10-year mortality among first-time mothers involved in family court care proceedings in England: cohort study using linked administrative hospital, mortality and family court records
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Family court care proceedings are instigated to remove children at risk of harm from parental care. Limited information is available on the health of mothers involved in care proceedings. We assessed maternal mortality and causes of death within ten years of first birth, comparing first time mothers with and without care proceedings. Methods Using linked, administrative hospital and family court data, we followed a whole-population cohort of first-time mothers delivering between 2007 and 2017 up to ten years. We calculated mortality rates comparing mothers with and without care proceedings. We examined proportions of deaths potentially preventable (suicide, homicide, drugs/alcohol, or injury) and identified factors associated with death after care proceedings. Results Of 2,775,835 first-time mothers contributing 21,856,503 person-years of observation, 28,405 (1·0%) had proceedings. Following proceedings, 314 (1·1%) died, compared to 5,103 (0·2%) among mothers without (age-standardised mortality ratio: 21·0, 95% CI 14·3, 27·7). Mortality ratios were lowest among first-time mothers aged less than 20 (4·5, 95% CI 3·5, 5·9) and highest for those aged 30-34 (28·3 95% CI 21·3, 37·5). Amongst mothers who died after proceedings, 73% of deaths were potentially preventable compared to 28% among mothers without. Factors associated with death were older maternal age at proceedings, health conditions and court orders related to child removal. Discussion First-time mothers with care proceedings had 21 times the risk of dying within 10 years than similar-aged mothers. Healthcare, social care and family courts must address the extreme health vulnerability of mothers before, during and after proceedings.
Institution: University College London
Language: English
Topic: Child Welfare and Adoption
Subfield: Safety Research
Field: Social Sciences
Domain: Social Sciences
Open Access status: hybrid
Awards: The contribution of health and social adversity to public and private family court proceedings: a public health approach, G3443191685, G3664739065, G4800590716, Linking health and education data for research to improve outcomes for children in England - Supplement, Linking health and education data for research to improve outcomes for children in England, G7164640792, Enhancement of ECHILD with a mother-child and Unique Property Reference number link, G7214758323, G721722156, G882590987, G8954866190, The contribution of health and social adversity to public and private family court proceedings: a public health approach
OpenAlex ID: W7165629645