Teenagers in the child welfare system have sex two years younger on average than other young people and are 2.5 times more likely to get pregnant.
New research from the University of Colorado points toward why: About two-thirds of eighth and ninth graders in metro Denver who have been involved with the child welfare system say they have never received information about birth control.
The teens interviewed were mostly 13 and 14 — not far off from 15, the average age that foster youth report first having sex.
Teens with an open child welfare case, whether placed in foster care or still living at home, have experienced many of the adversities that lead to risky behaviors, said the study’s lead author, Katie Massey Combs, with CU’s Center for the Study and Prevention of Violence.
Child abuse, neglect, domestic violence, community violence, incarcerated parents and other childhood traumas are all linked to risky behavior, including regarding sex, Combs said. On top of that, young people in the child welfare system are often missing out on opportunities available to other kids — possibly even sex education, she said.
“They are constantly missing opportunities that typical kids would get,” said Combs, who previously worked as a case manager for homeless teens. “They miss school a lot. They might miss that one day or one week where there was a conversation about sex education. They miss relationships with trusted adults, whether it’s the coach or the aunt or mom and dad. They miss a lot of opportunities to learn about sex in positive ways.”
Combs and fellow researchers interviewed 245 eighth and ninth graders in four metro Denver counties, asking students whether anyone had told them about birth control and whether they were concerned about becoming pregnant.
About 65% of teens interviewed said they had never received information about birth control or family planning. Almost half, however, said they knew how to get birth control if they needed it.
Most of the teens interviewed were confident they could avoid sex if they wanted to, and half said there was a high chance of pregnancy with unprotected sex. Nearly 40% said there was a high chance of contracting a sexually transmitted disease.
Girls were more likely than boys to have received information about birth control. And boys were less concerned than girls about the risks of unprotected sex.
The state child welfare division does not track how many young people in Colorado become pregnant while in foster care, spokeswoman Madlynn Ruble said. And there is no requirement under state law or Colorado Department of Human Services rules for kids in the system to learn about birth control, she said.
Data collection is a challenge across the country, Combs said. It’s one reason there are few studies about why young people in foster care get pregnant and how it affects them and their children.
“This is, nationwide, a problem. We have no way of counting this,” she said. When Combs worked as a case manager, she said, about half of her young clients had children of their own.
But through a handful of projects, including California research that links birth records to child welfare records, researchers know the pregnancy rate is 2.5 times higher for teens in the system. About half of young women in the U.S. child welfare system are pregnant by age 19.
Teenagers, on average, report first having sex at age 17, compared with age 15 for those in foster care. Foster youth also report having more sexual partners and more sexually transmitted diseases.
One big takeaway from the CU study, Combs said, is that the state’s efforts to increase access to birth control and sex education are not reaching everyone.
In 2017, Colorado became the third state in the nation to allow women to get prescriptions for birth control pills at a pharmacy instead of only from a doctor. The so-called morning-after pill has been available over the counter at pharmacies in the state since 2013, and state and federal funds provide free and low cost IUDs — intrauterine devices that prevent pregnancy for five years or more — at community health clinics.
The efforts have reduced abortion rates, and a previous CU study found that high school graduation rates for teenage girls in Colorado have increased alongside access to contraception.
“The return on investment is really high,” Combs said. “But we still have these groups that are really marginalized. If they don’t know these programs and services are available to them, it might as well not be available.”
The study was published this month in the journal Children and Youth Services Review.