New Birth Charter for women with involvement from children’s social care published

Women’s charity, Birth Companion, called for urgent improvements for pregnant women and mothers with children’s social care involvement.
The women’s charity has warned that support for women will deteriorate “as they fall between gaps in fragmented and overstretched services”.

The launch of the Birth Charter for women with involvement from children's social care sets out how services and systems in England should support all women involved with children’s social care from conception to their child’s second birthday - the period known as the '1001 critical days'.

The publication, supported by members of the Birth Companions Lived Experience Team, 4PB Family Law Barristers, MSB Solicitors, the Association of Child Protection Professionals, and the Centre for Child and Family Justice Research at Lancaster University, calls for a national health and social care pathway for pregnant women and mothers of infants who are subject to pre-birth or parenting assessment, or child protection proceedings.

Tens of thousands of women have contact with the children’s social care system during
pregnancy and early motherhood each year in England, with some having an initial assessment and receiving early help from social workers.

Some move into processes such as pre-proceedings or court proceedings, with thousands of mothers having their baby removed from their care by the family courts. Recent statistics showed that 5,410 infants under the age of one began being ‘looked after’ by the state in 2022.

Evidence from The Nuffield Family Justice Observatory’s ‘Newborn babies in urgent care proceedings in England and Wales 2021’ report revealed that the number and incidence rate of newborn babies and infants in care proceedings at national and regional level has increased in recent years. In England in 2012/13 there were 2,425 newborn babies in care proceedings rising to 2,914 in 2019/20 - an increase of more than a fifth. Newborn babies account for a growing proportion of cases relating to infants—just over half of cases in 2019/20.

The report states how research has shown that the health of many mothers is worsening and lacking support. Analysis published in 2022 shows that 20% of women who died in pregnancy or the year after birth had involvement with children’s social care. Women with children in care proceedings experience greater health vulnerabilities than other mothers, including more mental health issues, higher levels of substance use, and more injury-related conditions.

Birth Companions’ Director Naomi Delap said: “The health of many mothers in these situations is poor, and their treatment is often unfair. For example, women can be required to attend family court hearings very soon after birth, when they are still recovering, and they are not always given help to understand complex legal documents or processes.”

The Birth Charter for women with involvement from children’s social care outlines 14 principles to help protect women’s rights to safe, fair and compassionate care.

The charter states that pregnant women and mothers of children under the age of two with involvement from children’s social care should receive support that is specialist and continuous during pregnancy, birth and early motherhood.

It argues there is significant variation in the nature, quality and timing of children’s social care
assessments during the pre-birth period and infancy across England.

The Independent Review of Children’s Social Care has previously highlighted problems with sharing information and making referrals that impact on the success of multi-agency working. The review recognises that high turnover of social workers, and over-reliance on agency staff affect families’ relationships with professionals. This also makes it difficult for social workers to maintain relationships with key professionals in other services.

Women are often expected to engage with many different professionals and attend many different appointments. Research shows women can find this overwhelming in the midst of the other challenges they face.

The report suggests that women should receive support that is woman-centred, holistic and culturally appropriate.

“Peer research led by the charity AVA has highlighted that children’s social care may focus on one ‘problematic’ part of women’s experience, such as domestic abuse or drug use, and that this can shape every decision made. The report identified valuing women’s strengths and providing support built on understanding, empathy and
compassion is crucial to overcoming this.”

The charter also highlights that women should receive support that is trauma-informed and trauma-responsive, stating: “Trauma-informed approaches seek to recognise and reduce the impact of experiences of trauma, to support improvements in mental and physical health. The key principles of trauma-informed care are: safety, trust, choice, collaboration, empowerment and cultural consideration”.

The report emphasises the importance of support that is responsive to their specific needs before, during and after separation from their baby.

Research shows that the challenges and consequences women face during and after
care proceedings are poorly understood and not adequately reflected in service provision.

The period after separation is one of significant risk for the mother, according to the
2022 MBRRACE36 enquiry into maternal deaths. It shows that 59% of those who died
through substance misuse and more than one in ten of those women who died by
suicide in pregnancy or the year after birth had had an infant removed from their care
and/or were experiencing ongoing care proceedings.

Although focused solely on the interests of the child, family courts hear a great deal of
evidence about the needs, experiences and trauma of the birth mother. Currently, little
is done to translate this into support to address the mother’s needs.

The charter also states that women should be helped to give their babies the best start in life through support from all services as early as possible, with appropriate mental health support, as well as appropriate support in hospital before, during and after birth.

Other elements of the charter include the importance of helping women to understand and engage with every aspect of their involvement with children’s social care and the family justice
System, with access to independent advocacy support.

Commenting on the charter, Naomi Delap added: “Despite the clear evidence of need, most general and specialist services are not designed with these mothers in mind. Professionals across the health, social care and voluntary sectors are doing admirable work, but this good practice is not consistent or widespread, and services are under-resourced and overstretched. There is no national pathway, and these women are missing from key health and social care policies.

“As a result, mothers who are separated from their babies are often left to cope with their grief alone, with no support to address the trauma of separation and the issues that may have contributed. This can lead to the rapid escalation of mental health issues, substance use, domestic abuse and criminalisation, and we know that women in these situations are at risk of death by suicide or substance misuse. We urgently need to do better for them and their children.”

The report concludes: “Positive change in the care and treatment of women involved with children’s social care holds the potential to tackle complex and deeply entrenched inequality and disadvantage. The right care and fair treatment could mitigate risks for mothers and babies, reduce the number of avoidable separations, and improve health and social care outcomes for women and their children. We hope this Birth Charter can play a key role in supporting this work.”