My dissertation research examines reproductive decision-making among youth in foster care, focusing on contraception access, pregnancy recognition, and abortion decision-making. Youth in foster care experience disproportionately high rates of adolescent pregnancy, yet existing research provides limited insight into how they access reproductive healthcare or make decisions once pregnancy occurs. This gap is especially important because foster youth often navigate reproductive health decisions while interacting with fragmented systems like child welfare agencies, Medicaid systems, courts, foster caregivers, healthcare providers, partners, and biological family members.
Grounded in Reproductive Justice, this mixed-methods study examines how structural conditions shape whether youth can access contraception, recognize pregnancy in a timely way, obtain abortion care when desired, continue a pregnancy when desired, and parent safely with adequate support. The quantitative component uses linked child welfare and Medicaid claims data from the CCOULD dataset to examine how foster care experiences and healthcare access patterns are associated with reproductive outcomes. The qualitative component consists of in-depth interviews with foster care alumni who experienced pregnancy while in care, focusing on how they understood their options, navigated relationships and systems, and experienced autonomy, support, pressure, or constraint.
The study aims to advance family planning scholarship by theorizing foster care as a reproductive context, not only a background social service system. Findings will inform trauma-informed, youth-centered approaches to contraception counseling, pregnancy testing, abortion referral, and options counseling, while also providing evidence for practice and policy changes that advance just and equitable access to contraception and abortion for youth in foster care.