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Pre Birth

Babies can be particularly vulnerable to abuse, and early assessment, intervention and support provided during the antenatal period can help minimise any potential risk of harm. This guidance provides advice on how to respond when there are concerns for unborn babies; it emphasises the importance of clear and regular communication between professionals when working with the mother, the father and the family.

All professionals have a role in identifying and assessing those families in need of additional support and in sharing information where there are safeguarding concerns. . Most pregnancies will not raise safeguarding concerns. However, in some cases a co-ordinated response by agencies will be required to ensure that the appropriate support is put in place during the pregnancy with the aim of safeguarding the baby before, during and following birth.

The antenatal period provides an opportunity for practitioners and families to work together to:

  • Form relationships with a focus on the welfare of the unborn baby;
  • Identify strengths, risks and vulnerabilities;;
  • Assess potential risks to the unborn baby ;
  • Explore and agree safety planning options;
  • Assess the family’s ability to safely parent and protect the unborn baby and the baby once born;
  • Identify if any assessments or referrals are required before birth; for example an Early Help assessment or referral to Children’s Social Care for a Pre-Birth Assessment;
  • Ensure effective communication and joint working with health and other services that are providing on-going care, treatment and support to a parent(s);
  • Plan and agree on-going interventions and support required for the child and parent(s);
  • Identify at an early stage if care proceedings are likely to be needed.

If a professional becomes aware that a woman is pregnant, and they have concerns for the welfare of the mother, unborn baby, or any siblings, they should not assume that Midwifery or other local Health services will be aware of the pregnancy or the concerns identified.  Midwifery Services should, therefore, be informed of the pregnancy, and any concerns.  .  The professional should seek the consent of the expectant mother to share information with midwifery services in this way, unless to do so would place the unborn baby or others at increased risk of harm. Where the concerns relate to significant harm, a referral should be made to Children’s Social Care (see Referrals procedure).

Professionals should consider whether the new-born baby will be safe in the care of these parents/carers and if there is a realistic prospect of these parents/family being able to provide adequate care throughout childhood. If not, a pre-birth assessment (led by Children’s Social Care) may be required.

Each professional should follow their agency’s child protection procedures and, in complex cases or if they are unsure of the most appropriate response, they should discuss any concerns with their safeguarding lead.

Identifying Risks

The following parental or family risk factors  can indicate an increased risk to any unborn child / baby and, if they are identified, a Pre Birth Assessment may be required:

  • A previous unexplained death of a child whilst in the care of either parent;
  • Parental substance misuse(drugs and alcohol) which is likely to impact on the baby’s safety, health or development;
  • Perinatal/mental illness which is likely to impact on the baby’s safety, health or development;
  • Victims or perpetrators of domestic violence and abuse;
  • · Where there are significant concerns about parental ability to self-care and/or to care for the child.
  •  Where any other concerns exists that the baby may be at risk of Significant Harm.
  •  Where either parent of the unborn child is under 18.
  • Family history of Female Genital Mutilation (FGM)
  • Where there are maternal risk factors towards the unborn baby.
  • Either parent is or was a Looked After Child);

The list is not exhaustive and, if there are a number of risk factors present, then the cumulative impact may well mean an increased risk of significant harm to the child. Professional curiosity should highlight to any practitioner that if they are in doubt, they should seek advice from their Safeguarding lead or Children’s Social Care before making a referral.

West Yorkshire Pre-Birth Procedure

Pre-Birth Practice Model