Byline Times is an independent, reader-funded investigative newspaper, outside of the system of the established press, reporting on ‘what the papers don’t say’ – without fear or favour.
To support its work, subscribe to the monthly Byline Times print edition, packed with exclusive investigations, news, and analysis.
An increasing number of women who died between 2020-2022 during pregnancy or up to six weeks afterwards in the UK were known to social services, according to data released on Thursday.
This group makes up 22% of the 275 deaths reported, according to the MBRAACE report, and has risen for the past five years. In 2012-2014, the figure was 12%.
During the same period, a further 329 women died between six weeks and one year after the end of pregnancy, the report found, and rates of maternal deaths have “increased significantly, even when deaths due to COVID-19 are excluded”. While 13.56 women per 100,000 died during pregnancy or up to six weeks after, this risk doubled for women in the most deprived areas, and tripled for Black women.
Birth Companions, a charity that supports women from disadvantaged backgrounds, told Byline Times the figures are “shocking” and can no longer be ignored.
“Maternal suicide is still the leading direct cause of death between six weeks and a year after birth, and past MBRRACE reports have highlighted the fact that a large proportion of the women who died by suicide or because of substance use were at risk of having their baby removed, or dealing with the trauma of that removal,” Kirsty Kitchen, Birth Companions, head of policy said.
With the number of looked-after children in England at a record high – 83,840 as of 31 March 2023 – experts warn that these statistics will keep rising until mothers are better supported to keep their children.
“At Birth Companions we have been campaigning for improvements in the care of women who experience social care involvement in pregnancy and early motherhood for many years,” Kitchen explained.
Yet their needs are still largely absent from health and social care policy, and they are still struggling to access mental health services. Women are navigating one of the most traumatic experiences imaginable, alone. That has to change
Kirsty Kitchen, Birth Companions
Almost half of the women whose children are taken into care are care-experienced themselves, and many have the ‘toxic trio’ – professionals’ morbid-moniker for domestic abuse, substance abuse and mental illness.
Child removal escalates these issues. Just over one in 10 of the women who die by suicide, and six in 10 who die through substance misuse, have had a child removed, or are subject to ongoing care proceedings.
“I know women who’ve had seven children taken off them,” says Helen*, 39, who’s also had children taken out of her care. “They self-destruct because they think they’ve let their kids down.”
After a judge decides to remove a child from their mother’s care, she’s often left without support and struggles to hold it together.
“I’ve walked people to local drug and alcohol services to make sure they go to appointments,” says Natalie Prowse, senior lecturer in law at the University of Huddersfield.
“Parents always say they need their child back first, that they’re drinking alcohol or taking drugs because they haven’t got their child with them,” the former solicitor continued.
The Service Desert
It’s unclear who should be responsible for supporting women at risk of, or following, child removal. Councils are only legally obliged to offer short-term counselling to the birth parents of children who are adopted.
Dwindling budgets and increased demand for adult services are creating a vacuum of support, says Amy Van Zyl, chief executive of Women’s Reform, an organisation in Newcastle for women who’ve had, or are at risk of having, children removed.
“Social workers aren’t bad people,” she says, “but when a child is at risk in the family home, because of vulnerabilities perceived to be presented by the mother, and there are no support services available, what else can they do but remove children?”
Helen, whose first child was taken into care after she became addicted to heroin aged 15, has watched support dwindle around her community in Newcastle.
“Social workers used to get to know a family and do more intense work, but it’s massively changed,” she says.
Any available support isn’t often designed with these women in mind. Local authority drug and alcohol services aren’t generally tailored for women – especially those with complex trauma, says Sheena Web, consultant clinical psychologist specialising in families with complex needs.
“Many professionals just signpost women to services without understanding the practical difficulties they may face getting to the venue,” she says
Helen says women are judged harshly by professionals and service users in drug and alcohol services.
“Even in women’s groups, women are fearful to share what’s gone on with them,” she says. “But it’s much harder to recover if you’re not open and honest.”
Many housing and mental health services require people to be teetotal. But this is based on outdated Nice guidelines stating that professionals should treat a person’s substance abuse before PTSD. The newer edition says people shouldn’t be automatically excluded from therapy just because of a substance abuse issue.
“When you’ve got people supporting you, you feel like you can do it, but when you’re suddenly dropped from a service, it feels like you’re at square one again,” says Tia*, a member of Birth Companions’ Lived Experience Team, who had her children taken from her care six years ago.
I was stuck in a relationship and didn’t know how to get out. I needed support, but they took my kids away. My kids didn’t go through half of what I went through – they were looked after so well
Tia, Birth Companions’ Lived Experience Team
When deciding whether a child should be removed, a judge sees lots of evidence regarding the challenges preventing a mum from looking after her child appropriately, says Naomi Delap, director of Birth Companions, but “it’s used to justify why she can’t have her child in her care, not to make sure she gets the support she needs”.
A Recurring Theme
One in four women in England and Wales with a child in care risk going through subsequent care proceedings with other children – referred to as ‘recurrent cases’. Over the last decade, recurrent cases have gone from a ‘national problem with no name’ to an increasing concern among professionals.
Suzie* has six children in care and is pregnant with her seventh. A few years ago, she spent three months in hospital after her partner attacked her. The 40-year-old turned to alcohol and drugs to cope with her children going into care, including two sons taken from her when they were five days old.
Suzie’s in a refuge in the northeast of England, receiving counselling with the hope she can keep this baby. That, she says, is the only support she’s been offered since having her first child at 19, aside from six months in a mother-and-baby unit.
I was a victim of domestic violence, and then a victim again when social services took my children away because of it
Suzie
Breaking this cycle requires a joint national health and social care pathway for women at risk of having a baby removed, or who are separated from their baby soon after birth, Kitchen says.
“We are involved in driving forward improvements in care already, through our own services and through work to shape others. But we need the Government and the NHS to play their part too. Without urgent and coordinated action on these and other inequities, more women will die avoidable deaths,” she says.
Support Services Shut Down
In the vacuum of appropriate support, a group of professionals supporting women in South Suffolk launched Positive Choices in 2010. The programme of long-term, one-to-one support for women soon inspired other services to develop.
Charities and councils can now deliver Pause, the biggest network of its kind in England, a programme on which practitioners work intensively with women for 18 months.
But while mounting evidence shows that long-term therapeutic support can limit the impact of child removal on mothers and reduce the number of children going into care, the Government’s children’s social care innovation programme stopped funding local authorities to deliver Pause in 2020. Since then, numerous Pause programmes have shut down.
As of October 2024, there are 20 Pause Practices, covering 25 local authority areas across England. Around 45 councils have other services, while 77 of England’s 151 councils that provide social services offer no such support.
Services like Pause are most needed in deprived areas, but these are generally the councils that have had the biggest funding cuts on non-statutory services, at the same time as increased need.
In the northeast, where the number of children in care and the rate of recurrent cases is the highest in England, more could be done with less money, says Helen, who attends weekly Women’s Reform sessions in Newcastle.
“It’s so simple: women supporting each other over a coffee,” she says. “This support network was my saviour – but many women haven’t got anyone advocating for them.”
Tia, from Birth Companions’ Lived Experience Team, says more people should be recruited into social services with lived experience.
“When you lose a child, your world stops, and to my knowledge there are no therapists out there who’ve been through that and want to help others deal with it,” she says.
There is one, Rachael Grey. The research associate at the University of Lancaster’s Child and Family Justice Research Centre set up online group therapy for women with experience of domestic abuse and child removal after going through a court-ordered separation from her daughter.
“Child removal creates a complex set of needs that people really don’t understand,” Grey told Byline Times.
You grieve for the rest of your life. We’re not understanding that, if you add on a layer of child removal, it creates a different set of complex needs
Rachael Grey, University of Lancaster
Tia doesn’t know about Grey’s therapy group, because Grey knows that, if she advertises it, she’d be inundated with replies, and can’t afford to help everyone.
So, despite pockets of effective support, many women are left without the help they need to keep their children. Helen sees the effects of this – the shame, the isolation – every time she steps outside her house.
“A lot of my friends have passed away, and their kids haven’t got either parent. People don’t realise it’s an epidemic.
I pray for future generations that these gaps are filled. My friends’ children are growing up and going down the same road as their parents. Something needs to be done
Helen, who has had her children taken away
The Difference Help can Make
“I hope I don’t die,” says Sarah,* when I ask her how she feels about her looming due date. “I hope I ease into motherhood,” the 18-year-old adds in the same breezy tone.
The latter may be ambitious for someone who’s spent their childhood in foster care, but Sarah’s maternal instincts have already kicked in; she doesn’t know how, but she loves her son already.
Sarah was kicked out of her foster home two years ago when she was drinking excessively and in an abusive relationship. A year later, she was pregnant. Social services have said her baby will likely be taken into care.
With support from the charity Oasis Community Housing and substance abuse services, Sarah got a part-time job and moved into one of the charity’s mother-and-baby flats. After her son is born, she hopes to go to college.
“I’ve not had the motivation to do it before, but now, it’s a different story,” she says.
*names changed