Assessment where there are concerns that an unborn child is likely to suffer significant harm is one of the most difficult tasks that social workers undertake; the legal and ethical context makes the process of assessment and intervention during this period complex. This paper explores pre‐birth assessment guidance and practice in England. Local safeguarding guidance in 147 English localities was accessed and analysed, and interviews were conducted with 22 practitioners involved in pre‐birth assessments. The findings showed that while most local safeguarding guidance was more detailed and explicit than the national guidance, legal and ethical issues were rarely addressed. Interview data showed that, in general, guidance to support social work assessments during the pre‐birth period was insufficient, and that few practitioners used standardised tools to aid assessment. Some practitioners regarded pre‐birth assessments as less urgent than cases involving infants/older children, thereby increasing delays in decision‐making. It is concluded that existing guidance and practice with regard to pre‐birth assessment are inadequate. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages Existing guidance regarding pre‐birth assessment are inadequate with regards to providing practitioners with the necessary information about the assessment process or tools with which to undertake the assessment. Practitioners undertaking pre‐birth assessment should be provided with better training regarding the assessment process. There is a need for practitioners undertaking pre‐birth assessment to use standardised tools alongside professional judgement.

BackgroundYoung mothers living in low-income urban settings often are exposed to significant and chronic environmental difficulties including poverty, social isolation and poor education and typically also have to cope with personal histories of abuse and depression. Minding the Baby® (MTB) is an interdisciplinary home-visiting programme developed to support first-time young mothers, which integrates primary care and mental health approaches into a single intensive intervention from the last trimester of pregnancy until the child’s second birthday. The primary aim of the intervention is to promote caregiver sensitivity, and, secondarily, to promote both child and maternal socioemotional outcomes.Methods/designThis is a multisite randomised controlled trial (RCT) with a target recruitment of 200 first-time adolescent mothers (under 26 years of age). One hundred participants will be randomised to the MTB group and they will receive the MTB programme in addition to the usual services available in their areas. Those participants not allocated to MTB will receive Treatment as Usual (TAU) only. Researchers will carry out blind assessments at baseline (before the birth of the baby), and outcome assessments around the child’s first and second birthdays. The primary outcome will be the quality of maternal sensitivity and the secondary outcomes will focus on attachment security, child cognitive/language development, behavioural problems, postponed childbearing, maternal mental health and incidents of child protection interventions.DiscussionThis study evaluates the Minding the Baby® programme in the UK. In particular, this RCT explores the effectiveness of this integrative approach, which focusses on maternal mental issues as well as parent-infant interaction, parental concerns and developmental outcomes.Trial registration ISRCTN08678682 (date of registration 3 April 2014).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1618-4) contains supplementary material, which is available to authorized users.

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