Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales:a linked data study

Griffiths, L.J. and Johnson, R.D. and Broadhurst, K. and Bedston, S. and Cusworth, L. and Alrouh, B. and Ford, D.V. and John, A. (2020) Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales:a linked data study. BMC Pregnancy and Childbirth, 20 (1). ISSN 1471-2393

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Abstract

Background: Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. Methods: Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. Results: Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% <21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). Conclusion: This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women’s needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.

Item Type:
Journal Article
Journal or Publication Title:
BMC Pregnancy and Childbirth
Additional Information:
Funding text 1: All authors are part of the Family Justice Data Partnership (FJDP) - a collaboration between Lancaster University and Swansea University. The authors would like to thank other team members involved in the Family Justice Data Partnership including K Jones, A Akbari, A Lee, J Smart and S Thompson (Swansea University), and B Alrouh, S Doebler and J Harwin (Lancaster University). We would also like to thank the following for their support with this study: L Harker, Director, Nuffield Family Justice Observatory; Cafcass Cymru; Administrative Data Research Centre Wales; and Welsh government. The authors would like to acknowledge all the data providers who make data available for research, and the Adolescent Mental Health Data Platform for providing the substance use and mental health clinical codes used within this study. 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Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2729
Subjects:
ID Code:
149398
Deposited By:
Deposited On:
30 Nov 2020 15:40
Refereed?:
Yes
Published?:
Published
Last Modified:
16 Jun 2021 08:44