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Numerous infants are placed into care shortly after birth due to safeguarding concerns. This paper explores the themes and therapeutic needs of mothers who undergo the distressing experience of having their babies removed, leading to the development of complicated grief and trauma, and how maternal mental health services can support them. Drawing from existing literature, this paper identifies key therapeutic needs, including issues of identity, guilt, and shame, as well as feelings of isolation experienced by affected mothers. In the absence of specialised guidelines, this paper advocates for adaptions of existing evidence-based treatment modalities such as trauma-focused cognitive behavioural therapy, eye movement desensitisation and reprocessing, and narrative therapy. For each approach existing literature is utilised to discuss how these approaches can effectively address the unique needs of mothers affected by infant removals. This paper underscores the urgent need for robust evidence-based guidelines to guide maternal mental health services in effectively supporting mothers affected by infant removals. By highlighting the importance of appropriate timing for engagement, multi-disciplinary collaboration, and clear treatment recommendations, it aims to pave the way for a compassionate and effective approach to promoting the mental well-being of these mothers and fostering positive outcomes for both parent and child.
Key learning aims
(1) To understand the therapeutic needs of women who have experienced the removal of their babies at birth.
(2) To examine existing evidence regarding interventions for other types of loss and explore adaptions to support women who have experienced infant removal.
(3) To recognise the necessity for further research in developing recommendations for therapy interventions and enhancing the ability of maternal mental health services to effectively support these women.
Trauma is the most common cause of nonobstetric mortality worldwide and is most commonly caused by domestic violence, motor vehicle accidents, and falls. Placental abruption and fetomaternal hemorrhage can occur with minor traumas where no major maternal injury is present. Initial management of any trauma should focus on maternal stabilization and resuscitation. Cardiotocography should be initiated as soon as possible and continued for at least 4 hours to monitor fetal well-being and screen for signs of placental abruption. If there are fewer than six contractions per hour and the patient is otherwise stable and asymptomatic, discharge can be considered. If there are six or more contractions per hour, fetal heart rate abnormalities, pain, bleeding, or fundal tenderness are present, the patient should be admitted for 24 hours of monitoring.
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