‘On Paper, You’re Normal’: Narratives of Unseen Health Needs Among Women Who Have Had Children Removed From Their Care


Child protective services have statutory power to intervene if they believe a child to be at risk of significant harm due to parental neglect, abuse, or concerns around parenting capacity. Local authorities can introduce ‘child protection plans’, which strive to set out actions to keep the child safe, or in some cases, they may decide to take the child in to care. Placing children in out-of-home care via legal care proceedings (‘child removal’) is considered the option of last resort. Despite this,rates of child removal in England are at the highest level ever recorded,with over 82000 children looked after by local authorities. These trends disproportionately affect already disadvantaged families, such as children from minoritized ethnic groups and those living in poverty. In a recent independent review of children’s social care, there was a call to change how families are currently supported in child protection cases. In part, this advocates for addressing how services support the parents of these children.

Women who have children removed from their care have complex health and social care needs,which can lead to child protection involvement and be exacerbated by child removal. Parental substance misuse, mental health needs and developmental disabilities are frequent features in public care proceedings cases. Parents have often been exposed to high levels of trauma in their lives, with a recent review estimating that nearly one-third of parents experience clinically significant post-traumatic stress disorder symptoms. Child protective processes themselves add burden to families by increasing stress and threatening parental status. Although there is justification to protect the safety and well being of at-risk children, child protection policies tend to neglect the historic and structural disadvantages these families face.

Qualitative testimonies of birth mothers illustrate the immediate and enduring impact of child removal on women’s lives, including feelings of powerlessness, shame and further trauma.,Women described feeling like ‘it was night all the time’, with acute grief that was often unsupported.It is estimated that one in four birth mothers return to the family court within 7 years of an initial set of care proceedings. These statistics indicate likely unmet needs of women who are left by public services after child protection involvement and caught in a cycle of recurrent child removal. In Canada and Sweden,national mortality data report that birth parents who have children removed are over three times more likely to die of a preventable cause compared to their biological siblings or to other parents

In a review of care proceeding court files in England, parental non-engagement with services was reported as the most frequent professional concern. Reasons for lack of engagement with health services can be complex,especially for those fearful of service involvement or experiencing multiple disadvantages,both of which are likely for birth mothers, What’s more, there are known service gaps for women who have experienced child removal in England, with post removal support dependent on local authority, charity or innovation funding.Understanding the experiences and needs of these women is essential for improving the development and delivery of public support services.


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