Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK.
Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK.
J Public Health (Oxf). 2023 Nov 29;45(4):863-869. doi: 10.1093/pubmed/fdad137.
Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare.
We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges.
Three narrative subplots were developed to consolidate experiences of unmet health need: (i) 'on paper you're normal': narratives of complex need, (ii) 'in my family, everyone had issues': narratives of whole family need and (iii) 'I'm still mummy, no matter where they are': narratives of maternal identity and health.
Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women's narratives illustrate opportunities for health intervention, especially immediately following child removal.
被剥夺子女抚养权的母亲通常有复杂的需求。这些女性的健康状况不佳,并且由于可预防和可治疗的原因,比同龄人更早死亡。然而,对于医疗保健服务如何减轻这些风险,人们知之甚少。本研究旨在倾听被剥夺子女抚养权的女性的声音,了解她们的健康和医疗保健体验。
我们采用叙事方法收集和分析了六名在英格兰经历过子女被剥夺抚养权的母亲的访谈数据。每位参与者都被要求反思自己的生活和主要健康挑战。
我们整理出了三个叙事次情节来整合未满足的健康需求体验:(一)“表面上看你很正常”:复杂需求的叙述;(二)“在我的家庭中,每个人都有问题”:整个家庭需求的叙述;(三)“无论他们在哪里,我仍然是妈妈”:母亲身份和健康的叙述。
研究结果突显了当前支持系统中的局限性,包括不信任的文化以及女性在服务之间的脱节。女性的叙述说明了健康干预的机会,尤其是在子女被剥夺抚养权后立即进行干预。