For the past several years, the Center for the Study of Social Policy (CSSP) has been working to bring attention to the unmet needs of youth in foster care who are expecting a child and/or parenting. This document is the cornerstone of a three-part compendium of sexual and reproductive health guidance and resources for child welfare jurisdictions. This document is intended primarily for child welfare leadership and policy makers. The document briefly explores the urgent need for comprehensive sexual and reproductive health care for youth in out-of-home care and lays down nine fundamental principles for action. It provides extensive guidance for jurisdictions as they consider the policies and practices they should have into place to better serve adolescents in or leaving foster care.