High Risk, Low Priority: The needs of teen parents in foster homes are often unmet.

When Mayra Pacheco became pregnant at 16, she knew she didn't want to have her baby in the foster home in Queens where she and her younger brother lived because she didn't get along with her foster mother. But she didn't know much else about what lay ahead. "There were times I was very doubtful that I was actually pregnant," she says. "Like it was a dream."

Just before she gave birth, Pacheco moved in with a foster mother who owned a brownstone in Bedford-Stuyvesant, Brooklyn. Pacheco had two rooms, a bathroom and even a tiny kitchen for herself, her brother and her soon-to-arrive baby. What she didn't have was much guidance.

Arriving home from the hospital with her newborn daughter, Pacheco was terrified. An official at the hospital told her a nurse would stay with her the first two days to help out, but nobody came. "It was crazy," Pacheco, now 21, recalls. "It was very scary. I was so young. And I don't have any family members here. No mom, aunts or uncles, cousins."

Pacheco had found prenatal care for herself at a nearby hospital and took a birthing class there with her boyfriend. But she says her agency never referred her to parenting classes or groups where she could meet other teen moms. Her foster mother wasn't around much and did not offer any advice on how to care for a newborn.

Pacheco wishes someone had stepped forward to help. "After the baby was born, I felt very alone, very lonely, and just not sure if I was doing everything the right way," she remembers. She didn't understand why her baby was constantly crying, only later realizing that her daughter had probably needed to be fed more often.

As a group, teen mothers face many of the same daunting odds as teenagers in foster care. Research has shown that both groups are more likely than their peers to live in poverty and drop out of high school. And a study by the Robin Hood Foundation found that children of teen parents are twice as likely to be abused or neglected. Yet in New York City, pregnant and parenting teens are a group that has been largely overlooked by the foster care system.

Many teen moms in foster care are overwhelmed by the responsibility of caring for a newborn, like the 14-year-old mother of baby Daniella, the infant who made the news in February after a cabbie brought her to a firehouse in a desperate abandonment scheme.

The city's Administration for Children's Services (ACS) does not provide the privately-run foster care agencies it oversees with guidelines defining the services they must provide to pregnant and parenting teens. Nor does it keep track of how many teens in the system are pregnant or parenting, despite calls to do so, including a 1995 report by the Youth Advocacy Center and a 2005 report by the city public advocate's office.

Experts say this dearth of data makes it difficult to assess whether young mothers and their children are receiving appropriate care. "We all are clear on how high-risk this population is," says Linda Lausell Bryant, executive director of Inwood House, the only city nonprofit that exclusively serves pregnant and parenting teens. "But we're really uneven in terms of a systemic response."

"Foster parents must also negotiate the particularly tricky role of caring for a teen who's in the foster care system and a baby who is not.,

There are far more pregnant and parenting teens in the foster care system than there are available slots in programs specifically intended for them. The 2005 public advocate's survey estimated there to be 437 pregnant and parenting teens in the system, and ACS itself offers a similar rough estimate. But there are only about 42 beds for pregnant teens in the city's maternity shelters and 157 beds for teen moms in residences created for mothers and their children.

This means most pregnant and parenting teens in foster care live in foster homes, a policy in keeping with the city's efforts to keep as many young people in family settings as possible. Indeed, ACS has been referring fewer and fewer pregnant teens to maternity shelters. Last year, The New York Foundling reduced the size of its maternity shelter, one of only three in the city, from 22 beds to eight.

"Many of the kids that ACS used to put in maternity shelters they're now putting in family settings with support services," says Sister Ellen Hunt, the assistant director of Rosalie Hall, a maternity shelter in the Bronx, who has worked with teen moms for two decades. "Which is okay, if it works."

For young mothers to successfully live with families, Hunt says, foster homes have to offer support and close supervision. Yet there are no citywide standards for how foster parents should be trained to help young mothers, and ACS does not systematically measure whether or not pregnant teens are getting the basics, such as prenatal care and parenting skills. The agency does conduct periodic random reviews to determine whether foster children, pregnant or not, are receiving appropriate medical care. ACS also encourages agencies to refer pregnant teens to the Nurse-Family Partnership, which provides intensive in-home support to new moms for two years.*

In residences for pregnant and parenting young women, trained staff help teens find jobs and stay in school, an important goal, experts say, as one study found that an astonishing 70 percent of teen moms do not finish high school. They also help pregnant and parenting young women learn how to breast feed, bond with their babies and generally take on the responsibility of being a parent. At Inwood House, pregnant teens have "baby simulators" to care for, dolls that cry until their "mothers" take the appropriate steps to soothe them.

But for teens in foster homes, supervision and assistance falls to the foster parents, who must also negotiate the particularly tricky role of caring for a teen who's in the foster care system and a baby who is not.

"Some foster parents take over and try to parent the baby themselves," says Miranda Seaton, a caseworker at Good Shepherd Services. This can prevent the teen from stepping into the parenting role, she says. In the 2005 public advocate's survey, more than half of the 30 responding agencies reported they did not have specific training for foster parents on how to support pregnant and parenting teens.

In 1968, Inwood House created the city's only foster home program for young mothers, and it's now a national model. The agency recruits foster parents to work specifically with teen mothers, and has tailored the state-required foster parent training program to include topics like talking to teens about contraception and how to allow your teen to be a teen while teaching them to be a parent.

The agency also holds a monthly support group for all of its foster parents and provides them with lots of attention, says Norma Uriguen, director of teen family support services. "We're in the homes a lot more than in regular foster homes," she says.

Teens, too, get extra assistance. They're offered peer group meetings, parenting skills workshops, help completing their education and assistance finding daycare.

At 17, Melissa Cueves had a new baby who'd been born with disabilities, and was living in a kinship foster home with her aunt, who had four other kids. "I needed all the help I could get," she recalls.

When her foster care agency, Pius VII, closed just after her baby's birth, Cueves and her aunt switched to Inwood House's program. There, Cueves took classes on budgeting, domestic violence and parenting skills. Her social worker accompanied her on doctor's visits and taught her how to find and evaluate daycare centers. And Cueves met a group of peers, some of whom she's still in touch with six years later. "Everyone was dealing with the same issues as me," she says.

Attracting foster parents willing to commit to supporting young mothers isn't easy. Inwood House is contracted to provide approximately 45 foster boarding homes in its program, but currently has only 16 open, with 12 more families still undergoing the orientation process. And while most of the city's other 35 agencies accept and serve pregnant and parenting teens in their foster homes, few offer such comprehensive support, though some have taken creative approaches to accommodating this group's special needs. At Good Shepherd Services, for example, a sudden increase last year in the number of pregnant and parenting teens led the agency to return to a previous practice of giving one social worker responsibility for all the parenting teens.

"Teen moms have very specific needs, so it seems to work better to have them all centralized," explains MaryEllen McLaughlin, executive director of foster care/adoptive services at Good Shepherd.

The New York Foundling runs a maternity shelter and several residences for mothers and their children, but does not provide specific services for its teen moms in foster homes. Agency caseworkers try to match teen moms with foster parents who have recent experience caring for babies, says Executive Director Bill Baccaglini. The agency also makes sure pregnant teens in foster homes receive prenatal care. But, as with most agencies, these teens are dealt with on a case-by-case basis.

"Agencies really strive to do the best they can," says Bryant, of Inwood House. "But these services shouldn't be optional or up to one's best judgment."


Today Mayra Pacheco, has accomplished a lot, she received her GED and now has a full-time job doing administrative work at her former foster care agency, but she still considers her situation precarious. She's been able to stay in her foster mother's building since aging out of foster care last January, but the rent is high, amounting to more than half her monthly income. She dropped out of college, and may be facing probation at her job for missing too many days. Her daughter is sick a lot, Pacheco says, and finding someone to care for her is an ongoing struggle.

Her baby was her responsibility, Pacheco says, and she never expected the agency or her foster mother to take over. But she would have liked more support. "I could have used just a bit more care from them, for somebody to ask if I needed help," she says. "I was never offered that. I had to learn it on my own."


In the print edition of CWW, this article inaccurately stated that in order to participate in the Nurse-Family Partnership (NFP), teens must sign up by their third month of pregnancy. In fact, any low-income, first-time mother-to-be living in one of the Nurse-Family Partnership's service areas can sign sign up for the program as long as she is no more than 28 weeks pregnant. The NFP also has an initiative that targets teens in foster care, where a nurse travels to meet the mothers wherever they reside.