11 Jul New research on how to improve healthcare for women and babies when child protection services are involved
Home › News & insights › Latest news
11 July 2024
New research on how to improve healthcare for women and babies when child protection services are involved
A new study by maternity researchers at ARC South London highlights the complex healthcare experiences of women and healthcare professionals during pregnancy and early motherhood when child protection services are involved, and makes important recommendations for improving care.
About the study
A systematic review of qualitative evidence from 41 international studies, mainly from the Global North, published in PLOS One.
The perinatal period — before and up to a year after birth — is a time of change. For women with social risk factors, such as those experiencing mental illness, substance misuse or domestic abuse, child protection services may become involved. This can complicate their interactions with healthcare providers, causing feelings of fear, shame or judgement.
5,540
babies under one year old placed in State Care in the UK in 2023 — rates have nearly doubled over the last decade (ONS)
“I find a lot of them [nurses], you know, are not very sympathetic, they don’t want to help you… I’m finding they need to train their staff more to be more understanding of us — not just as parents and mothers, but as human beings, you know, how to interact with us with any situation and be more helpful when we’re asking questions instead of judging us or looking at us weird.”
Postnatal woman, Canada (Aston et al., 2021)
“This study provides a holistic overview of the experiences of healthcare in the perinatal period when child protection processes are involved. Importantly, it includes a wide range of views from women and healthcare professionals from settings around the world.”
Lead researcher; NIHR Doctoral Research Fellow in maternal and perinatal mental health, King’s College London
Key findings from the review
Women and healthcare professionals share a common goal at the start of healthcare interactions: doing what is best for the baby. However, this involved managing opposing risks:
For women
Balancing the risk of their child being removed from them against securing the best healthcare for their child
For healthcare professionals
Managing the risk of harm to the baby while maintaining a relationship with the mother
Other key findings included:
✓
How professionals managed their relationship with women was influenced by their confidence, expertise, personal beliefs and biases; supportive supervision and training were critical
✓
Many women had previous adverse life experiences with child protection agencies — often flagged as a ‘red flag’ shaping a perception of them as a risk and trouble-maker
✓
Navigating a fractured multi-agency system was challenging for both women and professionals, without oversight or clear communication between agencies
Three broad types of healthcare interaction identified
Women and healthcare professionals engaged with trust and compassion
Women and professionals felt forced to follow outlined processes, resulting in a lack of shared decision-making and opportunity to disclose concerns
Women managed the risk of an unfavourable child protection outcome by avoiding healthcare professionals and the healthcare system
“These interactions can shift between types and even coexist, highlighting the complex and reciprocal nature of healthcare experiences in this area. Also, these healthcare interactions are influenced by various factors at the individual, organisational and societal level, taking in everything from training and supervision, to individual feelings of self-worth and confidence, previous experiences and trauma, and wider factors such as systemic racism.”
Lead researcher, King’s College London
Four key recommendations for improving care
Building a trauma-informed workforce
Healthcare professionals need training and supervision to confidently safeguard women and babies while using sensitive trauma-informed care. This acknowledges women’s past traumas and treats them with respect and compassion.
Addressing systemic racism
Women of Black or Indigenous backgrounds reported systemic racism when accessing health and social care, which they believed negatively impacted their child protection outcomes. The researchers emphasise the urgent need to address racism in both healthcare and child protection processes to reduce existing inequalities.
Improving multi-agency collaboration
The study revealed complexities and fragmentation in how different agencies work together when providing care to women facing child protection involvement. Poor information sharing between agencies has been identified as a factor that can lead to serious harm, abuse or death of a child.
Increasing transparency and clear communication
Women need to be informed about what to expect when child protection services become involved, including possible outcomes and next steps. Transparency can reduce professional burden and provide a clear framework of mutual expectations that can increase engagement and trust.
“[…] at first, I thought I was crazy. I thought something was wrong because I wasn’t used to it…. People being nice to me about it. Not even just being nice, like, ‘Oh, good for you.’ It’s like people just treating me just like a person, not like a drug addict, not a loser.”
Postnatal woman using opiates or illicit substances, USA (Herriott, 2019)
📄
Read the full paper
Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis
Related content
- →
Maternity experiences and perinatal outcomes of mothers separated from their babies due to social care proceedings - →
Investigating maternal and perinatal outcomes among women from Black, Asian and Minority Ethnic groups - →
Maternity and perinatal mental health research at ARC South London - →
All latest news from ARC South London
Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.
No Comments