A look behind the scenes

A vulnerable pregnancy and refusing help

On a rainy Wednesday afternoon at the end of the day, the phone rings at the Crisis Intervention Team (CIT). It is the police who ask for consultation; they have received several reports of a woman wandering, using drugs and causing a nuisance. Although they have found her in several places in the Netherlands in recent weeks, the Hart van Brabant region is not her original home. Police suspected she was pregnant and contacted the mental health department to assess her state of mind, but no further action resulted from this. However, at the time of contact between the police and CIT, the woman has already disappeared from view and there is no contact with her.

After the police contact, CIT seeks contact with organizations in the region where the woman is from and discovers that several parties are involved. It becomes clear that the woman is pregnant, but her pregnancy is uncontrolled. In other words, she had no medical care from a doctor, gynecologist or obstetrician during her pregnancy. The suspicion is that she is at least 4 months pregnant. There are also signs that Youth Protection is already involved.

Shortly thereafter, the police call CIT again. They report finding the woman again, this time disrupting public order. Standing in the street and making a lot of noise, she categorically refused to listen to the directions of the police. As a result, she was detained, among other things, for insulting an officer. Police are asking CIT to consult on possible solutions so that the woman is not found on the street in a nuisance situation every time. They are also concerned about the well-being of the still unborn baby.

The CIT will consult to determine what role they can play in this troubling situation. The woman herself will not accept help and she is pregnant, which further complicates matters. Meanwhile, the CIT has received confirmation that Youth Protection is involved, and that a temporary child protection order has been issued for the unborn baby. However, Youth Protection has not yet been able to get in touch with the woman. For that reason, they are in the process of applying for a care authorization so that the woman can be forcibly hospitalized, both for her own well-being and that of the unborn baby. But at this point, the care authorization has not yet been issued. Youth Protection requests the CIT to engage with the woman to give her a chance to accept counseling.

The CIT makes an appointment with the police to go to the cell complex. They are aware that little can be done if the woman does not want help, but they still want to give her the opportunity to consider the assistance offered. They also want to discuss with her the concerns surrounding the unborn baby.

In the cell, they find a small woman, clad only in a bathrobe and smelling of urine. The CIT explains that they are not from the police, but that they would like to talk to her. The woman immediately makes it clear that she does not need help and does not appreciate the conversation; she lets them know they are not welcome. The CIT asks her about her pregnancy, but to this she does not answer. She reiterates again that they want to leave and that she is not interested in counseling.

It is one of those conversations that CIT had hoped for a different outcome, but knowing that an unborn baby is involved makes it extra confrontational. In consultation with the police, the CIT leaves the cell complex. They provide feedback to Youth Protection and inform a consultation between hospital and healthcare organizations about vulnerable pregnancies.”

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