Elsevier

Child Abuse & Neglect

Volume 76, February 2018, Pages 1-9
Child Abuse & Neglect

Research article
Predictors of having a first child taken into care at birth: A population-based retrospective cohort study

https://doi.org/10.1016/j.chiabu.2017.09.033Get rights and content

Abstract

The objective of this study is to determine which maternal events and diagnoses in the two years before childbirth are associated with higher risk for having a first child taken into care at birth by child protection services. A population-based retrospective cohort of women whose first child was born in Manitoba, Canada between 2002 and 2012 and lived in the province at least two years before the birth of their first child (n = 53,565) was created using linkable administrative data. A logistic regression model determined the adjusted odds ratios (AOR) of having a child taken into care at birth. Characteristics having the strongest association with a woman’s first child being taken into care at birth were mother being in care at the birth of her child (AOR = 11.10; 95% CI = 8.38–14.71), substance abuse (AOR = 8.94; 95% CI = 5.08–15.71), schizophrenia (AOR = 6.69; 95% CI = 3.89–11.52) developmental disability (AOR = 6.45; 95% CI = 2.69–14.29), and no prenatal care (AOR = 5.47; 95% CI = 3.56–8.41). Most characteristics of women deemed to be at high risk for having their child taken into care at birth are modifiable or could be mitigated with appropriate services.

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,

References (54)

  • C. Begley et al.

    Women with disabilities: barriers and facilitators to accessing services during pregnancy, childbirth and early motherhood

    (2009)
  • K. Belanger et al.

    The social service divide: service availability and accessibility in rural versus urban counties and impact on child welfare outcomes

    Child Welfare

    (2008)
  • M. Brownell et al.

    The educational outcomes of children in care in Manitoba

    (2015)
  • D. Chateau et al.

    Learning from the census: the socio-economic factor index (SEFI) and health outcomes in Manitoba

    Canadian Journal of Public Health

    (2012)
  • T.D. Cook

    Quasi-Experimental design

    (2015)
  • M. Feldman et al.

    Parental cognitive impairment, mental health, and child outcomes in a child protection population

    Journal of Mental Health Research in Intellectual Disabilities

    (2012)
  • K. Fong

    Child welfare involvement and contexts of poverty: the role of parental adversities, social networks, and social services

    Children and Youth Services Review

    (2016)
  • P. Gough et al.

    Pathways to the overrepresentation of Aboriginal children in care

    (2005)
  • L.D. Hollingsworth

    Child custody loss among women with persistent severe mental illness

    Social Work Research

    (2004)
  • D. Hosmer et al.

    Applied logistic regression

    (2000)
  • K. Howard et al.

    Early mother-child separation, parenting, and child well-being in Early Head Start families

    Attachment and Human Development

    (2011)
  • D. Jutte et al.

    Administrative record linkage as a tool for public health research

    Annual Review of Public Health

    (2011)
  • S. Kisely et al.

    Use of administrative data for the surveillance of mood and anxiety disorders

    Australian and New Zealand Journal of Psychiatry

    (2009)
  • Manitoba Centre for Health Policy

    Term: chld and family services information system (CFSIS)

    (2012)
  • Manitoba Centre for Health Policy

    Concept: intellectual disability (Mental Retardation)/Developmental disability (DD)

    (2015)
  • Manitoba Centre for Health Policy

    Concept: mood and anxiety disorders – measuring prevalence

    (2015)
  • Manitoba Centre for Health Policy

    Concept: schizophrenia – measuring prevalence

    (2016)
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