Born into care in Scotland: circumstances, recurrence and pathways

5. Infant and family circumstances

In order to build a comprehensive picture of the family backgrounds, experiences, and pathways of infants who were looked after away from home via the CHS in Scotland, we extracted information from the case files held by the Scottish Children's Reporter Administration (SCRA) for a random sample of 70 children who became looked after on a CSO between 1 April 2018 and 31 March 2019, before they were a year old. This included at least one child from 31 of the 32 local authorities in Scotland.

About the infants in the sample

There were 28 girls (40%) and 42 boys (60%) in the case file sample, and they were born between May 2016 and November 2017. The majority of the children were of White ethnicity (60, 86%), with most of the others not having ethnicity recorded. Only two children had a registered disability recorded in the case file, 23 (33%) had no disability recorded, and for the majority (64%) this was not evident/recorded.

In keeping with the sampling criteria, the children had a CSO, with requirement for a placement away from home, made between 1 April 2018 and 31 March 2019, although many became looked after before that date (as we consider below). When the CSO (away from home) was made, children were aged between seven weeks and a year old, with an average of six months.

Infant health concerns

Babies born preterm can have multiple difficulties in the days and weeks following their birth, with a possible impact on health and development persisting throughout childhood and adult life (Costeloe et al., 2012; Saigal and Doyle, 2008). A baby's weight at birth reflects their gestation and how well they have grown whilst in the womb, and both low birthweight and prematurity are associated with poverty (Larson, 2007), maternal mental health and substance use (Zhao et al., 2017), and experience of childhood adversity (Hardcastle et al., 2022). Babies who are both preterm and small for their gestational age are at particular risk of short and long-term health problems. In Scotland, 7% of all live singleton babies were born pre-term in 2016/17, and 5% had low birthweight (National Records of Scotland, 2021).

Over a quarter of the infants in the sample were known to have been born prematurely and/or had low birth weight (20, 29%). This is higher than found in a recent study which analysed linked family justice and maternity data for 1,000 mothers who subsequently entered care proceedings with an infant in Wales, which found that 14% of mothers went into labour prematurely (before 37 weeks gestation) and 8% of full-term babies were born with low birth weight (Griffiths et al., 2020). Similarly, a study of infants in care proceedings in England (Broadhurst et al., 2017) found that 15% were born pre-term (although did not record birth weight).

Illicit drug use during pregnancy has been associated with a wide range of adverse neonatal outcomes, including preterm birth and low birthweight. Prevalence of illicit drug use during pregnancy in Scotland is very low and is declining, recorded in just 1% of pregnancies in 2014/15, and the proportion of babies with withdrawal symptoms of maternal drug use at birth was six per 1,000 live births, 0.6% (for the period 2012/13 and 2014/15) (Scobie and Woodman, 2016). In contrast, we found that around a quarter of the infants in the sample (18, 26%) were recorded as having experienced substance withdrawal at birth. This is higher than the proportion found in the English study (Broadhurst et al., 2017), where 18% of infants were affected by their mother's substance misuse. This might reflect differences in definition and recording, but also possible variation in the thresholds for taking children into care.

Developmental delay was noted for eight children (11%) in the sample, with other health concerns recorded for 19 (27%). These included heart and liver problems, difficulty feeding/weight loss, bleeding on the brain, and sensory difficulties (vision and hearing).

Family circumstances

This section presents findings about family circumstances and difficulties prior to the infants becoming looked after away from home, as recorded in the case files. Previous research across the UK has demonstrated that children who come from backgrounds characterised by social and economic disadvantage are more likely to become looked after (Bebbington and Miles, 1989; Bywaters et al., 2015, 2018; Cusworth et al., 2019; McGhee and Waterhouse, 2007), and that the impact of austerity on families who come into contact with social workers has been significant (Jones, 2017). The Promise (Independent Care Review, 2020) also recognised that children in Scotland growing up in poverty are over represented on the child protection register and are more likely to be removed from their families.

It can be seen in Table 3 that housing difficulties and financial difficulties were a feature of the lives of a majority of families in our study (83% and 69% respectively). For four in ten of the children (41%), it was recorded in the files that there was no parent in employment (and this information was not evident/recorded for over half of the sample).

Following housing and financial difficulties, the next most common concern in the lives of families was domestic abuse and/or coercive control. This was mentioned as an issue for almost two-thirds (61%) of families, with parental conflict recorded for 10%. For three in ten children (29%), parents were recorded as having separated or divorced, and for a further six (9%) their parents had never been together as a couple. The presence of a (non-parent) risky adult in the household was a concern for one in five children (19%).

Levels of known concerns relating to the parents of infants in the sample, as recorded in the case files, are presented in Table 4. Again, this is likely to be an underestimate, especially for fathers, on whom no details were recorded for 12 infants.

As has been found in previous studies (Broadhurst et al., 2017; Cusworth et al., 2019; Griffiths et al., 2020) parental substance use and mental health problems are evident in a majority of cases where infants became looked after away from home. Substance misuse was recorded within the case file for 77% of mothers and 74% of fathers. Parental mental health concerns were also highly prevalent, particularly for mothers (70%).

Around a quarter of mothers (24%) and slightly fewer fathers (20%) were recorded in the child's case file as having learning disability or difficulties. Previous studies (Broadhurst et al., 2017; Cusworth et al., 2019; Hunt et al., 1999) have found that around a fifth of parents subject to care proceedings in the UK were described as having a learning disability or cognitive impairment, and such difficulties were often been found to co-occur with other problems, such as substance misuse or mental health problems, that may impair parents' capacity to meet their children's needs (Cleaver et al., 2011).

Half of the mothers (50%) and seven in ten of the fathers (71%) were known to have a criminal history, with the fathers of almost half (46%) of the infants known to have served a custodial sentence. Smaller proportions of each (13% of fathers and 9% of mothers) were known to have committed (Schedule 1) offences against children.

Existing research has considered the ongoing impact of negative childhood experiences on different aspects of health and development, and on parenting capacity (Dube et al., 2001) and found that both mothers and fathers in (recurrent) care proceedings had childhoods characterised by adversity, including being abused or neglected, being looked after, parental substance misuse and mental health difficulties (Broadhurst et al., 2017; Cusworth et al., 2019; Phillip et al., 2021). Drawing on data from the Wales Adoption Study, Roberts et al., (2017) found that more than a quarter (27%) of birth mothers and a fifth (19%) of birth fathers with children placed for adoption were care experienced.

In our sample, high proportions of mothers (57%) and fathers (33%) were known to have experienced abuse and/or neglect during their own childhoods, with over a third of mothers (37%) and a quarter of fathers (24%) having been in care themselves as a child. Lack of a support network or extended family support was recorded in the case files as a known issue for three in five mothers (61%) and two in five fathers (39%).

Key findings

• The sample consisted of 70 infants who became looked after away from home on a CSO in 2018/19 before they were a year old.
• 60% were girls, and the majority (86%) were of White ethnicity.
• Infants were between seven weeks and a year old when the CSO (away from home) was made, with an average age of six months.
• Over a quarter of the infants (29%) were known to have been born prematurely and/or had low birth weight.
• Significant numbers of the infants, around a quarter (26%), were noted as having experienced substance withdrawal at birth.
• Development delay was noted for 11% of children, with other health concerns recorded for around a quarter (27%).
• It is evident that, prior to infants becoming looked after, family circumstances were challenging.
• The lives of a majority of families were characterised by financial and housing difficulties, domestic abuse, parental mental health difficulties, substance misuse, and criminal histories.
• Many of the parents were recorded as having difficult and disrupted childhoods. Over a third of mothers (37%) and a quarter of fathers (24%) were care experienced.