Remember the golden rule always breast feed they will try to stop you or tell you that you can't but it is legally your human rights and free choice to choose to breast feed and they cant stop by doing so this will allow you extra contact they cannot refuse the extra contact either because you need it to b3 allowed to breast feed even if you have to express the milk it is still extra contact.

The Local Authority will be looking at and carefully considering a range range factors when considering whether or not to carry out pre-birth assessments on families they will be trying to tease out issues that they feel have potential for having a significant negative effect and impact on your unborn baby.

They use the word “parent” loosely and interpret it as the mother and father, the mother’s partner, anyone with parental responsibility, and anyone else who has or is likely to have day to day care of your child. This means anyone involved who is a potential parent or carer in the assessment I'll try to cover as much of the framework for assessment as I possibly can.

I will try to provide you with as much useful guidance about the timing of a pre birth assessments as I can.

Antenatal care begins as soon as your pregnancy is confirmed and midwives continue care in the postnatal period for at least 10 days following birth.

Once your pregnancy is confirmed your G.P will make an appointment for you to see the midwife. Your booking Appointment with your midwife takes place ideally between 8-12 weeks gestation, and if your midwife feels its relevant they will make a referral to Children's Services at this point. So be aware of this and remember it's more like an interview than an appointment. If you get it right at this stage then your laughing my advice is blag it deny everything!! If you have had previous involvement with Children Services and your have had any previous cases closed then when they ask JUST SAY NO! Remember pregnancy makes us women very forgetful and our concentration spam is very limited don't offer yourself up on a plate, let them find out for themselves and do there own homework, it ain't down to us to do there job for them.

The booking interview is a time of collection of information and an opportunity for the midwife and mother to plan her care in pregnancy. It is an ideal time for the midwife to assess health and social needs of families and to consider packages of care and support suitable for individual needs.

Antenatal appointments are arranged to suit the individual clinical needs of the mothers and the initial choices may change if complications of pregnancy arise. 

For births in hospital with either the midwife, GP or obstetrician, initial postnatal care is provided by midwives and support staff on the maternity wards. Hospital stays are getting shorter with many women going home within a few hours of birth but generally 12-48 hours are the more normal lengths of stay.

On transfer home care is undertaken by the community midwife for at least 10 days following the birth. Care can be extended to up to 28 days if a particular clinical or social need is identified. 

Following the birth of the baby most Health Visitors arrange a primary visit within 21 days of the birth, which coincides well with the handover of care from the midwives.  

They should hold an initial TAF "team around the family" meeting, attended by the midwife, the local family centre, the health visitor, the parents and the social worker and Ideally with your family GP attending. The reason for this meeting is to explore your family history and determine whether a formal pre-birth risk assessment should be considered and decide whether or not if a pre-birth assessment is needed this meeting should of been done by your 20 weeks gestation.

If a Child and Family Assessment identifies any of the following circumstances, a pre-birth risk assessment will be considered.

The pre-birth assessment should begin as quickly as possible.

The interview is usually at your home or at the GP's surgery. It is here that your midwife will go through your choices for childbirth discuss all your options.

If Childrens services are called in they will be looking for the following risk factors of parents, partners, all household members and anyone else that your baby may be left in the care of, or around once born.

They consider the following as risk factors .....

• Where there are concerns over your parenting capacity and not being able to meet your unborn baby's needs, particularly where parents have either severe physical or perinatal/mental health illnesses or maybe supporting needs like learning disabilities that may present a risk to your unborn baby.

• Are victims or perpetrators of domestic abuse/violence (domestic abuse may start or get worse when a woman is pregnant). 

• Where an adult has already been identified as presenting a risk, or a potential risk to children. Such as someone found by a child protection conference to have previously abused children, someone who has committed a crime against children, or who is a Registered Sex Offender.

• Are already known to Children's Services such as previous parental involvement whether as a child or an adult, where historical concerns have been raised over previous children suffering harm, abuse or neglect where other children have previously been subject to a child protection plan or to legal proceedings or have been removed from parental care.

• Where the expected parent is very young and a teenager/young adult themselves or are a Child Looked After (CLA) or a Care Leaver. this should include both prospective parents not simply the expectant mother. Where this is the case then they will be carrying out a dual assessment and looking at your own needs aswell as your ability to meet your baby's needs.

• Have a history of violent behaviours.

• Where concerns exist about a mother’s ability to protect.

• Are living in poor home conditions, homelessness or temporary housing.

• Any other circumstances or issues that give rise to concern.

• Where alcohol or substance abuse and a risk of affecting the health of your baby.

The Local Authority will be watching at this early stage of the possibility that legal proceedings may need to be initiated either as a framework around a parent and baby foster placement or because separation of parent(s) and baby is indicated.

The pre-birth assessment should be completed to a standard that meets the requirements for evidence in Court Proceedings and should be signed of by their team manager.

Circumstances indicating an immediate Pre-Birth Assessment:

• Always if a previous child/young person has died unexpectedly in the care of the parents and the cause of death is a result of anything other than ‘natural causes’

• Always if a previous child has been removed via Care Proceedings due to abuse or neglect or other Risk of Significant Harm or if they have a current child who is the subject of Care Proceedings or within a PLO process.

• Always if the parents have a child living with them who is currently the subject of a Child Protection Plan.

• Always if there is a current Sec 47 investigation on the unborn that is likely to lead to an Initial Child Protection Conference or Child In Need Plan.

• Always if for any reason (in addition to the above) it is possible that the mother and newborn will need to be separated at birth and CSC will be part of the planning (not including a parent’s request for adoption).

• Always if either of the prospective parents is a Child Looked After (CLA) or Care leaver.

Areas they cover:

e.g. Unborn Baby ……….EDD: 01.01.11

2 Family Structurs, Names, addresses, dob, relationships with extended family members.

3 Reason for the Assessment, This should be one of the circumstances set out above.

 4 Sources of Information, Names of professionals and dates as well as any records that have been presented.

 5 Ante-Natal Care, Medical History.

This section is usually completed by your midwife. The central question there looking for is whether there is anything in your medical history that is likely to have a significant negative impact on your child.

Assessment they will carry out and the potential risk to the child they will be looking for.

This section will usually be completed by the Social Worker.

Particular care should be taken when assessing risks where the parents are themselves children i.e, under the age of 18 years and in particular if they are themselves Children Looked After. Attention should be given to evaluating the quality and quantity of support that will be available within the extended family, the needs of the parent(s) and how these will be met, the context and circumstances in which the baby was conceived, and the wishes and feelings of the child (or children) who are to become parents.

If the perspective parent is a Child Looked After then attention should be paid to their long term plan and how assessing for independence should incorporate the thinking of ‘independence with responsibility for a child’.

Questions they are considering are:

• Partner's support.
• Whether this was a planned or unplanned                 pregnancy.
• Feelings of mother about being pregnant.
• Feelings of partner / putative father about the           pregnancy.
• Any issues about dietary intake.
• Any issues about medicines or drugs taken before    or during pregnancy.
• Alcohol consumption.
• Smoking.
• Previous obstetric history.
• Current health status of other children.
• Miscarriages and terminations.
• Chronic or acute medical conditions or surgical           history.
• Psychiatric history – especially depression and           self-harming.
• Housing/Finance.

Relationships..

• History of relationships of parents.
• Current status.
• Positives and negatives.
• Violence.
• Who will be main carer for the baby?
• What expectations do the parents have of each         other re: parenting?

Abilities..

• Physical.
• Emotional (including self-control).
• Intellectual.
• Knowledge and understanding about children and     child care.
• Knowledge and understanding of concerns and the
   reason for assessment.

Social history..

• Experience of being parented.
• Experiences as a child, and as an adolescent.
• Education.
• Employment.

Behaviour..

• Has there been any violence in the relationship?
• Violence to others?
• Violence to any child?
• Drug misuse?
• Alcohol misuse?
• Criminal convictions?
• Chaotic (or inappropriate) life style?
• Unemployment / employment.
• Debt.
• Inadequate housing / homelessness.
• Court Orders.
• Social isolation.

Home conditions..

• Are they chaotic?
• Does the home pose a health risk / unsanitary /        dangerous?
• Over-crowded?
• Is the home a temporary one or is it a foster            placement with an uncertain long term plan?

Mental Health..

• Mental illness?
• Personality disorder?
• Any other emotional/behavioural issues?
• Learning Disability.
• Communication.
• English not spoken or understood?
• Deafness?
• Blindness?
• Speech impairment? 

Support – quality and quantity..

• From extended family
• From friends
• From professionals
• From other sourcesIs support likely to be available     over a meaningful time-scale?
• Is it likely to enable change?
• Will it effectively address any immediate                   concerns?

History of being responsible for children..

• Are there any convictions for offences against          children?
• CP Registration/ Child Protection Plan
• CP concerns – and previous assessments?
• Court findings?
• Care proceedings? Children removed?
• Category and level of abuse
• Ages and genders of children
• What happened?
• Why did it happen?
• Is responsibility appropriately accepted?
• What do previous risk assessments say?
• What is the parent’s understanding of the impact       of their behaviour on the child?
• What is different about now?

History of abuse as a child..

• Convictions – especially of members of extended      family?
• CP Registration
• CP concerns
• Court findings
• Previous assessments

Attitude to professional involvement..

• Previously – in any context?
• Currently – regarding this assessment?
• Currently – regarding any other professionals?

Attitudes and beliefs re convictions or findings (or     suspicions or allegations) ..

• Understood and accepted? 
• Issues addressed? 
• Responsibility accepted?  

Attitudes to child..

• In general 
• Re specific issues 
• Expectations of what having a baby means/ how it will alter their lives. 

Dependency on partner.

• Choice between partner and child? 
• Role of child in parent’s relationship? 
• Level and appropriateness of dependency? 

Ability to identify and appropriately respond to risks?  

Ability and willingness to address issues identified in this assessment.

• Violent behaviour 
• Drug misuse 
• Alcohol misuse 
• Mental health problems 
• Reluctance to work with professionals 
• Poor skills or lack of knowledge 
• Criminality 
• Poor family relationships 
• Issues from childhood 
• Poor personal care 
• Chaotic lifestyle Planning for the future
• Realistic and appropriate?  

Analysis and conclusions.

1. Concerns identified. 

2. Strengths or factors identified. 

3. Is there a risk of significant harm for your baby?What is the risk? Who poses the risk? In what circumstances might this risk exist? 

4. Will this risk arise:  

   a) Before your baby is born? 

   b) At or immediately following the birth? 

   c) Whilst still a baby (up to 1 year old)? 

   d) As a toddler? or pre-school? or as an older               child? If there is a risk that the child’s needs               may not be met. 

5. What changes they expect you to make for the well-being of your child? If there is a risk of significant harm to the child? 

6. What changes must be made to ensure safety and an acceptable level of care for your child? 

7. How motivated are you in to making changes? 

8. How capable are you of being able to make changes? And what is the potential for success? 

Expecting Parents With Learning Disabilities.

Mother and Baby Placement.....

Types of parent and child fostering

Assessment placements – these usually last for last around 12 weeks and involve completing an assessment report of the parent’s ability to care for their child

Pre-birth placements – to help prepare the parent for the birth of their child by supporting them to understand their own needs and the needs of their baby

Parenting supporting placements – these are offered to parents who need help with learning how to provide basic care, safety, warmth and guidance for their child. This type of placement can also be offered if the parent needs a safe place to live.

Where there are concerns pre birth or postnatal, a baby must not be removed from its mother’s care without parental consent, even if this is only to move the child to a different part of the hospital, unless:

There is judicial sanction for removal via an ICO or EPO, or The police have exercised their powers under s46 Children Act 1989 (PPO), The removal is justified either because ..

a) the mother poses a risk of exposing the child to immediate physical attack or physical harm or

b) there is a medical justification for the separation/intervention, i.e. the baby needs to placed on special care baby unit.

Any birth plan in place must be made available to hospital staff and will need to make reference to the three points above, as well as confirming, among other things, the arrangements for contact..

Babies can only be removed or accommodated away from their mothers under the following circumstances ...

• With the written, informed consent of the mother following the birth under Section 20 of the Children Act 1989.. PLEASE NEVER SIGN THIS UNLESS YOU SEEK LEGAL ADVICE AND FULLY UNDERSTAND THE CONSEQUENCES.....

• By the police using Police Protection (Section 46)

• With a court order under Section 44 (Emergency Protection Order, with or without notice) of the Children Act 1989

• With a court order under Section 38 (Interim Care Order) of the Children Act 1989

• In exceptional circumstances, a wardship order made by a judge of the Family Division of the High Court,

• any person, for example a social worker or a health professional, may intervene, if necessary, to protect a child from immediate violence at the hands of a parent, but police must be called.

The risk factors that lead to this action must be of sufficient gravity to lead professionals to believe the baby would be at risk of significant harm if left in mother’s care whilst on the same ward, including..

• Risk of physical harm

• Risk of significant neglect through inappropriate handling, inappropriate feeding, inadequate and poor supervision to the extent that the baby would suffer harm.

• Concerns that parent(s) will attempt to leave the hospital with the baby, placing the baby at risk of significant harm

And

• A professional judgment, based on a full assessment, that it is not possible to manage these risks in any other way.