Adolescent health brief Extended Foster Care for Transition-Age Youth: An Opportunity for Pregnancy Prevention and Parenting Support Emily Putnam-Hornstein, Ph.D. a, b, * , Ivy Hammond, M.S.W. a , Andrea Lane Eastman, M.A. a , Jacquelyn McCroskey, D.S.W. a , and Daniel Webster, Ph.D. b a School of Social Work, University of Southern California, Los Angeles, California b School of Social Welfare, University of California at Berkeley Article history: Received June 30, 2015; Accepted November 27, 2015 Keywords: Child welfare; Teen births; Adolescent mothers; Transition-age youth; Extended foster care; Pregnancy prevention; Parenting A B S T R A C T Purpose: This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal legislation extending foster care beyond age 18 years. Methods: Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N ¼ 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ ethnicity. Results: One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years. Conclusions: Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support. Ó 2016 Society for Adolescent Health and Medicine. All rights reserved. IMPLICATIONS AND CONTRIBUTION A growing number of states are coordinating transitional services for foster youths beyond age 18 years. Linked data indicate that in addition to adolescents already parenting, a significant share will have a first birth between 18 and 21 years. Extended foster care pro- vides an opportunity for targeted pregnancy pre- vention and parenting supports. During the last 25 years, teen birth rates in the United States have steadily declined. Still, in 2013, roughly one in 14 children was born to adolescent mothers [1]. Research has indicated that girls in foster care have heightened rates of early sexual debut, pregnancy, and childbirth during their teens and into young adulthood [2,3]. Yet, most jurisdictions have limited data to document and track cross-sectional or cumulative birth rates for these adolescents. Information on births is increasingly relevant given that California and at least 21 other states have adopted policies that extend foster care services beyond age 18 years [4]. In addition to supports intended to improve outcomes in the areas of health, housing, education, and employment, this tran- sitional period also provides an opportunity to engage youth who are among the most vulnerable next generation of parents. Extended foster care may serve as a vehicle for health care sys- tems and community programs to deliver targeted pregnancy prevention and parenting supports to high-risk youth during a period in which many become first-time parents. In a 2014 analysis from California, researchers used linked child protection and birth records to document that 11.4% of adolescent girls in foster care had given birth at least once before age 18 years and 28.1% had given birth as a teen (before age 20 years) [5]. The current brief builds on this earlier study by Conflicts of Interest: There are no potential conflicts of interest on the part of any authors, real or perceived. * Address correspondence to: Emily Putnam-Hornstein, Ph.D., University of Southern California,1150 South Olive Street, Suite 1400, Los Angeles, CA 90015. E-mail address: ehornste@usc.edu (E. Putnam-Hornstein). www.jahonline.org 1054-139X/Ó 2016 Society for Adolescent Health and Medicine. All rights reserved. http://dx.doi.org/10.1016/j.jadohealth.2015.11.015 Journal of Adolescent Health 58 (2016) 485e487