds, coupled with Carla’s determination and maternal love, helped change the direction of her life and the life of her baby.

The Nurse Family Partnership Program

In many ways, Carla’s circumstances at the time of her pregnancy were similar to those of many NFP mothers. According to 2011 entry rates, the median age of mothers participating in the NFP Program was 19, 44% of the mothers had completed high school, 85% of the mothers were unmarried, and the average household income was $16,000.

The significant, positive effect of the NFP nurse on Carla’s life and the well-being of her baby is also common to the program. The New York Times has described the NFP program as “one of the rare public initiatives that have shown consistent and rigorously tested benefits for the mothers and children, as well as significant savings for taxpayers.” Evidence shows that mothers participating in the NFP program:

have had fewer premature deliveries, smoked less during pregnancy, spent less time on public assistance, waited longer to have subsequent children, had fewer arrests and convictions, and maintained longer contact with their baby’s fathers. Their children have had fewer language delays and reported less abuse and neglect, slightly higher I.Q. scores, fewer arrests and convictions by age 19, and less depression and anxiety.

Jennifer Friedman is an attorney working with Rebecca Gudeman at the National Center for Youth Law on issues of reproductive health care for foster youth.

1This is not her real name. In conversations with the author, this individual has asked to remain anonymous.


3The Nurse Family Partnership program is a nationwide program designed to help first-time mothers during their pregnancy and the first two years of the child’s life. See