Evidence is clear: women who have previously experienced care proceedings or a child removed at birth are 25 times more likely to experience a repeat incidence in a subsequent pregnancy within 10 years. Age, learning difficulties, low socio-economic status and substance misuse are some of the predisposing risk factors for care involvement. There is widespread consensus on the association between adverse childhood event and longer-term developmental impacts for the child. There is also recognition of the ‘bereavement’-type experience felt by the women during this life event. The most recent MBRRACE-UK report (Felker et al 2025) highlights the significant impact this has on maternal mortality up to a year post-birth, with women who have had their child removed at risk of disjointed working across health and social care agencies. Of the 46 women who died via suicide 59 percent had their child removed from them and a further four were known to social services (Felker et al 2025). The report clearly stipulates the need for better service provisions and a more collaborative approach.

Midwives are likely to provide support to women during this difficult period and yet may not have all the evidence to care appropriately for these families. Most evidence spans across multiple agencies and many disciplines. This is why nearly all literature refers to this group as ‘slipping through the net’ in terms of who is responsible for their care and managing interventions. This paper combines current evidence from all disciplines in one place for midwives. It provides an overview of risks, interventions and how they can be implemented to foster changes in midwives’ practice, in the hope that we can break the cycle of recurrent removals.