Hanni Stoklosa1,2, Lujain Alhajji3, Lindsey Finch4, Sacha Williams5, Jaya Prakash6, Anna K Sfakianaki7, Lunthita M Duthely8, JoNell E Potter8. 1. Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. hstoklosa@bwh.harvard.edu. 2. HEAL Trafficking, Los Angeles, USA. hstoklosa@bwh.harvard.edu. 3. Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA. 4. Jackson Health System, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA. 5. Johns Hopkins All Children's Hospital, St. Petersburg, USA. 6. Harvard Medical School, Boston, USA. 7. Section of Maternal-Fetal Medicine, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA. 8. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, USA.
Abstract
BACKGROUND: Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. OBJECTIVES: The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. METHODS: Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. RESULTS: Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. CONCLUSION FOR PRACTICE: Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers.
BACKGROUND: Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. OBJECTIVES: The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. METHODS: Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. RESULTS: Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. CONCLUSION FOR PRACTICE: Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers.
Authors: Lindsay E Clark; Rebecca H Allen; Vinita Goyal; Christina Raker; Amy S Gottlieb Journal: Am J Obstet Gynecol Date: 2013-09-18 Impact factor: 8.661
Authors: Jill R McTavish; Melissa Kimber; Karen Devries; Manuela Colombini; Jennifer C D MacGregor; C Nadine Wathen; Arnav Agarwal; Harriet L MacMillan Journal: BMJ Open Date: 2017-10-16 Impact factor: 2.692