The Efficacy of Birth Alerts: Literature Scan

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Sistovaris, M., Sansone, G., Fallon, B. & Miller, S. (2021). The Efficacy of Birth Alerts: Literature Scan. Toronto, Ontario: Policy Bench, Fraser Mustard Institute of Human Development, University of Toronto.

Issue: The efficacy of birth alerts for purposes of child protection in Canada. 

Background: In Canada, the practice of birth alerts has garnered considerable debate among child welfare advocates, practitioners, legal professionals and professional child welfare organizations regarding their efficacy in ensuring the safety and well-being of children. Typically issued by child welfare workers without a mother’s knowledge, birth alerts flag expectant mothers whose newborn may be at risk for harm, often resulting—but not always—in the traumatic apprehension of the newborn immediately after birth. The issue is of importance for two central reasons. First, decisions informed by birth alerts can have a lifelong impact on the lives of both children and parents. Failure to adequately assess a caregiver’s potential to parent runs the risk of harming the child by either removing the child prematurely from a family or by subjecting the child to continued harm if returned to the family. Second, compared to other developed countries, Canada has an exceptionally high rate of children in care and a disproportionate number of Indigenous children in care. 

Methods: A scan of existing peer reviewed and grey literature was carried out to identify, collect and synthesize research assessing the efficacy of birth alerts in Canada. The process involved a series of steps that included: the identification of key words/search terms; the identification of relevant data sources; the development of search strategies; an extensive and detailed search of peer reviewed and grey literature; literature screening and data extraction; and a synthesis of the literature. A list of keywords/search terms was developed that included the following: birth alert; birth apprehensions; apprehended at birth; and taken into care at birth. Throughout the search process, keywords/search terms were added, deleted or modified as different terms were discovered to enhance the search strategy. Search strategies were developed to meet the specifications and search parameters of each unique database. Pertinent information was extracted from the literature, synthesized and presented in tabular form. 

Results/Findings: The results of the scan reveal limited evidence-based research assessing the efficacy of birth alerts. Although the characterization of birth alerts as “problematic” and growing disapproval of birth alerts were common themes, supporting literature has largely been exploratory in nature and untested, requiring rigorous and systematic testing before any results can be used for guidance and decision-making. The profound effects birth alerts can have on the health and well being of children and families—particularly those of marginalized populations such as Canada’s Indigenous peoples— demands greater cooperation and coordination between policymakers, practitioners and researchers, all of whom play a central role in Executive Summary supporting evidence-informed policy making.

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