Improving Pregnancy and Parenting Outcomes for Young Mothers with History of Child Welfare Involvement

Stoneleigh Fellow: Meredith Matone, 2014-2019

While the national teen birth rate has declined to historic lows in recent years (around 11 percent of all girls give birth before age 20), nearly half of girls involved in the child welfare system become pregnant by age 19.  While adolescent childbearing itself is associated with numerous adverse outcomes for mothers and children, child welfare–involved mothers face a unique set of challenges that further complicates teen parenthood.

Research suggests that children who have been victims of maltreatment may be at higher risk of becoming perpetrators of maltreatment when they become parents.  While past studies have examined the link between social factors and maltreatment perpetration in this population, little is known about how the health of young mothers and their newborn children may be related to maltreatment perpetration. 

However, available research suggests this link is worthy of further exploration.  Youth involved in the child welfare system are more likely to be in poor physical health—dealing with chronic conditions like anemia, obesity, diabetes and asthma—as well as struggle with mental health issues like attentional disorders and depression.  While past studies have not specifically examined the health status of these youth once they enter motherhood, it is likely that they suffer from ongoing health problems similar to those seen in the general child welfare–involved population.  When mothers are in poor health, it becomes more likely their children will have adverse birth outcomes—such as low birth weight, preterm delivery, and congenital anomalies—that put them at a significantly higher risk for maltreatment.

Existing family-focused home visiting services to expectant and new parents represent a promising way of reaching this population.  However, there is little policy and practice guidance in place to standardize the delivery of much needed services.  Furthermore, teen parents in the child welfare system need help accessing health services and coping and parenting skills that could ensure healthy growth and development for them and their children.   While the Philadelphia Department of Human Services (DHS) collects data on the number of pregnant and parenting youth in the child welfare system, it could benefit from a clearer understanding of the health and parenting profiles of these youth to effectively develop policies and practices that will serve them and avert the perpetuation of neglect and maltreatment.

To address these interrelated issues, Meredith Matone is leading a five-year Philadelphia-based research study examining the health status of child-welfare–involved mothers and their children.  With her institutional partner, PolicyLab, Meredith will assess the effectiveness of state-funded home visiting programs for this target population and ultimately advance new policies and practices to improve well-being of young mothers and their children.  

The specific goals of the project are to:

1.)    Understand the association between maternal health, birth outcomes and maltreatment perpetration in this population.

Meredith is undertaking a five-year research study of 10,000 Philadelphia mothers, between the ages of 15 and 24 with chronic health conditions and current or past child welfare involvement to: describe the prevalence of chronic physical and behavioral health conditions; determine the association of maternal chronic health conditions with birth outcomes; examine injury and maltreatment of offspring in the first 24 months; and characterize the perceived service needs across health and parenting domains.

2.)    Understand the effectiveness of the various interventions aimed at preventing intergenerational maltreatment in this population.

Meredith’s institutional partner, PolicyLab, is working with Pennsylvania’s Office of Child Development and Early Learning (OCDEL) to evaluate the effectiveness of home visiting programs across the state.  Working with her colleagues at PolicyLab, she is extending this to include an assessment of the effectiveness of these programs specifically for this target population and to determine the capacity of these services to connect these young mothers to other community-based services they need.

3.)    Work with system partners to integrate research findings into policy and practice reforms.

This research will inform and enhance health and social service policy and practice to improve well-being outcomes for child welfare–involved teen mothers and their children.  Specifically, Meredith is working closely with DHS and the Philadelphia Department Public Health to identify opportunities to adapt current child welfare policies and practices supporting young adults and to implement new policies and practices aligned with the needs of this population and strengths and resources of these agencies.