Abstract
The child care literature consistently reports a lack of support for birth mothers following their child being taken into care or adopted. This is despite consistent evidence of the long-term consequences of the removal of children on their mental health. The aim of this study is to explore the effects of separation, the subsequent sense of identity and the experience of contact and support throughout the process. Semi-structured interviews were conducted with seven mothers recruited from birth mother support groups and the transcripts analysed using Interpretative Phenomenological Analysis (IPA). Four themes emerged: ‘no one in my corner’; disconnecting from emotion; renegotiating identity; and the children are gone but still here. The findings contribute to our understanding of the experiences of birth mothers whose children are removed from their care and are discussed within a range of psychological theories.
Introduction
This study seeks to explore the experiences of birth mothers whose child or children have been taken into care or adopted. National statistics for the year ending 31 March 2014 show that 68,840 children were looked after by local authorities in England in 2013–2014 and that there were 5050 adoptions from care. The Adoption and Children Act 2002 (sections 3 and 4) in England and Wales and the Adoption and Children Act 2007 (sections 3–5) in Scotland stress the importance of providing independent support to birth parents and birth families both during and after the adoption process. The National Minimum Standards for adoption that accompany the legislation state that ‘Birth parents and birth families … are entitled to services that recognise the lifelong implications of adoption. They will be treated fairly, openly and with respect throughout the adoption process’ (Department of Health, 2001: 23).
Despite recognition of the needs of birth parents, they remain largely neglected in practice, research and policy. As Zamostny and colleagues have written: ‘ … the silence of the mental health community on and psychology’s relative lack of research attention to adoption issues compromise empirically based knowledge on adoption’ (Zamostny, et al., 2003: 648). They go on to assert that psychologists’ expertise in clinical interventions and research methodology could be used to advance our knowledge of adjustment to adoption, but their lack of attention to this area has meant that it has not benefited from such contributions.
There is very little research in the UK that looks specifically at birth mothers’ experiences of being compulsorily separated from their children; most studies have focused on those who have relinquished their children voluntarily. While in many ways this is a comparable experience, it does not speak to the uniqueness of having one’s child or children compulsorily removed.
A number of studies suggest that the removal of children has long-term consequences for the mental health of birth mothers (Condon, 1986; Logan, 1996; Neil, 2013; Schofield, et al., 2011; Wells, 1993; Winkler and van Keppel, 1984). For example, Winkler and van Keppel (1984) found that birth mothers’ sense of loss intensified over time and six of the women they studied became pregnant again within a year of relinquishment – a trend still evident today and a growing national concern.
The process of taking a child into care via a care order is often a long, gruelling and distressing process. Many observers have noted the ‘adversarial nature’ of the child protection process (Drumbill, 2006; Mason and Selman, 1997; Ryburn, 1994; Smeeton and Boxall, 2011) and how court reports are often filled with deficits and a source of trauma, shame and frustration for the birth parents who find themselves ‘publicly branded as bad parents’ (Mason and Selman, 1997: 24).
In order to support these mothers effectively, it is essential to understand more fully their needs and experiences, particularly in relation to their emotional well-being. This is also important because it is now common for adopted children to have ongoing contact with their birth parents and under such arrangements the emotional well-being of the birth parent will continue to have some bearing on the welfare of the child (Neil, 2013; Neil and Howe, 2004).
Methodology
Seven mothers, all recruited from birth mother support groups across two non-NHS organisations, participated in this study. Six of these described themselves as white British and one as Asian. Six of the seven were aged between 29 and 35 years, with one aged 23. The length of time that had elapsed since having their children taken into care and/or adopted ranged from two to nine years and the number of their children who were in foster care or adopted ranged from one to six. Three of the women interviewed had other children living at home and all continued to have either direct or letterbox contact with some or all of their absent children.
A semi-structured interview schedule was constructed with reference to relevant literature and Interpretative Phenomenological Analysis (IPA) guidance (Smith, Flowers and Larkin, 2009). This sought to explore various aspects of the mothers’ experience ranging from broad questions, such as ‘What was life like for you after your children were taken into care?’, to more specific matters such as ‘Can you tell me about your sense of being a parent now that your children have been taken into care?’ Interviews were audio-recorded and transcribed by the first author.
Analysis
The transcripts were analysed using IPA, an approach to psychological qualitative research that delineates how people make sense of their life experiences (Smith, Flowers and Larkin, 2009). It is influenced by phenomenology, hermeneutics (the double hermeneutic) and idiography and offers more than descriptions by applying an interpretative methodology. In addition, IPA is idiographic in that it is concerned with the particular individual experience as well as making claims at a group or population level (Smith, Flowers and Larkin, 2009). By using this method of analysis, superordinate and subordinate themes were identified while acknowledging the idiosyncrasies of each case. Four themes emerged from the process.
‘No one in my corner’
This theme captures the feeling expressed by all the participants that they were trying to cope alone both before and after the departure of their children. They described how their children were taken into care in a context of struggling to parent amid a chaotic situation at home.
Tracey, whose five children had been taken into care, described her chaotic circumstances and alluded to feeling out of control of her situation: ‘My house was like Piccadilly Circus.’
Many participants felt there was a lack of support to help them to improve their situation and prevent the care admission, leading to feelings of anger towards children’s services. During the court process, a number of mothers described feeling that professionals were not hearing their side of the story and that the evidence presented gave the wrong impression of them as parents. All participants conveyed a sense of not feeling important and that professionals viewed their emotions about having their children taken away as insignificant.
There was also a sense that, with the correct support, it might have been possible to avoid having their children removed. Alice, who was 23 at the time, explained: They could’ve helped with some sort of counselling or whatever for the drinking and obviously I was going through the violent relationship, but they just didn’t wanna … They didn’t care, they didn’t wanna help. To me it felt like it was just about getting him into care, they didn’t care, sort of, how that impacted on me or anything.
Lucy told a similar story. She had nine children and became overwhelmed by their needs in the context of the chaotic social situation in which she lived. Six of her children were adopted and three remained with her at home. She expressed what appeared to be frustration at being unable to get her story across to others. She referred to the power held by professionals, which privileged the account they gave about her as a parent and left her powerless: … You’re in this room, these people have got so much power, and they can ruin your life like that [clicked fingers]. In a snap. On basically listening to other people’s evidence, which really is a snapshot of your life because they don’t know you, these people.
Lucy’s words also stressed birth mothers’ experience of how one part of the child protection story can obscure others, such as moments of ‘good’ parenting, good intentions and positive aspects of the parent–child relationship.
Disconnecting from emotion
All of the participants spoke about their experiences in a way that lacked a sense of connection with the emotional content of their situation. This manifested itself when mothers’ accounts adopted a matter-of-fact tone when describing highly emotive experiences. Others struggled to find suitable language to describe their feelings or to ‘remember’ how they felt at the time. They seemed to disconnect themselves from emotion by minimising the reasons why their child had been taken into care.
Sarah had one child in foster care and three who were adopted. When asked why her children were removed, she responded with a stark description that seemed at odds with the gravity of what she was saying: Erm, it was mostly missing appointments for her health, not looking after her, making sure she weren’t … she was going to school clean … physically neglecting her and mentally, and, that was it.
This distancing from emotions can be difficult for clinicians to understand and accept, so it is important to try and make sense of such incongruent responses. Lucy expressed her guilt at having let her children down, suggesting that her attempts to minimise the reasons for her children being taken into care served to protect her from these difficult feelings: It’s a lot of guilt. You feel so guilty. I mean that’s my biggest hurdle, is getting over that. That guilt that I feel that … I messed up. I really messed up, I let them down because ultimately you’re their parent, you’re the one that’s meant to be there to protect them and make sure these things don’t happen and obviously I did.
Many of the participants alluded to their emotional experience being difficult to bear. All described coping with the loss through strategies that blocked out their feelings, such as drinking. For many, there was a wish to not show emotion to others and there was often a contrast between the way they described their internal world and what they revealed.
Tracey described being in a state of despair after her children were taken into care and her perceived inability to cope with her feelings: ‘ … At the beginning I lost the plot, I was self-harming, I was overdosing, couldn’t cope with it all … ’
She went on to describe poignantly the intensity of her emotions and her attempts to escape from them: … I locked myself away. Locked myself in my bedroom basically and just played Xbox or computer … and that’s all I did … It felt like I’d never be happy again. It felt like it was night all the time, the sun had been taken out of my day.
In Lucy and Tracey’s accounts we clearly see the overwhelming intensity of their emotional responses to the removal of their children, including acute experiences of guilt, shame, despair and hopelessness. However, within the context of the invalidation of their emotional pain and the stigma and judgement experienced, they appear to feel unable to tolerate these emotions or share them with others, instead turning to numbing and disconnection through strategies like distraction, minimisation, alcohol use or self-destructive actions. Minimising the circumstances around their children being taken into care seemed to allow mothers to create a narrative that could be lived with (Schofield, et al., 2011).
The alternative to this appeared to be an acceptance of the full reality of the situation, which would mean allowing themselves to recognise the mistakes that they had made. For the majority, there were moments when they appeared able to acknowledge these and tolerate the intense emotions associated with this acceptance, both to themselves and others. However, mothers would often move away from this position into the type of avoidance tactics mentioned above. Thus, it seems that the despair and guilt experienced by these mothers in relation to the loss of their children, as well as the associated shame and stigma, are too overwhelming to maintain for longer than short periods of time and that disconnection offers another way of managing their situation. It can also be argued that the lack of support services for these mothers increased the need for reliance on some form of ‘escape’.
Renegotiating identity
It was clear that having their children taken into care or adopted had made a profound impact on the birth mothers’ sense of identity as a mother and as a person. All seemed to find themselves questioning who they were and the image they had of themselves as ‘good mothers’.
Tracey had had a strong identity as a mother from a young age and her life continued to centre around her children after they were taken into care. She described feeling like a mother when she was with her children, but not when she was apart from them. This left her feeling confused about her sense of herself: I understand that I’m always gonna be their parent … mother but having them not in my life is … Especially the two that are up for adoption, not having them in my life but knowing they’re out there and they’re being raised by someone else. I see myself as a part-time mum. When I’ve got contact with them, that’s when I’m a mum, but other than that I’m just me now. And I’m just trying to work out who me is. All I’ve known from the age of 17 upwards is being a parent. Erm, so, to have them suddenly removed … I just didn’t know who I was anymore. And I couldn’t work out who I was.
For many, this loss of their sense of themselves led to feelings that their lives had lost meaning; in some cases, it felt as though life was not worth living. Often they expressed the need to move on, take on new roles and improve themselves somehow. Their accounts suggest that while this renegotiation is continuous, it is not easily achieved. It highlights their confusion, in part related to the internal struggle to reconcile being a mother but not a parent. It also reflects the struggle to label this ‘in-between’ position in a society that offers no validation or guidance for such a status.
Kate’s child was adopted nine years ago and she has letterbox contact once a year. She questions her identity as a mother in the context of what other people might think and expressed something important about whether or not she was a mother and a parent in the eyes of others: Am I still a parent? Sometimes I ask myself that. Yes, of course I'm still a parent and I'll always be her mum, but I do get questions. People that don't know the situation are like, ‘Have you got any children?’ Sometimes I choose to say no, I don't have any children because then I don't have to go into details, and other times, if I feel it's somebody that I maybe, possibly could trust, I will.
She alluded to feeling that she would be a different person had she not made the decision to change her life, a decision triggered by her child being taken into care: If I hadn't of got into the further education or finding a career then god knows where I’d be. I’d probably be on the streets begging for money, taking drugs and stuff like that. Only I could make that decision that I wanted to change my life and I knew that.
Tracey described a wish to be a different person to whom she was when her children were taken, alluding to the need to move away from her ‘old self’, which she no longer felt was ‘OK’: ‘Don’t be the same person that you was when you had your children taken.’
This shows the mothers’ need to ‘better themselves’ or transform themselves somehow, possibly in an attempt to reduce their sense of shame. For the majority, it seemed that even after many years, they were still in a process of grappling with their sense of themselves. Having their children taken into care had been a shock and gone against their own hopes and expectations as mothers. As a result, many felt a strong need to repair their identity or find a new one.
The children are gone but still here
The birth mothers felt challenged by being in an ‘in-between state’ whereby they had lost their children but continued to have contact with them. Contact evoked complex feelings for those who were, in parallel, processing painful feelings in relation to their loss and sense of identity.
Eve had one child in foster care and three who were adopted. The frequency of contact with her child in foster care varied and she had letterbox contact with the other three once a year. She captured her mixed feelings about contact when she said: I can't wait to see her but I'm dreading it. I don't know how she's going to be, how she's going to be towards me. I don't know if she's going to be angry, happy or sad; I don't know what's going to happen … I don't know the children. I don't know what they like, what they don't like.
In many ways, contact was viewed as very precious. It provided a way for the mothers to try to hold onto a parenting role as they sought to have some influence over their children’s upbringing. It also meant they were able to have information about their children that allowed them to continue their relationship with them.
Alice had annual letterbox contact with her child and told of the importance of having information about him as a means of still feeling a part of his life: I get photos, so I get to see how he’s growing up and they put a lot of detail in it … what he’s into, how he’s doing at school, what he’s been doing with his friends … which is really nice cos then it feels like I’m still … I’m still part of his life. And then, if and when he decides to come back, we haven’t gotta start from scratch, it’ll be like we already know each other.
At the same time, having contact with the children they had lost also brought challenges. Despite the mothers looking forward to direct contact, they also felt a pressure and anxiety to make the occasion special and memorable. This seemed to be complicated by the infrequency with which they saw their children and their sense of guilt about the child’s situation. Lucy remembered the time when she had direct contact with her children; she expressed the pressure she felt and associated anxiety to make the time they had together special, describing herself as ‘over-run with emotion’: … You’re so over-run with all these emotions of, ‘Oh my god, I’m not going to get to take them to the cinema ever, I’m not going to do … ’ So them things become more important to get done and it becomes … they’re enjoyable, but there’s always … there’s this other bit where you’re thinking … anxiety … Oh, what can we do to make it special … especially when it’s their birthday or Christmas. It all has different elements to it, I think.
For Tracey, saying goodbye reminded her of the mistakes she had made. Each time she saw the children upset, she experienced guilt and anger at herself: Saying goodbye, that’s the challenge … I still find it hard, but I seem to find it more hard with the girls, but then that’s because they always cry when it’s goodbye time, so that always puts the extra, you know, if I hadn’t messed up, we wouldn’t be having to say goodbye, therefore they wouldn’t be crying now. So that sort of like brings the guilt back and everything else, and I get angry at myself for messing up and for putting my kids through pain.
This shows the complex emotions that contact evokes for mothers who at the same time are trying to renegotiate their identities as mothers and parents and to process the loss of their children within the context of still seeing them. Contact seemed to help them with their sense of grief at losing their children because they were able to feel a part of their lives. However, it also served to highlight their loss, especially in having to say goodbye and seeing the distress of their children at parting.
Discussion
Trauma
All the mothers in this study described intense shock and disbelief after their children had been removed. All recalled vividly the moment when their children had been taken away and, in particular, the distress of their children at the time. They described intense experiences of despair, hopelessness, guilt and shame following the removal of their children. This demonstrates the overwhelming nature of their feelings in relation to their loss, as reported in several other studies of separation (Castle, 2010; Charlton, et al., 1998; O’Leary-Wiley and Baden, 2005; Wells, 1993).
The birth mothers also appeared to find it very difficult to maintain tolerance of these intense emotions and had to find ways to cope with these overwhelming and potentially traumatising experiences. Their disconnection from emotion can be seen as consistent with the concept of ‘psychic numbing’, defined by Litz and colleagues (1997) as a loss of interest, detachment from others and lack of emotional responsiveness. These manifestations of ‘psychic numbing’ have potential implications for the ways in which birth mothers are perceived by others, for example, as uncaring and emotionally cold. As this study demonstrates, they also have implications for how birth mothers cope with their loss, such as by drinking or self-harm, responses that are counterproductive since they reduce the likelihood of seeking help.
Although not explored in the interview, many of the mothers described or alluded to having come to motherhood with their own histories of trauma, abandonment and loss. One had herself been adopted. This was also found by O’Neill (2003), who suggests that not only is this likely to have contributed to the reasons why their children were removed, but also to the mothers’ subsequent inability to cope.
This context of historic trauma and lack of secure attachment histories helps to explain the mothers’ tendency to minimise or misrepresent the seriousness of what had occurred. Many described childhoods in which they were physically abused or neglected, which suggests that they were not able to develop secure attachments and therefore the ability to mentalise. One of the ways in which the mothers demonstrated difficulty understanding the impact of their actions on the children’s emotional development and well-being was in their descriptions of how their children were cared for physically. For example, some talked about how the children ‘had food in their tummies’ and ‘a roof over their head’ as a way of demonstrating that they had not been neglected. While this narrative might represent a wish to disconnect from emotion and to create a version that can be lived with, when viewed through an attachment lens it might also reflect a reduced capacity to understand the impact of their actions on the emotional development of their children.
These findings place the spotlight on the support and therapeutic services available to these mothers. Alpert (2005) suggests that services are not always available to parents in a timely and accessible manner. Although this is a US study, it raises many issues that apply to situations in the UK. For example, Alpert notes that many parents are mandated to attend therapy as part of proving their fitness to parent but that the services that provide this are often unavailable or inaccessible.
Finally, the findings of this study support the need for early intervention programmes to prevent the transmission of maternal trauma (Schwerdtfeger and Goff, 2007). Crucially, though, this should form a part of an approach that addresses the complex needs of mothers and families in a holistic manner.
Disenfranchised grief
The overwhelming perception of the birth mothers in this study was that they had ‘no one in their corner’ and that they were left to cope alone after their children had been removed. There was a strong sense that they felt that their grief and loss were not considered to be legitimate. This was evident in statements such as, ‘I should be happy now that my children are happy’ and ‘My feelings don’t matter, it’s all about the children.’ The majority of mothers described or alluded to not feeling like a person who has (or should have) needs and feelings in relation to their children being taken away, a finding that speaks to the strong social discourses around motherhood that create a stigma for those whose children have been removed.
Mathur and Rutherford (1996) suggest that socially acceptable behaviour enables individuals to gain social reinforcement and acceptance. Therefore it is likely to follow that expressing emotions in relation to having one’s children taken into care puts one at risk of being socially excluded. This can be viewed as consistent with the concept of disenfranchised grief (Doka, 1989), which suggests that stigma influences the process of grieving and psychological adjustment to loss. It is a concept that has been applied to the experiences of mothers who voluntarily relinquished their child for adoption (Aloi, 2009) and so is even more likely to be relevant to those whose child has been compulsorily removed. Doka (1989) suggests that disenfranchised grief occurs when a loss is not acknowledged or socially validated, especially in a context of ‘ambiguous losses’ (Boss, 1999), of which having a child taken into care or adopted is one. Boss identifies two types of ambiguous loss, the most relevant being when a person is physically absent yet psychologically present, as in when your child is taken into care or adopted. It is a loss which, unlike death, is undefined, not immediately recognisable to others and does not have rituals around it, such as a funeral. When someone dies, there are cultural practices and social support systems that help to facilitate the grieving process because loss through death is publicly recognised and legitimised (Betz and Thorngren, 2006; Robinson, 2002). As a result, one is more likely to receive support from the community.
Managing ‘spoiled’ identities
Betz and Thorngren (2006) expand these ideas and argue that following an ambiguous loss, some mothers may no longer know what their role entails. Furthermore, they suggest that those whose children have been taken away may feel confused as to whether or not they are a mother at all if they are not raising their child. The accounts of the mothers in this study indeed suggest that they found themselves renegotiating their identity to move away from the stigma of being labelled a ‘bad’ or ‘failed’ parent. For some this meant that they tried to ‘better’ themselves by finding a new career, moving away and getting out of destructive relationships, and many expressed a wish to ‘repair themselves’. This process of renegotiation relates to Goffman’s (1963) concept of ‘spoiled identities’ discussed in his book Stigma: Notes on the management of spoiled identity. Holt succinctly defines the concept as ‘an identity which possesses an “undesired differentness” and which therefore needs to be carefully managed’ (Holt, 2010: 416).
As was explained earlier, another way in which the mothers in this study tried to defend against a ‘bad mother’ label was to create a narrative for themselves that they could live with (Schofield, et al., 2011) and which they could present to others. This was illustrated in their minimisation of the circumstances around which the children were removed. Although there were moments when many mothers accepted their mistakes, this was painful to stay with and several of them found it easier to pursue a narrative in which services and professionals were to blame, as it allowed them to defend against the alternative, which threatened their identity and self-esteem.
The mothers’ tendency to minimise their actions, or inactions, suggests that it may be important to address issues of responsibility before embarking on therapeutic work or to make this an integral part of the intervention. Working with these mothers to help them to hold more responsibility may also ameliorate their anger with services and make their voices more likely to be heard. Jenkins (1990) describes the narrative approaches he has used with men who were violent and abusive; he suggests that ‘the more forcefully we argue for responsibility, the more we invite the perpetrator to argue for the avoidance of responsibility’ (Jenkins, 1991: 193). If conversations about taking responsibility leave mothers drawing negative conclusions about their identity, responsibility will be resisted. Instead, dialogues that explore preferred relationships with their children are more likely to enable safe exploration of their current or past relationship and, importantly, the chance for redemptive action. Interventions in a group format are also likely to be a useful way in which to begin to have conversations about responsibility. For example, these conversations could be integrated into mentalisation-based group therapy programmes (Bateman and Fonagy, 2004) which, in and of themselves, may contribute towards accepting responsibility through the development of empathy. If mothers are able to develop their capacity to mentalise and to understand the impact of their actions, and inactions, on their children, they are more likely to be able to hold responsibility.
Experiences of the child protection process
In relation to their experiences of the child protection process, mothers described feeling on their own; most felt that if they had been given the right support, their children might not have needed to be taken into care. Some talked about feeling that they needed therapy at the time in order to be able to manage their own emotional difficulties, but that it was not in sync with the timeframes of plans for their children. Others felt that professionals had been aware of their parenting difficulties in the context of a chaotic home situation but that support had not been forthcoming.
The birth mothers also talked about ‘one story obscuring others’ and how frustrated and powerless they felt in the face of a confusing and adversarial court process (Smeeton and Boxall, 2011).
When considering the aims of the child protection process, it is understandable that the focus needs to be on the limitations and failures within the birth mother’s parenting and the risks related to her environment. However, when appraising the psychological well-being of and the meaning-making process for women after their children had been taken into care, it is clear that they struggle with the fact that there was no room for positive elements within the child protection ‘story’.
As part of providing holistic and comprehensive services, it is important to consider the impact of, and response to, mothers’ experiences of the child protection process. While it is acknowledged that the power imbalance described is very often necessary to safeguard a child, it is also important for practitioners to be aware of and to be able to talk about its impact on parents. Featherstone and Fraser (2012) piloted a parental advocacy scheme in England for parents whose children were subject to child protection proceedings. They call for ‘a more robust recognition of how daunted parents often are by current systems’ in policy and in practice (p. 3). Of the 18 parents surveyed, 13 described the advocate as ‘helpful’ and felt they had facilitated their understanding of the process and represented their needs and views. Eleven felt that advocacy support had made it easier to communicate with the local authority and six believed it had helped them to contain their emotions, feel empowered and understand their rights.
The complexity of contact
The issue of contact between birth parents and their children absent in care has been widely discussed. In her thesis exploring the experiences of mothers who voluntarily relinquished their children for adoption, Castle (2010: 243) writes: Contact between a birth mother and her relinquished child is perceived as a (partial) solution to a painful decision, a salve to an enormous loss. For some it meant not having to say goodbye. Yet it is a solution that also appears resistant to fully resolving the grief associated with the act of relinquishment.
Similarly, Logan (1996) interviewed birth mothers about their experiences of simply receiving information about their child and found that all of them described this as something they looked forward to but that was also very upsetting. Neil (2010) found that birth mothers often experienced high anxiety during contact as a result of not knowing what they were allowed to do, for example, whether they could comfort their child or whether this should be done by the adoptive parents. Birth mothers described feeling unclear about where the boundaries lay and were concerned about overstepping them and losing contact altogether, findings echoed in the current study.
Although contact meant that some mothers were able to see their children, it also meant that they continually had to say goodbye and many described the pain of seeing their children distressed by this and how it reignited feelings of anger towards themselves because it served as a reminder of their own ‘failings’ as a parent. It also rekindled feelings of grief at their loss. Furthermore, some mothers described trying to parent their children during contact, but finding themselves in a ‘tug of war’ with the foster carers or adoptive parents who were raising them with values of their own. Neil (2003) suggests that part of the problem is that the role of birth relatives, particularly after adoption, is poorly defined, raising further questions for them in terms of their identity – a conclusion confirmed in this study where mothers talked about not knowing what to say or how to behave and, in general, not really knowing what the ‘rules’ around contact were.
Conclusions
The findings of this and other studies suggest that the experiences of birth mothers are complex. They face psychological tasks such as processing complex and disenfranchised grief, coping with difficult feelings such as guilt and shame, and renegotiating identity in the context of stigma. At the same time, they are more and more commonly faced with the task of sustaining useful contact with their absent children and maintaining effective relationships with foster carers or adoptive parents.
The need for therapeutic support to be routinely offered to birth mothers to address their needs is indicated (Slettebø, 2013). Given the trauma associated with care admissions and the possible detrimental effects of this on the children, our energies should first be focused on preventing this situation from occurring wherever possible. This will require much greater support for mothers who are vulnerable and where there are concerns that children’s needs are not being met. Attachment-based interventions such as ‘Minding the Baby’ (Slade, et al., 2005), underpinned by the theory of mentalisation, provide intensive support to vulnerable or high-risk first-time mothers. Interventions like this can prevent the transmission of maternal trauma to the parent–child relationship which, it seems, contributes significantly to the problem of successive removals.
Alongside this concern for the well-being of birth mothers lies a strong economic argument for providing interventions at an early stage. Many parents find themselves in a cycle of recurrent legal proceedings which, as well as causing untold distress, costs the local authority approximately £15,000 per care proceeding (Broadhurst and Mason, 2013).
But if separation is necessary, narrative approaches could be useful to enable mothers who perceive their stories as decontextualised to re-author and take back ownership of them (White, 2007). This might serve to reduce feelings of shame and disenfranchised grief by allowing a richer story to be told that would include their love for their children, the positive moments they shared with them and the parenting they were able to maintain despite so many problems. This kind of intervention might also serve the dual purpose of supporting mothers to manage a ‘spoiled identity’ by eliciting other stories about themselves. Robinson (2002) describes post-adoption grief counselling for birth mothers as part of a government-funded group called the Association Representing Mothers Separated from the Children by Adoption (ARMS) in South Australia. Here a narrative-based approach is used, designed specifically for the client group. Clinical psychologists are in a unique position to be able to deliver complex interventions such as these.
Despite the fact that policies like the Adoption and Children Act (2002) have raised the profile of birth mothers and specify the need for post-adoption services, in practice this is minimal and does not mandate agencies to address their needs (Slettebø, 2013). Without specialist provision of support for mothers after their children have been taken into care or adopted, they are left to try and access mainstream services that often fail or are delayed due to the high threshold for eligibility. In their study of support services for birth families, Neil and colleagues (2010) found that, where such services were accessed, the majority reported finding them helpful and, significantly, that positive outcomes for birth relatives are important for helping them to sustain contact with their children.
Casey (2012) suggests that services should have an understanding of the family as a whole as well as what has happened to the parents as children. The social work model Reclaiming Social Work (Goodman and Trowler, 2012) was developed in response to children’s services becoming risk-averse, anxious and over-bureaucratised, largely following tragic deaths such as that of Peter Connelly. It was first introduced in the London borough of Hackney and resulted in a 40% reduction in the number of children being taken into care. The model, which radically transformed the process of child protection, aims to work proactively with families, privileging direct work with them in order to keep families together where possible. Embedded in this model are clinical practitioners, such as clinical psychologists, who work with the parents and the family as a whole. Here, clinical psychologists can play a key role in providing interventions at an early stage to assess and work with the needs of both parents and children.
This study, too, highlights the need for greater collaboration between child and adult services. The current divide precludes systemic thinking about the needs of children and families and may mean that multidisciplinary expertise is not utilised effectively. Cleaver, Unell and Aldgate (2011) argue that children’s services should give greater priority to using the expertise of adult services, for example, which can offer experience in assessing the impact of difficulties such as mental health problems, learning disabilities and domestic violence on parenting capacity.
The use of IPA in this study was considered to be the most appropriate since birth mothers’ experiences have been under-researched and because it fits with the open and exploratory nature of the research question. IPA constantly allows researchers to stay close to the participants’ experiences, helping them to avoid viewing their accounts through potentially blaming social discourses. This was particularly important, for example, in understanding possible constructions of the theme ‘minimising seriousness’.
A number of limitations to the study need to be considered. The findings presented here represent one possible construction of the experiences of birth mothers, in line with the interpretative nature of IPA. Since this is an idiographic approach, it does not make claims about the generalisability of the findings. The findings do, however, contribute to the knowledge base around birth mothers’ experiences and give a voice to a group of people who are marginalised. In addition, the participants were recruited through birth mother support groups and the sample is small, thus the findings are more illuminating about processes than able to provide a national picture.
It is argued that support for mothers following their children being taken into care should use a multidisciplinary approach. Services must go beyond monitoring and assessing to providing interventions that address the needs of mothers and families holistically. Our findings support the need for early intervention parenting programmes in order to stop families from reaching a crisis point and to prevent the inter-generational transmission of parenting difficulties. In particular, early intervention is essential for addressing the growing concern around mothers losing successive children to care. Crucially, though, it is suggested that interventions must go beyond the teaching of parenting skills. This study highlights the need for clinical psychology to recognise, understand and respond to the complex needs of birth mothers and to make key contributions to the child protection process. Further research into therapeutic interventions to help these mothers is needed not only for their well-being but also to prevent children from being repeatedly removed and to break inter-generational patterns. As Broadhurst and Mason (2013: 298) argue, ‘It is timely to consider a post-proceedings protocol for parents, which would encourage a proactive multi-agency approach to enable the cycle of repeat pregnancies and removals to be broken.’
