Illustrated bumblebee flying in the air. The background has colorful surfaces.

The child welfare officers pick up a call from a maternity hospital. A newborn baby is suffering from painful withdrawal symptoms and is transferred to ICU.

A phone call like this is always alarming and stands witness to the failure of our society to protect the most vulnerable members of society.

In Finland, an unborn child does not have a legal status, which makes it impossible to restrict the mother’s right of self-determination, even if she is placing the safety of the foetus at risk with their substance abuse.  There are several acts that aim to secure the access of pregnant women to voluntary services and the Child Welfare Act includes provisions on the anticipatory child welfare notification obligation that is binding on the authorities.

In practice, however, the experience of pregnant women using these disconnected services is potentially even more confusing than that of the users of services in general. The situation is even more challenging if the mother also simultaneously struggles with addictions and housing and relationship problems. There isn’t a service provider that seems willing to assume the responsibility for the overall situation and the pregnancy is spent navigating between different authorities.

While a mother is pregnant, the social services are provided through adult social services. Yet, on a national level, there are no established, consistent procedures in place after the anticipatory child welfare notification has been filed. In the worst care, the mother meets with the child welfare officer for the first time at the maternity hospital. In the best case, the mother has been supported and motivated to engage with the child welfare services during pregnancy well before the baby is born. The latter of these alternatives is an investment that all policy-makers should be quite enthusiastic about. Not only will it save the local government money, but it is also, simply, the right of the child and what family services should essentially be about.

Calling for active debate

Sometimes even a timely intervention and help is not enough, and the duration of the pregnancy not long enough, to make a difference. Sometimes, an addiction is so severe that the mother is not able to control it even if they are aware that they are risking the health of their baby. Norway is the only Nordic country where involuntary treatment of the mother is legally possible to protect the unborn child. The provision of addiction services and the possibility of involuntary treatment during pregnancy should be under a much more active debate in Finland.

The new National Child Strategy provides tools for assessing the impact of measures on the child from many aspects when the services for pregnant women are evaluated by the social services and health care sector and the much anticipated reform of the Act on Social Work with Substance Abusers is being prepared. In the meantime, while we wait for all this to take effect, we must not rest on our laurels, because even the current legislation does offer us plenty of tools and, indeed, obligations to act.

Child welfare officers constantly struggle with the lack of sufficient, evidence-based services and methods. Working with pregnant women is an exception, however, as there is a wealth of research to back up effective work towards change.

In terms of the rights of the child, the National Child Strategy guides towards the proactive implementation of the best interest of the child as well as the provision of social and health services that match the needs of families. In practice, this means that child welfare services must have the necessary competence and skillsets to offer round-the-clock services in the home that support a substance-free lifestyle.

Since we must start somewhere, we might as well start from here. So that no child needs to be born with an addiction.

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