The 2022 MBRACE enquiry into maternal deaths showed that 59% of those who died through substance misuse and more than one in ten of those who died by suicide in pregnancy or in the year after birth, had a baby removed from their care or were experiencing ongoing care proceedings. Improving the maternity care and support for women who have involvement with children’s social care services is crucial in addressing these unacceptable disparities in maternal outcomes and deaths.
The newly published Birth Companions Birth Charter clearly shows how some of the most vulnerable women in our communities can be let down by those involved in their care and support. As maternity professionals, we have a responsibility to ensure we deliver high-quality, personalised maternity care to every woman, regardless of her background or circumstances. Every woman has the right to give their baby the best possible start in life. They also should receive trauma-informed care from appropriately trained professionals alert to the effects of possible past trauma on women, and who are committed to meaningfully supporting them. We support the need for a new national health and social care pathway in England for women with involvement from children’s social care.
It is particularly concerning that research has shown that women’s choices around birth can be influenced by their involvement in care proceedings, where external services want to influence factors such as the timing of a birth. Women have the right to make informed decisions about their birth plans, based on their preferences and supported by personalised information on risks and benefits. This is central to safeguarding positive maternal and neonatal outcomes.
Women going through care proceedings in the postnatal period are more likely to require personalised postnatal services that truly meet their needs. It is simply unacceptable that specialist perinatal mental health services are not always available to women if they have been separated from their baby, and this must change.
Access to specialist care and in particular continuity of carer is recognised in the Birth Charter as crucial in improving outcomes, particularly for women in deprived areas. The roll-out of this model is still limited by the persistent staffing pressures in maternity services. We hope the publication of the long-term NHS workforce plan will address this to ensure that all women and people have access to the best possible care.