The practice of birth alerts in Ontario is ceasing October 15th. What’s next for child welfare agencies and their approach to working with expectant mothers?

Angela Arcuri, Director of Service at The Children’s Aid Society of the United Counties of Stormont, Dundas and Glengarry, and co-chair of the Provincial Directors of Service Group tells us how child welfare plans to move forward.

What was a birth alert and why was the practice problematic?

A birth alert was the practice of child welfare agencies notifying a hospital and birth centres of safety concerns before a baby was born. Those concerns might be due to previous involvement with child welfare, drug use, issues surrounding mental health or other challenges that could impact their parenting. The practice could result in the baby being immediately taken away from its mother after being born.

Before the National Inquiry into Missing and Murdered Indigenous Women and Girls, we didn’t really look at the practice critically. We never reflected on its long-term impact on the infant or their mother, or that the other components of the baby’s safety, for example their emotional, spiritual, and intellectual safety, were compromised in those situations. We also didn’t consider how the practice was inequitable, and led to overrepresentation of Indigenous, Black, and other marginalized communities in the child welfare system.

Does the end of birth alerts mean hospitals won’t be calling a children’s aid society if they have concerns? What role do healthcare providers and hospitals have now with regards to supporting pre- and post-natal patients and their infants?

Hospitals and healthcare staff should absolutely still call if they’re worried about an infant, child, or youth’s safety and well-being. There is still a “duty to report” any concerns to their local Children’s Aid Society or Indigenous Child and Family Well-Being Agency: that has not changed. And if a healthcare professional has a concern about an expectant parent, they can still ask for their consent to contact a Children’s Aid Society or Indigenous Child and Family Well-Being Agency. If the expectant parent does not consent, and concerns remain following the birth for the safety of the newborn, healthcare staff can still call their local Children’s Aid Society or Indigenous Child and Family Well-Being Agency.

I’m hopeful that over time, the social workers, nurses, midwives, obstetricians, and other key partners who work with infants will become an even greater part of the pre- and post-natal planning so that when the baby is born, they are working together to put in the place the safety mechanisms to keep the mother and child together.

Is there a concern that babies at risk might get missed without the birth alert practice in place?

We know from our partners from other provinces who have already undergone this process of eliminating birth alerts, that there isn’t evidence that this has posed significant or additional harm or risk to infants. We’re mindful of people’s worries and hopefully it helps to hear that in other provinces, people’s worries haven’t actually materialized.

We also need to realize that continuing the practice is just as worrisome because of the over-intrusion and irreparable harm that birth alerts were causing, especially to Indigenous families.

How will Children’s Aid Societies and Indigenous Child and Family Well-Being agencies support pregnant mothers going forward? What are some of the principles and considerations that will guide this work?

When we talked as a child welfare system about what should guide our work, we spent a lot of time reminding ourselves that the family and the child are at the centre of all this. They are experts about themselves, so they need to lead their plan.

We talked a lot about adopting a truly collaborative and interactive approach. That means that we are just one of many partners at the table, having conversations about and considering all the different aspects of a baby and their family’s safety and well-being. It moves us away from that reactive, most disruptive decision, to being planful and thinking it through with the people’s voices who are most impacted by the decisions. In terms of principles and guidance, this was a huge part of our conversation.

The other consideration we have to put front and centre is the traditional and cultural values of families. It’s a matter of truly understanding who you are serving. Do they have socio-economic barriers, like poverty, race, class? We need to understand those barriers and how they impact, and have impacted, that family. Because that history, that layering of trauma, is so important in providing the right support.

How does the cessation of birth alerts relate to the child welfare sector’s commitments to equity and reducing the overrepresentation of Indigenous, Black, and other marginalized communities in the system?

We know that birth alerts have caused harm, in particular for Indigenous families. And we know that other marginalized communities were also disproportionately impacted by the practice. So, ceasing this practice and coming up with new ways of working with families is really in line with the child welfare system’s commitments to equity and reducing overrepresentation. We are ready to make these changes.