AUSTIN — The pregnancy rate for teens in foster care is almost five times as high as the rate for other Texas girls ages 13 to 17, according to a report from an advocacy group.

The analysis, which Texans Care for Children released Monday, also found that more than half of teens who age out of foster care at 18 or extend their time until 21 will become pregnant before they turn 20. That's double the 1 in 4 American teens who will be pregnant before turning 20, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.

The pregnant foster youths are also less likely to receive prenatal or postnatal care, according to the report, and their babies are more likely to be of low birth weight, a health risk to the child.

To reverse the trend, the report suggested a three-pronged approach: educate foster youths on healthy relationships, provide regular access to health services and support teen parents.

Texans Care for Children also wants to see policymakers do more to prevent pregnancy in foster care youths and provide support for those who do become parents, said Kate Murphy, senior child welfare policy associate.

"There is a lot of interest from policymakers both at the state and federal level in providing better support for youths in foster care, particularly for youths aging out," she said. "I think there's an opportunity to seize on the attention that policymakers are paying to older foster youths."

Educating foster youths

The state requires foster care and adoption agencies to meet minimum educational standards to help teens prevent pregnancy and sexually transmitted infections, but Texans Care for Children's survey data found that only 38 percent of the providers that responded said their agency had such a plan.

SJRC Texas, formerly known as St. Jude's Ranch for Children, houses foster kids and helps place them in permanent homes. At its New Braunfels facility, which is dedicated to foster youths who are pregnant or parenting, chief executive Tara Rousett said most come in without ever seeing a doctor for prenatal care.

That can be attributed to both unstable home situations and a lack of education, she said.

"Many of them don't even seem to know how they got pregnant in the first place," she said. "We don't know if they're embarrassed and won't tell us, but it's scary. That's one thing we do as a program [is say] just because they're pregnant, let's not assume they know how that happened, and we start from the basics."

The report found that a contributing factor to teen pregnancy in the foster system came from youths wanting to be loved. There was a fear of rejection — for example, if a girl's partner refused to use contraception, she might acquiesce to prevent a potential end to the relationship.

Experiencing stressful and traumatic events and being placed in multiple homes also contributed to high pregnancy rates.

The numbers

In fiscal year 2017, the Texas foster care system served 50,293 youths. While 8,952 of them were 15 to 21 years old, 1,200 left when they aged out of the system.

The Texas Department of Family and Protective Services had 332 pregnant youths and 218 parents in its care in the 2017 fiscal year. In Dallas County, there were 28 pregnant youths, 18 parents and six children removed from youths in foster care.

"It is important to note that the number of children in foster care who are pregnant or parenting is low enough for the state to provide ample support to each one," the report said. "We owe them nothing less."

Spokeswoman Lisa Block said Friday that the health and well-being of foster children is the department's priority.

"The Department of Family and Protective Services, caregivers, medical providers and Preparation for Adult Living (PAL) providers work together to ensure that children in our care are educated and have access to the healthcare they need," she said in a prepared statement. "We are continually evaluating and working to improve the programs provided to youth in our care."

'Healthy connections'

Rousett said her organization has seen success with the life skills and relationship lessons they teach girls. They have been housing pregnant and parenting teens for about five years, so they have not gathered much long-term data. But the kids who stay in touch have not yet had a repeat pregnancy, she said.

"A lot of it is really based on their healthy connections and the way they are healing from trauma they suffered," she said. "These kids are in foster care, so they're coming from family who are already broken. Sometimes they are pregnant not by their own choice. Teaching those healthy connections and ending that cycle with the baby and mama, is key."

"Being in foster care is a vulnerable place to be," she added. "At the end of the day they just want to be loved, and they're looking for ways to find it."

Murphy said it's encouraging that Texas already has a foundation of pregnancy prevention to build on, rather than starting from scratch. Not only are there existing programs to teach foster care kids life skills, reproductive health and good communication, but the relatively small number of foster kids who are parents also means Texas can fully support them.

"Texas has the resources to help 218 kids to support 218 young families," she said. "That's an issue we can tackle. If we just dedicated the resources to these kids, we can help set them up for success instead of seeing some of the negative outcomes that we've seen in the past, the cycle of poverty, of kids who have kids in foster care who wind up in foster care. We have the opportunity to break that."