Research articlePredictors of having a first child taken into care at birth: A population-based retrospective cohort study
Introduction
Mother-child separation can be a profound experience for both mothers and children, causing a great deal of trauma and grief. This separation can result from several different situations, including a child being placed into care by child protection services (CPS). CPS involvement generally occurs after documented neglect or maltreatment. However, not all mothers whose children are taken into care have demonstrated a history of neglect or maltreatment. Mothers deemed to be at high risk for being unable to care for their child may be separated from their children at birth. The number of children taken into care at birth is not well documented. However, we do know that in Manitoba, Canada, 15 percent of children in care were taken into care at birth (Brownell et al., 2015).
Previous studies examining risk factors for having a child taken into care have focused on cases where the child was placed in care due to abuse or neglect. This research found that mothers with developmental disabilities, mental illness, and substance dependencies have significantly higher rates of involvement with CPS (McConnell & Llewellyn, 2002a; Minnes, Singer, Humphrey-Wall, & Satayathum, 2008; O’Donnell et al., 2015). Where a mother lives contributes to her likelihood of involvement; higher rates are seen among mothers living in poor or urban neighborhoods and those moving frequently (Adam, 2004, Belanger and Stone, 2008; Coulton, Crampton, Irwin, Spilsbury, & Korbin, 2007). Sociodemographic variables such as age, income, marital status, level of education, and employment status also predicted involvement with CPS (Becker and Barth, 2000, Fong, 2016, Putnam-Hornstein and Needell, 2014, Raissian, 2015; Zhou, Hallisey, & Freymann, 2006; Zuravin & DiBlasio, 1996). Mothers whose children had been placed in care were more likely to have been in care themselves and to have been involved with the criminal justice system (Becker & Barth, 2000; Phillips & Gleeson, 2007). Mothers who accessed low levels of prenatal care, and whose children were in worse health at birth were also more likely to be involved with CPS (Putnam-Hornstein and Needell, 2014, Zhou et al., 2006).
Less is known about the risk factors of child protection involvement in cases where abuse or neglect is not documented, such as when a child is place in care at birth. Separation at birth disrupts bonding and can have serious consequences for both mothers and children, including increased aggression among children and increased mental health conditions and substance use in mothers (Howard, Martin, Berlin, & Brooks-Gunn, 2011; Kenny, Barrington, & Green, 2015; McKegney, 2003). A better understanding of factors that contribute to risk of separation at birth can identify women who may require additional supports during their pregnancy to be able to care for their newborn. This study uses linkable administrative data to identify events and diagnoses in the two years before childbirth to identify women at highest risk for having their first child taken into care at birth. Using previously identified risk factors for CPS involvement, we examine whether risk factors for such involvement due to abuse or neglect differ from those for involvement at the birth of a child.
Section snippets
Setting
Manitoba is in central Canada, and had approximately 1.2 million residents at the time of the 2011 census (Statistics Canada, 2014). While Manitoba is representative of Canada in many aspects, ranking in the middle for several health and education indicators, the rate of children placed in out-of-home care is among the highest in the country (Brownell et al., 2015; O’Grady, Deussing, Scerbina, Fung, & Muhe, 2016). With 3% of children in care, Manitoba has one of the highest rates of children in
Results
Less than one percent of women (0.90%) had their oldest child taken into care at birth. Table 2 displays the frequency and means of specific predictors for women whose child was taken into care and those whose child was not taken into care at birth. Mothers in the two groups differed significantly on almost all variables.
The maternal variables with the strongest association of having a child taken into care at birth were the mother being in care herself at the birth of that child, substance
Discussion
To our knowledge, this is the first study to examine predictors of having a child taken into care at birth. Most of the covariates included in the model were significant predictors of having a child taken into care, with the strongest predictors being the mother having been in care when she gave birth, substance use diagnoses before and during the pregnancy, schizophrenia, developmental disabilities, and not accessing any prenatal care. These characteristics have also been identified as
Funding
This work was supported by a Social Sciences and Humanities Research Council of Canada Joseph-Armand Bombardier Canada Doctoral Scholarship, a Graduate Enhancement of Tri-council Stipend, and a Women’s Health Research Foundation of Canada Full Time Scholarship.
Conflict of interest
None.
Acknowledgements
Data used in this study are from the Population Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health, Seniors and Active Living, Manitoba Families, Healthy Child Manitoba, Manitoba Education and Training, Manitoba Justice, and Vital Statistics under project #2016/2017-09. The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy,
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Term: chld and family services information system (CFSIS)
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Concept: mood and anxiety disorders – measuring prevalence
Concept: schizophrenia – measuring prevalence
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2022, SSM - Population HealthCitation Excerpt :In addition to this, while it is well known that rates of and susceptibility to MHD differ between males and females (Riecher-R ö ssler, 2017; WHO, 2001), there are a few and not consistent findings on sex differences in OHC in terms of MHD (Baldwin et al., 2019; Cotton et al., 2020; Harpin et al., 2013; Heflinger et al., 2000; Tarren-Sweeney and Hazell, 2006). On top of that, studies investigating intergenerational associations between these two constructs (i.e. parental experiences of OHC (or maltreatment) and offspring's mental health (Plant et al., 2018; Su et al., 2020; Yoon et al., 2019) or between parents’ mental health and their children's OHC experience (Hammond et al., 2017; Wall-Wieler et al., 2018c)) have not paid much attention to sex differences. Many of these studies investigated only maternal circumstances (not paternal), in addition to the fact that the children's sex was used as a covariate, without discussing the potential implications to the results.