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The needs of pregnant women in contact with the criminal justice system

Clinks and Birth Companions report into the needs and experiences of pregnant women and new mothers in contact with the criminal justice system in the community.

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A window of opportunity

Clinks and Birth Companions have today (24 May 2021) published a new report: A window of opportunity: Understanding the needs and experiences of pregnant women and new mothers in contact with the criminal justice system in the community in England. The report recognises that while there has been plenty of (much needed) attention on the plight of pregnant women and mothers of infants in prison, there has been very little space paid to many women who are in contact with the criminal justice system but not in prison still face challenges in their engagement with both health and criminal justice services during their pregnancy and early motherhood.

About the report

The report is based on information for a range of sources. Data was collected through two separate online surveys which were completed by 46 professionals from voluntary sector organisations and 27 specialist safeguarding midwives. All those who took part had experience of working with women who were pregnant or who had given birth in the last two
years – regardless of whether that child remained in their care or not – while in contact with the criminal justice system in the community.

There were also three online focus groups which included representatives from the voluntary sector and six women with lived experience of pregnancy, early motherhood and maternal separation while serving community sentences or under probation supervision following release. Discussions were also held with specialist midwives by phone to follow up on points raised in the online survey.

Findings

Several key themes emerged  from the research:

  1. Complexity of need
  2. A lack of recognition of, and responsiveness to pregnancy and motherhood
  3. The barriers to engagement: fear, stigma and judgement
  4. Success factors
  5. Multi-agency working – benefits and barriers
  6. The impact of Covid-19
  7. The window of opportunity.

Complexity of need

Voluntary sector professionals identified striking levels of need among pregnant women and those who had given birth in the last two years. The vast majority of voluntary sector professionals said the needs of pregnant women and new mothers are more complex than others on their caseloads.

This is stark given the fact that women in contact with the CJS are as a whole recognised as among the most vulnerable and complex groups in society.

The level of complexity highlighted by respondents was linked to the overlap of several issues dominated by CJS procedures, child protection procedures, housing, mental and physical ill-health, and high levels of isolation. Alongside these were needs in relation to domestic violence or abuse, financial hardship, risk of self-harm or suicide, substance misuse, and employment and training.

Lack of recognition and response

Less than half of the voluntary sector respondents felt probation services take sufficient account of the needs and
circumstance of pregnant women and new mothers. When asked about decision-making at different points of a woman’s CJS contact, a third of respondents said they felt pregnancy or recent motherhood was only sometimes taken into account in decisions relating to sentencing, compliance expectations, breach or recall to prison.

Barriers to engagement

Many participants highlighted the impact that feelings of fear, stigma and judgment had on women’s ability to engage with services, rooted in past experiences or worries about the future. These largely centred on fears about, and experiences of, separation from children, and the impact of stigma and judgement related to contact with the criminal justice system.

Success factors

In reflecting on good practice and areas for improvement, voluntary sector professionals, midwives and women with lived experience identified a number of factors that can have a positive impact in the support provided to pregnant women and mothers of infants in contact with the CJS in the community.

The most frequently cited factor was effective partnership work across the criminal justice, health and social care systems (see below). Respondents highlighted the value of input from key players and advocates within services, who see the importance of working with women on a long-term basis.

There was a clear sense that positive outcomes for women were in many cases reliant on individual statutory or voluntary sector workers going out of their way to respond to these needs, rather than as a result of systematic and consistent approaches.

Multi-agency working

The research provides strong evidence of the large degree to which voluntary sector organisations work with statutory and other services around the needs of pregnant women and mothers in the criminal justice system. Work with services focused on mental health, housing and substance misuse is the most common.

Multi-agency working within and across systems was identified as being possible – with the right approach – and as delivering positive outcomes.

Several voluntary sector professionals cited the importance of specialist midwives and the positive impact they’d had with women they had been involved with. One specialist midwife talked about the value in her area of “good multi-agency team work with probation and social services, robust pathways and continuity of care.” An important element of this, reinforced by several other responses, was the use of joint casework files which are “routinely updated by all partners” and used by key decision makers.

The impact of COVID

This research was conducted during the pandemic, although professionals and women with lived experience focused on describing practice and experience related to pre-Covid-19 conditions. However, the pandemic was raised at several points throughout the focus group sessions.

There was universal agreement on the significance of the impact of Covid-19 and associated restrictions on women in relation to issues of mental health, domestic abuse, social isolation, digital exclusion, access to community-based support services, food poverty and general wellbeing.

The loss of face-to-face contact was identified as reducing the effectiveness of probation supervision and the level of support provided by statutory and voluntary sectors.

The window of opportunity

Almost all the voluntary sector professionals who responded to the survey said they found working with women who are pregnant or have recently had a child presents particular opportunities to facilitate positive changes. Almost a third felt this was often the case with the majority saying they identified these opportunities in some cases.

Despite the strength of this opportunity, however, respondents made clear that the challenges created by contact with the criminal justice system can create significant barriers. If those challenges are not addressed and overcome then these opportunities and the chances they offer women and children will be missed.

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