The NIHR funded research, led by maternity researchers at ARC South London, also found women who had any type of previous contact with children’s social services were more likely to be in contact with them during pregnancy, even if there were no current safeguarding concerns recorded.
The study, published in BMC Pregnancy and Childbirth on 16 October, aimed to identify characteristics of pregnant women when children’s social services are involved and investigate what risk factors are associated with children’s social services involvement during pregnancy.
In the last decade, rates of infants and babies with child protection agency involvement have increased in the UK and many other high-income countries. The UK Office of National Statistics reported that in 2023 in England almost 8,000 unborn babies and 21,000 infants under the age of one were considered by children’s social services to be at risk of harm and required some level of intervention. Disparities in child protection referrals as well as maternal and child health outcomes have been widely evidenced, yet no previous research has investigated contact with children’s social services during pregnancy using linked maternity and mental health records in England.
The research team analysed linked electronic health records from maternity and mental health services in South London (eLIXIR-BiSL cohort). The study looked at 36,322 pregnancy records and found 2,206 pregnancies had children’s social services involvement. The research found that this was more often among women who were unemployed, single, living in deprivation, and from Black or mixed ethnic groups. In addition, their pregnancies more often had medical, obstetric and mental health complications.
The researchers also investigated the potential reasons for children’s social services contact in pregnancy. They found that women more likely to be referred if they had any history of previous contact with children’s social services. For example:
In contrast, for nearly half of the pregnancies with children’s social services contact, the researchers could not identify any referral reasons. This was particularly the case among young, single women, who were unemployed, living in deprived areas, and of Black and mixed ethnic backgrounds.
Our study found stark differences between pregnant women with and without involvement from children’s social services. While over half of the pregnant women with involvement from social services had risk factors that warranted a referral during pregnancy, it is worrying that for nearly half of them, we could not identify such risk factors.
Our study has highlighted the need for careful professional consideration about who needs to be referred to children’s social services during pregnancy, and to address any biases in such referral decisions. At all times, safeguarding risk assessments need to be grounded in the present, taking into account a holistic, strengths-based and family approach. If we want to tackle inequalities in children’s social services involvement, decisions around referrals have to be based on current safeguarding risks towards the unborn baby, without bias or judgement
The study was led by Kaat De Backer, as part of the MUMS@RISC research project and was informed by an advisory group of six women with lived experience of children’s social services involvement in pregnancy and infant removal at birth.