Parents' experiences with child protection during pregnancy and post‐birth

Institute of Child Protection Studies, Australian Catholic University, Canberra, Australian Capital Territory, Australia Institute of Child Protection Studies, Australian Catholic University and School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia Australian Centre for Child Protection, University of South Australia, West Perth, Western Australia, Australia Ngangk Yira Institute for Change, Murdoch University, Murdoch, Western Australia, Australia Centre for Child and Family Justice Research, Lancaster University, Department of Sociology, Bowland College, Bailrigg, UK

the 'Born into Care' report highlighted that 42% of all care proceeding for infants were for newborns and 47% of these newborns were the siblings of older children who had previously appeared before the court (Broadhurst et al., 2018). In NZ, an inquiry into the removal of Maori infants conducted in response to concerns raised by the Maori community made extensive recommendations aimed at reducing the need for the removal of newborns from family and transforming the care and protection system (Office of the Children's Commissioner, 2020). No similar work has been undertaken in Australia focused on newborns and the prenatal period.
Despite growing prenatal child protection involvement, there is limited international literature on the experiences and views of parents involved in child protection interventions during pregnancy and following birth (Taplin, 2017). Previous literature has examined the role of midwives and social workers in child protection processes prenatally and with infants (Critchley, 2020;Everitt et al., 2017;McElhinney et al., 2021). However, there is minimal research privileging the voices of parents. In England, Broadhurst and Mason (2019) interviewed 72 birth mothers about their experiences, highlighting their immediate psychosocial crisis and the ongoing impacts of infant removal. Subsequent to this, Mason et al. (2022a) documented parents' experiences of pre-birth assessment and practice in maternity settings when a baby is removed at birth, uncovering shortfalls in inclusive practice. Broadhurst et al. (2022) also captured parents' experience of urgent care proceedings at birth, finding that many felt ambushed by a first hearing within hours or days of birth with little preparation or adequate legal advocacy.
The few Australian studies conducted with parents involved with child protection have recruited from substance use treatment services (Taplin & Mattick, 2015) or child protection agencies. One Australian study recruited 18 parents through community-based services who had had a child removed from their care (Ross et al., 2017). Flaherty and Bromfield (2020) described the challenges they experienced in recruiting mothers involved prenatally in child protection services.
These include gatekeeping by service providers, concerns about confidentiality and other challenges of recruiting hard-to-reach populations. The result is that little is known about the circumstances and characteristics of Australian parents involved with child protection during pregnancy and soon after birth (Wise & Corrales, 2021).
The views of parents have rarely informed performance measurement in child welfare, but as the service recipients, it is appropriate that their views of their service needs and expectations are included (Tilbury et al., 2010). Tilbury et al. (2010) argued that evidence-based practitioners must integrate the best available knowledge about what works, for whom and in what circumstances, with client feedback a mechanism by which to do so. Obtaining parent views also promotes the principles of listening to parents and involving them in decisionmaking and may improve interactions between agencies and parents (Tilbury & Ramsay, 2018).
The limited input from parents as the primary stakeholders, in terms of their views and experiences of prenatal and postnatal child protection policy and practice, results in a silencing and further marginalizing of already marginalized parents.
There are benefits from talking directly with the groups directly affected by particular policies and practices-in this case, parents involved perinatally with the child protection system-and learning about their views and experiences. Such input can provide new insights or understanding of service provision that are different to those of staff and others responsible for service delivery and can help inform service provision and potentially lead to improvements in outcomes (Parkinson et al., 2017). Protection and Family Support, 2020). The purpose of the NSW Act, for example, is 'to allow assistance and support to be provided to the expectant parent to reduce the likelihood that the parent's child, when born, will need to be placed in out-of-home care' and to provide early information about risk of significant harm subsequent to his or her birth (Section 25). There are legislative provisions for the development of a Parental Responsibility Contract with parents (Wise & Corrales, 2021).
Although the intent of the legislation and processes is clear, there has been little evidence gathered to date about the impact and effectiveness of these processes and, importantly, the views of the expectant parents who are subject to these processes. As such, this study aimed to generate knowledge focused on parents' involvement with child protection services in these two Australian jurisdictions (NSW and WA) during pregnancy and with their newborn. This study achieved this by providing them with the opportunity to share their stories, views and experiences through interviews.

| Study approach
A qualitative methodology, guided by a phenomenological approach, was adhered to for the present study. Interview data collected via 13 parent interviews were analysed to assist our understanding of their experiences of child protection involvement in pregnancy or with their infant, including infant removal. Phenomenological studies are interested in understanding the human experience of phenomena, including how people make sense of their experience of the phenomena (Lester, 1999;Moustakas, 1994). As a research approach, phenomenology is suited to exploring and describing the life worlds and shared experiences of participants and focuses on their views, feelings and experiences (Creswell & Poth, 2018;Laverty, 2003).
The main purpose of employing a phenomenological approach to the present study is to provide a voice for the parents (Neubauer et al., 2019), to address questions about, interpret and describe this group's unique and collective experiences (Creswell & Poth, 2018).
The present study employs hermeneutics methods and concepts to arrive at an in-depth understanding of participants' experiences. Hermeneutic (interpretative) analysis enables an elicitation of an in-depth understanding of shared and distinct meanings from the data. A phenomenological approach guiding the thematic analysis (TA) ensured the focus remained on participants' subjective experiences and sensemaking (Guest et al., 2012;Joffe, 2011).

| Selection and recruitment of parents
Parents were eligible to be interviewed if they had recently been involved with child protection services, either pre-or post-birth, and/or had an infant under 1 year of age removed from their care because of concerns about child abuse and/or neglect. There were some variations in the recruitment methods between the two jurisdictions, because of differences in the approvals and the access granted, resulting in more parents with children in their care in WA. The recruitment methods are outlined below.
In NSW, permission was granted to the researchers to recruit parents who were attending the NSW Children's Court in relation to their infant who had recently been removed by the child protection system. Flyers were distributed throughout the court building and the court staff referred infants' parents to the researchers sitting in the court reception area. Interviews took place in a private room in the court building immediately following discussion about the study.
In WA, pregnant women and mothers of infants involved with child protection services within the previous 2 years (but not necessarily removed from their care) were recruited through the Family Inclusion Network of Western Australia (FINWA) or Joondalup Women's Health Service.
Service organizations passed on the contact details to researchers of mothers who agreed to be interviewed and researchers conducted interviews in person. Parents interviewed in WA and NSW were given a $30 and $50 voucher, respectively, for their participation as per guidance from state ethics committees regarding amounts.
The following groups were excluded from the study: (i) mothers under the age of 16 years and (ii) potential participants who were unable to provide informed consent because of insufficient proficiency in English or had communication difficulties. Eligible parents who were willing to participate completed an informed consent process with the researchers. Interviews were audio-recorded and later transcribed. To retain parents' anonymity, pseudonyms were assigned to each participant and used consistently throughout the presentation of the study findings.

| Characteristics of participating parents
Most parents interviewed were female (11/13). One-third (4/13) of the parents were aboriginal, whereas five of the infants were aboriginal. At the time of the interview, eight parents had had their infant removed from their care (six of whom were aiming for restoration), whereas five parents were caring for their baby under a safety plan.
Most of the parents had older children, half had had older children removed by the child protection system (7/13), and two were firsttime parents (Table 1).

| Interview schedules
Interview schedules were used to guide the questions asked by the researchers utilizing a semi-structured interview approach. The

| Data analysis
To understand the parents' experiences of child protective processes, an approach to data analysis consistent with a phenomenological approach of balancing both the objective and subjective approaches to knowledge production was utilized (Moerer-Urdahl & Creswell, 2004;Moustakas, 1994). This was achieved by following recognized techniques for qualitative and hermeneutic data analysis, including TA and network maps (Attride-Stirling, 2001) constructed to visualize the themes generated. TA is used to identify, analyse, organize, describe and report on themes generated from datasets (Braun & Clarke, 2006). While providing methodical systemisation to textual data, it also allows for a deep and rich exploration of a dataset's underlying patterns (Attride-Stirling, 2001). Interview transcripts were managed using NVivo 12 Plus software and analysed manually in Microsoft Word. Initially, each interview was transcribed and then read and re-read to gain familiarity with and immersion in the data (Rivas, 2018). After this, a process of complete coding was conducted on each individual data transcript (Smith et al., 2009). Adopting these processes early meant the data was initially managed openly, and knowledge and research literature was put aside throughout the analysis until concepts and categories began to emerge (Moustakas, 1994;Oktay, 2012).
The results of this process across the 13 transcripts generated several significant statements, comments, initial codes and emergent themes. These were then grouped together and labelled with initial basic themes grounded in participant language before several organizing, and then final global themes were constructed (Charmaz, 2006;Oktay, 2012;Rivas, 2018;Starks & Brown Trinidad, 2007). The global themes summarize and capture the key concepts that affected parent's experiences. Finally, to ensure rigorous analysis and complete coding and to limit misinterpretation and researcher bias, the research team members each undertook a review of the codes prior to the write up of the findings. Organized as a thematic timeline that depicts four significant and interwoven narratives reflecting child protection service involvement in parent's lives, the shared experiences that parents described are

| Pre-birth or prenatal child protection
This section presents parents' pre-birth or prenatal 1 involvement with child protection services (the Department). Most parents became involved during the pregnancy, usually through a prenatal report and/or a pre-birth alert to hospital maternity wards. Four themes that captured parents' experiences during this period are presented below.
Pre-birth or prenatal child protection Concerns about the potential for removal contributed to parental stress during the pregnancy. Several of the mothers had pregnancy complications which required hospital monitoring and management while they also tried to meet Departmental requirements. One mother who was admitted by the hospital as an inpatient because of her complex pregnancy was notified by the Department that she had not met the requirements for visitation with her older children in OOHC.
This was despite the evidence that the mother provided to the Department of her admission into hospital at the time visitations with her older children were due to occur.
Parents often received information about child removal processes from sources other than the Department, including birth parent advocate groups (e.g. FINWA), not-for-profit or non-government organizations, social work staff employed at the hospitals where parents gave birth, health care workers, lawyers or legal aid organizations.
One parent couple shared that a hospital social worker informed them that their infant could be removed immediately following the birth because they had older children in care and recommended actions they could take to reduce the risk of removal. For another parent couple, it was the duty lawyer who explained the risks and the processes, including the paperwork the Department had to provide them regarding the removal of their child, which they had not received at the time.

| Theme 2: Pre-birth planning meetings
Parents had varied experiences of pre-birth planning meetings, the meetings held by the Department following a prenatal report. Parents described how their caseworker could affect the outcome of the meeting for the parent, either in a positive way or a negative way. Some parents emphasized the minimal support they received from their caseworker including the lack of consultation and negotiation at pre-birth planning meetings, as illustrated by a mother below: Parents commented that the Department seemed focused on their past lives and did not recognize the changes parents had made to their circumstances over time, as illustrated by a mother below: … they're trying to use things from five or ten years ago … but you need to look at now … I was younger, One mother with an intellectual disability was not appropriately represented at the prenatal meetings because of a lack of support from her legal guardian. The mother explained that the guardian's said: 'that it is not my job to fight the department' (Katie). The legal guardian dealt directly with the lawyers, and the mother had no voice in the process.
In WA, the use of independent facilitators-skilled workers who are not associated with District child protection teams-at prenatal meetings between families and caseworkers has been trialled at the primary maternity hospital. Parents commented favourably on their access to independent facilitators as they helped to ensure that parents opinions were properly heard and considered. A mother described the positive impact of the facilitator: she was awesome … when we did the meetings … there was a couple of concerns I had with my case- where if others don't, the baby or the child gets taken. (Chantelle).
Most mothers who retained care of their children had multidisciplinary care teams (health workers, social workers and advocates from non-government organizations) who worked with them to develop safety plans, organize supported placements with family, provide transport to appointments and seek housing and income support.

| The removal of an infant from its parents
This section outlines the challenges face by parents who did not have their child in their care at the time of their interview-as they had been removed soon after the birth. Most parents reported that they were not informed of any decision to remove until after the infant was born, even if the Department had been involved with the family throughout the pregnancy. Two themes that emerged from these parents' experiences during this period are presented below.
The removal of an infant from its parents There were two families who spoke of concerns about their children being abused in OOHC. One mother was concerned for her baby because she herself had been sexually abused in care. Another mother discussed her concerns about the safety of her children in care as her older child was sexually abused in care and there was a lack of departmental communication: He was sexually abused … At first the department just told us that there was one incident and we came to find out it was more … Even when the first incident happened they came to tell us six weeks after … As a parent we deserved to know … the children's lawyer (told us at the pre-hearing conference) … She thought the department had already told us. (Belinda)

| Parent reflections on child removal processes
In this final section of the findings, parents describe how the Department's child removal processes could be improved and the supports they needed but did not receive. Three themes emerged that captured parents' experiences during this period and are presented below.

Parents reflections on child protection removal processes
Theme 1: Information sharing by the Department Theme 2: Support and empathy for parents, and the role of agencies Parents reported feeling that the Department did not care about their wellbeing and emphasized the lack of support before, during and after the removal of their child (ren). Parents called for caseworkers to practice with empathy and concern for the emotional impacts that child removal processes had on them. In particular, the mental health impacts on families after the child was removed, as illustrated by a mother as follows: This issue was significant for a mother with an intellectual disability, who stated: 'if you have got disabilities, you have the right to have a family' (Katie). This mother planned to use her NDIS funds for a parent educator to work with her so she could have supervised visits with her children at home, but this was denied by the department.
Parents offered other specific suggestions to improve child protection removal processes, particularly in relation to infants. These are listed below: • Improve the ability of caseworkers to collaborate with parents to develop and implement prenatal plans.
• Improve casework practice with families experiencing family and domestic violence, particularly partnering with mothers to address concerns around perpetrators' safe access to children.
• Provision of greater supports targeted at prevention of removals and trauma informed practice (parents feel the department currently operates on a reactive response action)-provide opportunity to demonstrate capacity and change.
• Families experiencing homelessness require support to secure stable housing, particularly mothers escaping domestic violence, who lack family supports, have themselves been in OOHC or are transitioning from prison.
• A supportive process for parents in which infant removal is required (i.e. providing a parent a voice in how removal occurs, options for kinship care arrangements, meeting carers and contact visits scheduled prior to removal).
• The use of independent facilitators at prenatal meetings in WA was supported by parents. Facilitators were reported to play a significant role in ensuring that all parties were heard and were accountable in the decision-making processes.
• An independent office for parent support that provides direction and advocacy for parents during child protection processes and/or removals.

| DISCUSSION
This Australian study provides a rare look into the processes of the child protection system from the perspectives of parents during the prenatal and postnatal period. These parents-who have previously had limited opportunity to participate in research in Australia, as well as from providing input into policy and practice-provided unique insights into their involvement with the Department and the impact of these interactions. Further strengths of the study were the parents' suggestions about improvements to a range of Departmental processes at the various stages of the child protection process. Emphasis was placed on the need for more supportive casework and interventions to reduce the need for infants to be taken into care but also on better preparation and inclusive planning if safeguarding action at birth is needed.
Given the lack of voice for parents involved in child protection processes during pregnancy, this was an inherent strength of the present study. Our research highlights that the parents' voice is vital to improving our understanding of child protection processes and their impacts. Only by including the input of the parents involved-not just the workers-can their insights be used in recommendations for support, thereby increasing the likelihood of improved outcomes for them and their infants. Furthermore, in the present study, there was a contrast between quotes and examples highlighting parents' powerlessness and lack of voice, to the mothers who had independent facilitators. Our research highlights the importance of independent facilitators allocated alongside parents involved in child protection processes as they played a key role in providing a voice or strengthening the voices of parents throughout their communications and interactions with child protection processes.
Our findings are consistent with those from other qualitative studies of parents involved in the broader child welfare system (Collings et al., 2018;Harries, 2008). These studies describe inexperienced caseworkers, misinformation or lack of information from welfare workers and the disrespect that parents experienced.
Parents in these studies expressed despair and ongoing trauma in their engagement with the child welfare/protection system and from their experience of child removal (Pannor et al., 2010;Wells, 1993;Wilson-Buterbaugh, 2010). Parents in the present study were highlighted by Mason (2013, 2019), the removal of a child from a parent is the gateway to further adversity and additional pregnancies, making it vital to reduce its occurrence.
The parents' interviews highlighted the need for a greater focus on early intervention and prevention, with the establishment of respectful, trauma-informed and supportive relationships between agencies and parents. Most of these parents had experienced multiple traumas and adversities, thereby necessitating long-term, targeted support across multiple agencies and professionals to improve outcomes for them and their children.

| Study limitations
This research is not without challenges and limitations including an acknowledgement that research was conducted at a specific point in time (from 2019 to 2021) amongst a relatively small group of parents in two Australian jurisdictions. Access to interviewees was halted and restarted because of the COVID-19 pandemic, which affected the numbers recruited. Parents demonstrated an interest in the study through their participation; thus, the accounts and insights provided are not necessarily the views or experiences of all parents. In NSW, interviewed parents were more likely to have children removed from their care because of recruitment in the courts, whereas in WA, there was greater variability because of recruitment through service organizations who supported parents in developing child protection safety plans. For some participants, more than one interview may have enabled a fuller examination of the complex experiences of their involvement with the child protection system (Polkinghorne, 2005). We only had one parent with intellectual disability included in the interviews, and further research should investigate the complexity of issues faced by mothers with disability including the issues of guardianship and the intersection of disability support services and child protection that have been touched on in previous studies (Gould & Dodd, 2013).

| Conclusions
The consistent reports in the child protection literature that describe the lack of supports for parents after a child is removed by the authorities are concerning (Broadhurst & Mason, 2019;Memarnia et al., 2015). New guidelines from Mason and colleagues in England and Wales aim to promote far more inclusive practice, attuned to histories of child removal and trauma (Mason et al., 2022b). Significant distress and frustration were expressed by parents in the present study, including their lack of power in the child protection process and the lack of consistent information from the authorities, highlighting the need for improvement in the handling of these processes by the child protection system. Given that most of the study parents have ongoing involvement with the child protection system, with many having further children and repeat removals (Broadhurst & Mason, 2019), obtaining a better understanding of these parents' needs, the distress related to the removal of an infant and their treatment by the child protection system is vital if improvements are to be made to the system.

DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

ENDNOTE
1 The terms prenatal and pre-birth have been used interchangeably.