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Teen Parenting by Previously Maltreated Youth: An Important New Study of California’s Most Vulnerable Parents

By Jennifer Friedman

5ed4604f97This is the latest in a series of articles looking at reproductive health among youth in foster care. 

In November 2013, the Conrad N. Hilton Foundation released a new study on teen pregnancy among foster youth entitled, “California’s Most Vulnerable Parents: When Maltreated Children Have Children.”i The study, led by Professor Emily Putnam-Hornstein of USC, linked approximately 1.5 million birth records from Los Angeles County to one million Child Protective Services records, allowing the team to cull out not only teen birth information but information about teen parents who have been touched by the child welfare system. A second phase of research focused on the risk that children born to teen mothers would be involved with child welfare. This new research is particularly important as to date, most attempting to understand teen pregnancy among youth in foster care have had to look to the Midwest Evaluation of the Adult Functioning of Former Foster Youth for data.2 There simply were no other large-scale studies available regarding teen pregnancy among foster youth. What follows are a few key highlights from the new study.

1. Cumulative Teen Birth Rates Among Girls in Foster Care at Age 17

A previously unanswered threshold question had been what the rate of teen births among California youth in foster care was. Dr. Putnam-Hornstein and her team concluded that more than 1 in 4 girls who were in foster care at age 17 had given birth at least once before age 20.3 The study also broke down the numbers to identify birth rates according to the reasons for the teen parents’ most recent removal. The birth rates for youth removed for neglect were higher (12.5%) than those removed for physical abuse (9.7%).

2. Birth Rate Trends Among Girls in Foster Care

The researchers looked at birth rates for 15- to 17-year-olds in Los Angeles between 2006 and 2010. The study revealed that girls in foster care gave birth at a rate of 3.5 per 100, a rate more than 50 percent higher than that of adolescent girls in the general population, 2.2 per 100.4 Notably, the data revealed higher birth rates among those girls in foster care for shorter periods of time: the birth rate of those in care for less than 12 months was more than twice the rate for those in care for 60 months or more.5 The placement stability was associated with a lower rate of childbirth among youth in foster care.6

3. Maltreatment History Among Adolescent Mothers

The study documented the prevalence of prior Child Protective Services involvement among adolescents who give birth. After looking at records of 10, 350 adolescent mothers, the researchers found that 41% had been previously reported for alleged maltreatment during the prior decade, and nearly 20% had been substantiated as victims of maltreatment.8

4. Intergenerational Child Protective Service Involvement

Until the publication of this study, there had been no data presenting the rates of abuse or neglect across generations. By linking birth and child protective service records, the researchers discovered that, after adjusting for other risks, a maternal history of maltreatment emerged as the strongest predictor of offspring maltreatment by age 5.9 The study examined records for 24,767 infants born to teen mothers in Los Angeles in 2006 and 2007. The rates of children reported to CPS for maltreatment who were born to mothers with a history of unsubstantiated or substantiated report of maltreatment were 30.7% and 39.8% respectively. In contrast, among teen mothers who had not been reported as possible victims of maltreatment, 15.8% of their children were reported for maltreatment by age 5.

5. Infant Birth Weight and Maltreatment of Adolescent Mothers

The link between teen pregnancy and low birth weights of the babies born to teen mothers has been noted.10 However, the California study is the first to link population-based birth data to official child protection records to examine the effect of maternal maltreatment on infant birth weight.11 The study considered maternal maltreatment as an independent predictor of low birth weight among babies born to teenage mothers. Maternal maltreatment history was associated with a 10% increased risk of low birth weight.12 The researchers noted several limitations on this study, such as other risk factors including prenatal drug or alcohol exposure, as well as the lack of data regarding mothers who experienced maltreatment before age 10.13 Yet setting aside these limitations, the study suggests a startling link between maltreatment and intergenerational health disparities.

The California research study offers a wealth of new data highlighting the teen births among youth involved with the child protection system. The full report can be downloaded at

  1. Putnam-Hornstein, Cederbaum, King and Needell, California’s Most Vulnerable Parents: When Maltreated Children have Children (2013), available at
  2. See Mark Courtney, et al., Midwest Evaluation of the Adult Functioning of Former Foster Youth: Outcomes at Age 21 (Chapin Hall Center for Children, University of Chicago) December 2007 (a 2006 study of youth in Illinois, Iowa and Wisconsin transitioning out of foster care and into adulthood).
  3. Emily Putnam-Hornstein, et al., California’s Most Vulnerable Parents: Cumulative Teen Birth Rates Among Girls in Foster Care at Age 17, vol. 1-2 at 3.
  4. Emily Putnam-Hornstein, et al., California’s Most Vulnerable Parents: A Cross-Sectional Study of Birth Rate Trends among Girls in Foster Care, vol 1-4 at 3.
  5. Id.
  6. Id.
  7. Emily Putnam-Hornstein, et al., California’s Most Vulnerable Parents: A Population-Based Examination of Maltreatment History among Adolescent Mothers, vol. 1-1 at 2
  8. Emily Putnam-Hornstein, et al., California’s Most Vulnerable Parents: Adolescent Mothers & Intergenerational Child Protective Service Involvement, vol 1-3 at 1.
  9. Id. at 4.
  10. See e.g., Fact Sheet: Adolescent Pregnancy (World Health Organization) May 2012; Why it Matters: Teen Pregnancy and Other Health Issues (The National Campaign to Prevent Teen Pregnancy, Washington D.C.) available at;
  11. Emily Putnam-Hornstein, et al., California’s Most Vulnerable Parents: Infant Birth Weight and Maltreatment of Adolescent Mothers, vol 1-5 at 1.
  12. Id. at 3.
  13. Id. at 4.