Assessing Parental Capacity when there are Concerns about an Unborn Child: Pre‐Birth Assessment Guidance and Practice in England

Abstract

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.

Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change

“…Data revealed the fairly short timescales for pre‐birth assessments to be conducted and the need for practitioners to be non‐judgemental and honest in their attitudes and practices. The study also found that some interviewees ‘regarded pre‐birth assessments as less urgent than cases involving infants/older children, thereby increasing delays in decision‐making’ (Lushey et al ., , p. 97).…”

“…The first paper in this issue by Clare Lushey and colleagues () reports on a study which explored pre‐birth assessment guidance and practice in England. Pre‐birth assessment is undertaken when there are concerns that an unborn child is likely to suffer significant harm.…”

Recognition of risk and prevention in safeguarding of children and young people: a mapping review and component analysis of interventions aimed at health and social care professionals

“…Five studies examined the use of date and frameworks within child protection [93][94][95][96][97] , study characteristics are provided in Table 6 Two studies analysed routinely collected data. Data recorded about hospital admissions for children under 5 years old from 2007 to 2009 related to child maltreatment was analysed 93 .…”

“…One study 97 investigated local safeguarding guidance on and social workers use of pre-birth assessments. The local guidance was generally more detailed than the national guidance but rarely considered legal and ethical issues.…”

Characterizing newborn and older infant entries into care in England between 2006 and 2014

“…Most local authorities have built upon national statutory guidance by developing local protocols tailored to referrals involving unborn children, which contributes to variation in the quality of guidance and pre-birth child protection practice across England ( Lushey, Barlow, Rayns, & Ward, 2018 ). There is also an abundance of qualitative evidence suggesting many practitioners have insufficient guidance on these pre-birth procedures, resulting in delayed pre-birth assessments and missed opportunities for early intervention ( Honey, Miceli, & Mayes, 2019 ; Lushey et al, 2018 ; Mason, Robertson, & Broadhurst, 2019 ).…”