Separation at birth: learning from lived experience (Dr Claire Mason)
Dr Claire Mason withCatherine Randall, National Associate Director of Safeguarding at NHS England.
Funding gives mums and midwives a chance to change practice
When a newborn is taken into care, safeguarding is focused on the infant, not the mother or the midwives making the best of a traumatic situation. Now a project developed with NHS England by Lancaster University, joint funded by an ESRC Impact Acceleration Account (IAA), is harnessing a wealth of experience to co-produce a solution with the potential to become best practice.
Claire Mason, a Research Fellow at the University’s Centre for Child and Family Justice Research, was leading the qualitative work on a wider project drafting new national guidelines for when the state intervenes at birth. “As part of that,” she says. “We had assembled an advisory group of women with lived experience of separation at birth. And Becs Reynolds, who chairs the National Maternity Safeguarding Network, asked us to come and speak about our work.”
“It was a meeting of minds,” says Becs, National Safeguarding Clinical Lead for NHS England. “Claire brought one of her Lived Experience Group to the session and it was incredibly powerful. So we got our heads together to ask What would a solution look like? What already exists? And there were pockets of amazing practice where midwives, off their own backs, had created a version of what would become the Giving HOPE intervention.”
Giving HOPE began to build on these innovations, as well as the wider research and the input of charities including Birth Companions, who helped facilitate the work. The idea was to adapt existing bereavement pathways and practices to support this cohort of women in dealing with their sense of loss.
The acronym HOPE was developed by the Lived Experience Group (‘HOPE Mums’) who participated in workshops that fed back to a midwife-led steering group looking at ways to embed innovations in practice. It stands for Hold on, Pain Eases, and encapsulates the principle that this help comes from a place of shared experience, understanding and compassion.
The HOPE Mums were instrumental in designing the HOPE Boxes that are central to this initiative. There are two, one that stays with the mother and another that goes with the baby to its placement with foster carers. The contents range from a letter and poem written by the HOPE Mums to various means of recording memories, as well as soft toys and hand-knitted blankets that may be swapped between mother and baby at contact sessions to share scents.
As Claire points out, maintaining a connection is very important, not only to minimise trauma for mother and baby, but also because when the boxes are first offered, the separation might not be permanent. “It still has to go through the court, so there is a chance the baby could go home, but the current system doesn’t give the best chances of that happening. The boxes can help to keep the mother’s mental health in the best state it can be, so she is motivated to be engaged in all the services supporting her. And then, if the baby doesn’t go home, it becomes about loss and grief work.”
In addition to the workshops and the boxes, the IAA helped to fund a site readiness process to ensure that the project could be piloted effectively across 18 NHS Trusts. It also enabled the production of a professional video featuring the HOPE Mums, to explain the background and support the implementation.
“Actually,” Becs says. “It’s about giving hope to staff as well. We see why children might need to be removed. But we also see a mother leaving a maternity ward with nothing. This gives her something to take with her, including a sense of ownership over the process. And it gives something to everyone in the multi-agency space – a way to continue a relationship with this woman.”
“The IAA was the stepping stone.” Claire explains how she was initially interested in the grant because it had a straightforward application process and focused on impact from the research, which she expected to be impact from the guidelines. “Instead, it took off as a project in its own right and enabled us to create something very tangible which has generated massive response so far. And it has really allowed us to develop the partnership with NHS England.”
A further benefit has been the impact on the HOPE Mums, which Becs characterises as their amazing confidence and ‘roar’ now they have found a collective voice. Claire agrees. “The growth in them has been phenomenal. One woman who was at the launch and received a National Safeguarding Award said ‘I’ve never felt so seen’. I hadn’t anticipated it having quite that effect. And they’re chomping at the bit to do more!”
Project website https://www.cfj-lancaster.org.uk/projects/giving-hope