Pre-Birth Assessment in Social Work

The Children Act 1989 imposes a duty on Local Authorities in England to ‘safeguard and
promote the welfare of children’ and to ‘promote the upbringing of children by their families’
wherever possible. If, during pregnancy, concerns are identified that suggest the child may be
at risk of harm a referral may be made to the Local Authority for a pre-birth assessment.
When completing a pre-birth assessment social workers and other professionals are often
involved in the process of collecting and analysing information, which will ultimately be used as a basis for planning and decision-making and can have life long consequences for the family. Removing a baby at birth brings with it an inevitable impact on the process of attachment and bonding, as well as the impact of subjecting a family to court proceedings and all of the
emotions that entails. However, allowing a baby to be discharged from hospital to a family
who are unable to provide appropriate care and protection or do not have the necessary
support in place to assist them may result in irreparable harm to, or even the death of the
baby.

Sitting within the context of general child and family social work assessment, pre-birth
assessment has received a very limited amount of specific research attention. This thesis
comprises a report on the outcomes of my own research, which was exploratory in nature, and
details the findings from a mixed methods study of relevant legal and procedural frameworks
in England, Local Safeguarding Children Board procedures and a case study of pre-birth social
work assessment practice in one Local Authority.

The findings were that pre-birth assessment is a complex process guided by a national and
local procedural framework which does not recognise the unique status of the unborn child.
Having evolved from a historical perspective based on protecting live children, the procedural
guidance is contradictory as it does not acknowledge that an unborn child has no legal status and a pregnant woman maintains rights over her own body. The case study also revealed that
social workers in the host LA were practising in an environment of managerial systems which
aimed to improve accountability and yet the very systems designed to ensure children did not
fall through the ‘safety net’ of professional support were, ironically, prompting systems which
made practice in (and research into) pre-birth social work assessment a challenge. A narrow
forensic approach to pre-birth assessment was found to have developed, with the documentary
process of completing pre-birth Initial and Core Assessments (as defined by the Department of
Health (2003) documentation) becoming split from the process of actually ‘doing’ a social work
pre-birth assessment.