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What does it mean to raise a child while you're still growing up yourself?

Navigating pregnancy and potentially becoming a parent is a major life transition. For youth in or transitioning from foster care, it can mean navigating adolescence, adulthood, pregnancy, and parenthood all at once. This critical and often overlooked population has different needs than other youth in foster care and require specialized support.

Over the last 5 years, Child Welfare Information Gateway has developed a suite of products about expectant and parenting youth in foster care, including a bulletin for professionals, factsheet for families, State statute publication, and podcast episodes (85, 86, and 87). In the development of many of these products, Information Gateway partnered with young people from FosterClub who were either pregnant, expecting, or parenting during their time in foster care to learn from their experiences—what worked, what didn't, and what they wished professionals knew. The tips outlined in this article are informed by those insights.

Why Specialized Support Matters

Expectant and parenting youth have unique developmental and contextual needs. Youth continue to develop decision-making, problem-solving, and emotional regulation skills into adulthood. Additionally, expectant and parenting youth in care often face layered challenges, such as fewer placement options, limited social supports, histories of trauma, and heightened scrutiny as parents. While there are some programs and services available to support expectant and parenting youth in care, young people may not know about them or find them difficult to navigate. This is where an informed, unbiased adult (e.g., a caseworker, guardian ad litem, court appointed special advocate, relative, mentor, or community member) can make a big difference in a young person's life at a time when he or she needs it most.

Big Picture Best Practices

At the system level, there are practices and standards that agencies can operationalize so that professionals are prepared to support expectant and parenting youth. Just having policies in place can ensure youth are not overlooked or feeling as though they must fend for themselves. The following strategies can help improve systemwide support of expectant and parenting youth in care:

• Coordinate across systems. Aligning services across child welfare, health, education, early childhood, and other human services systems can make it easier for young people to access benefits and resources without feeling overwhelmed.
• Implement two-generation approaches. Two-generation support that bolsters young parents and prioritizes the safety and well-being of their children can interrupt cycles of poverty and maltreatment.
• Partner with lived experts. No one knows how well something works quite like someone who lived it firsthand. Partner with those who experienced pregnancy or parenting in foster care in shaping policy, research, and practice.
• Improve data use. When organizations collect and leverage data on expectant and parenting youth in foster care, they are better able to identify which policies, practices, programs, and services can improve youth well-being and outcomes.

Quick Tips for Those Working Directly With Youth

For those who work with young people, like caseworkers, consider incorporating the following practical tips:

• Take a strengths-based, youth-centered approach. Partner with youth as decision-makers and respect their autonomy and parenting decisions. Support informed choices rather than directing them.
• Strengthen support networks. Lasting relationships with consistent, caring relatives and other adults can ensure young people have support systems that last beyond their time in foster care.
• Engage young fathers and partners intentionally. Fathers are often overlooked by the child welfare system despite the positive impact they can have on their children's lives. When working with expectant and parenting youth, engage fathers and partners early and often, and treat them as equals who need the same support and resources.
• Connect youth to concrete supports. Know what resources are available so youth are not left to find support on their own.
• Prepare for the transition to adulthood. Comprehensive transition planning for young parents should begin early and address logistics such as housing, financial planning, prenatal and pediatric care, education, child care, and employment.

Professionals play a critical role in reducing barriers, building supportive systems, and empowering young families. Supporting expectant and parenting youth is not optional—it's a key strategy for improving outcomes across generations.

"One of the reasons why families continue to be system involved is because needs continue to not be met. Allowing people the tools to be self-sufficient and giving them the space to reach permanency and stability on their terms is important. . .If this cannot happen, then the cycle will repeat."—Lanitta, lived experience leader with FosterClub who experienced pregnancy and parenting in foster care

Understanding the available options, including adoption, is an important part of navigating a pregnancy. Between prenatal appointments and labor and delivery, it is very likely that the first conversation about available options occurs with a medical professional. However, these professionals may not feel knowledgeable about adoption or qualified to provide pregnancy options counseling. Recognizing this opportunity for cross-system collaboration, the National Council For Adoption (NCFA)—in partnership with Spaulding for Children, The Adoption and Foster Care Clinic, and the University of Washington School of Social Work—developed the Adoption Sensitive Clinical Care (ASCC) training program to help hospital staff talk to pregnant and parenting patients about adoption.

Program Overview

Funded by the Children's Bureau, the ASCC curriculum focuses on equipping hospital staff and medical professionals with the knowledge and skills needed to talk about adoption with expecting or new parents, including those who may be facing unintended pregnancies, considering adoption, or interested in learning about adoption processes. It is available online for free.

The training expands upon an existing curriculum called Understanding Infant Adoption (UIA) that has a foundation of more than 20 years. The ASCC project's rendition of the UIA curriculum, titled UIA 7, builds on existing research and workforce familiarity while updating it based on current needs. It also modernizes the curriculum, making it available online for users to take asynchronously in varying levels of depth, from a 1.5-hour course to a 6-hour course.

The research and development process for the new curriculum involved a multidisciplinary advisory committee that included physicians from multiple specialties, labor and delivery nurses, social workers, parents who have placed a child for adoption, people who experienced adoption, and adoptive parents. It was also informed by a needs assessment with input from medical professionals, families of origin, and adoptive parents.

At its core, the ASCC training equips healthcare staff with knowledge of the following topics:

• The adoption process and legal implications of adoption
• How to present adoption as an option in an objective, nonbiased way
• How to make adoption service referrals
• Common influences on expectant parent decision-making
• Adoption best practices in hospital settings

A key element is training hospital staff to speak about adoption in a noncoercive, nondirective manner.

"Even if healthcare providers do have knowledge about adoption, some may go in with a preconceived notion, either for or against adoption," Ali Richards, grant program manager with NCFA, said. "The ASCC training encourages participants to recognize that and check any opinions or biases at the door, saying, 'How can I best serve my patient, whether she chooses parenting or adoption? If she wishes to consider adoption, how can I provide her with the information, supports, and referrals she needs to make a fully informed, autonomous decision?'"

Cross-System Collaboration in Action

The program exemplifies a key best practice in child welfare: cross-system collaboration. This practice is built on shared knowledge and support. Siloed service delivery from various sources—such as child welfare agencies, health-care providers, courts, basic needs programs, and others—can lead to inefficiencies, a lack of targeted support, and confusion. In action, cross-system collaboration doesn't mean all human services professionals are experts in all sectors; rather, it means they are aware of how their work interacts with other sectors and able to identify opportunities for collaboration and referral.

In the ASCC project specifically, the goal is not for health-care professionals to become adoption experts. Instead, the goal is to teach health-care professionals about adoption and help them deliver that information to their patients in a supportive, unbiased manner. The result is a major return on investment: health professionals invest a small amount of time in training, which leads to increased knowledge and skills, which results in improved experiences and outcomes for the individuals receiving services.

There are many situations where it's helpful for hospital staff to have a general understanding of adoption and child welfare. One of those key moments is during and after labor and delivery.

"We've learned a lot about how important that time in the hospital is, and how much influence a health-care professional can have on the experience for an expectant mom," said Dr. Jennifer Chambers, a member of the ASCC project team and medical director and pediatrician with The Adoption and Foster Care Clinic. "A health-care provider really can make or break an expectant mom's experience, even though that interaction is possibly just 2 days out of her life. It's very crucial to not make her feel judged, to help her see all of her options, and to make her feel fully supported. That experience can sit with her for the rest of her life."

The program encourages hospitals to establish policies and procedures for situations in which adoption enters the discussion. Chambers said that when the team was developing the ASCC training, they found that many hospitals do not have existing adoption policies and procedures in place. She also witnessed this administrative barrier during her time working in a hospital-based women and infants center.

"Every time a mother came in who wasn't sure that she was going to be able to parent or she mentioned, 'I'm not sure if I can do this,' then chaos ensued," Chambers said, "health-care providers didn't know how to talk to her, what language to use. Nobody knew who had the authority to make consents for the baby or who to contact if the hospital social worker was not readily available."

Having established policies and procedures for these situations takes out the guesswork and is vital for the prevention of child welfare involvement, including unnecessary child protective services (CPS) reports. As mandated reporters for suspected incidents of child maltreatment, hospital staff who are not trained in adoption competency may make a CPS report in a situation that could otherwise be addressed through another pathway, such as connecting a patient with an adoption agency or other resources.

The training may also support hospital staff in working with youth in foster care. Expectant and parenting youth in foster care may face barriers in a hospital setting related to consents, support, or their newborn's child welfare status. (Hint: just because the parent is in foster care does not mean the newborn is also in State custody). Cross-system collaboration through programs like the ASCC training can prepare hospital staff to better support this unique population with specific needs.

For More Information

For more information about the program and curriculum, visit the ASCC website. There is a breadth of resources beyond the training itself, including the following:

• "Train-the-trainer" sessions to prepare qualified individuals to conduct the UIA 7 training at local hospitals
• Technical assistance to help health-care providers integrate the online curriculum into their systems
• State adoption guides to help hospital staff understand adoption laws and policies where they live and work
• Supplemental training modules to help health-care providers in specific situations, such as working with adolescent patients and patients with complex circumstances
• Free continuing education units for licensed social workers and continuing medical education credits for physicians, nurses, physician assistants, and health-care teams

Pregnancy and early parenthood can be one of the most vulnerable times of a person's life. Programs like the ASCC training help ensure that individuals navigating those times receive the specialized care they need.