8.35 Pre-Birth Child Protection Procedures

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In some circumstances, agencies or individuals are able to anticipate the likelihood of Significant Harm with regard to an expected baby.


Such concerns should be addressed as early as possible to maximise time for:

  • Full assessment, including establishing the whereabouts of any previous children;
  • Enabling a healthy pregnancy;
  • Supporting the parents so that (where possible) they can provide safe care.



Where agencies or individuals anticipate that prospective parents may need support services to care for their baby or that the baby may be at risk of Significant Harm, a referral to Children's Social Care must be made at the earliest opportunity, using theMaking a Referral Procedure.


Referrals must always be made in the following circumstances:

  • There has been a previous unexplained death of a child whilst in the care of either parent;
  • A parent or other adult in the household is a person identified as presenting a risk, or potential risk, to children;
  • Children in the household / family currently subject to a Child Protection Planor previous child protection concerns;
  • A sibling has previously been removed from the household either temporarily or by court order;
  • Where there is knowledge of parental risk factors including substance misuse, mental illness, domestic abuse;
  • Where there are concerns about parental ability to self-care and/or to care for the child;
  • Where there are parental risk factors e.g. denial of pregnancy, avoidance of antenatal care (failed appointments), non-cooperation with necessary services, non- compliance with treatment with potentially detrimental effects for the unborn baby;
  • Where a pregnant women informs a professional that she is considering relinquishing the care of her infant following the birth to another person either through adoption, surrogacy (see Surrogacy Procedure) private fostering (seeChildren Living Away from Home Procedure) or by an informal arrangement;
  • Any other concern exists that the baby may be at risk of Significant Harm.

Where the concerns centre around a category of parenting behaviour e.g. substance misuse, the referrer must make clear how this is likely to impact on the baby and what risks are predicted.


Delay must be avoided when making referrals to Children's Social Care in order to:

  • Provide sufficient time to make adequate plans for the baby's protection;
  • Provide sufficient time for a full and informed assessment;
  • Avoid initial approaches to parents in the last stages of pregnancy, at what is already an emotionally charged time;
  • Enable parents to have more time to contribute their own ideas and solutions to concerns and increase the likelihood of a positive outcome to assessments;
  • Enable the early provision of support services so as to facilitate optimum home circumstances prior to the birth.

Concerns should be shared with prospective parent(s) and consent obtained to refer to Children's Social Care unless this action in itself may place the welfare of the unborn child at risk e.g. if there are concerns that the parent(s) may move to avoid contact.



All pre-birth Referrals to Children's Social Care must be subject to a Child and Family Assessment and a multi-agency Strategy Meeting must be held in the circumstances described in Recognition above.

Pre-Birth Multi-Agency Strategy Meeting


This Strategy Meeting will be chaired by a Children's Social Care line manager and involve:

  • Community midwife;
  • Maternity services manager;
  • GPs;
  • Health visitor;
  • Police;
  • Social worker for the unborn baby and social worker for the parent(s) if applicable;
  • Other professions as appropriate e.g. obstetricians, mental health services, probation;
  • Where required, a legal advisor.

The purpose of the meeting is the same as that of other Strategy Discussion/Meetings and should determine:

  • Particular requirements of the pre-birth Child and Family Assessment;
  • Whether a Section 47 Enquiry is to be initiated;
  • Role and responsibilities of agencies in the assessment;
  • Role and responsibilities of agencies to provide support before and after the birth;
  • Identity of responsible social worker(s) to ensure planning and communication of information;
  • Timescales for the assessments and enquiries, bearing in mind the expected date of delivery;
  • How and when parent(s) are to be informed of the concerns;
  • Required action by ward staff when the baby is born;
  • The need for a pre-birth conference, or (where this will depend on the outcome of assessments) establish the date by which this decision must be made.

The assessment plan must be consistent with standards required for possible court proceedings, including clear letters of instruction.


Parents should be informed as soon as possible of the concerns and the need for assessment, except on the rare occasions when medical guidance advice suggests this may be harmful to the health of the unborn baby and/or mother.

Pre-Birth Assessment


The overall aim of the pre-birth assessment is to identify and understand:

  • Parental and family history, life style and support networks and their likely impact on the child's welfare;
  • Risk factors;
  • Parental needs;
  • Strengths in the family environment;
  • Factors likely to change and why;
  • Factors that might change, how and why;
  • Factors that will not change and why.

Pre-Birth Conference



A pre-birth conference should be conducted as if it were an Initial Child Protection Conference concerning an unborn child. Such a conference has the same status and purpose and must be conducted in a comparable manner to an Initial Child Protection Conference.


A pre-birth conference should be held where a:

  • Pre- birth assessment gives rise to concerns that an unborn child may be at risk of Significant Harm;
  • A previous child has died or been removed from parent(s) as a result of Significant Harm;
  • A child is to be born into a family or household which already have children subject to a Child Protection Plan;
  • A person identified as presenting a risk, or potential risk, to children resides in the household or is known to be a regular visitor.

Other risk factors to be considered are:

  • The impact of parental risk factors such as mental ill-health, learning disabilities, substance misuse and domestic violence;
  • A mother for whom there are concerns regarding her ability to self-care and/or to care for the child or to protect the child from potential harm caused by a known person.

All agencies involved with pregnant women who have concerns should consider the need for an early Referral to Children's Social Care, so that assessments are undertaken, and family support services provided, as early as possible in the pregnancy.

Timing of Conference


The pre-birth conference should take place ideally at least 3 months before the due date of delivery, so as to allow as much time as possible for planning support for the pregnancy and the birth of the baby.


Where there is a known likelihood of a premature birth, the conference should be held earlier.



Those who normally attend an Initial Child Protection Conference must be invited (see Membership of Child Protection Conference Procedure). In addition representatives of the midwifery and relevant neo-natal services and social worker(s) for the parents, if applicable should also be invited. If either parent is a care leaver and the social worker is unable to attend, the service should be represented by a senior social worker, senior practitioner or Manager.

The Development of a Pre-Birth Child Protection Plan


If a decision is made that the child requires a Child Protection Plan, the main cause for concern must determine the category of concern and a Child Protection Plan should be outlined to commence prior to the birth of the baby and made available to midwifery staff 4 weeks prior to the expected date of delivery where possible.


The Core Group must be established and is expected to meet prior to the birth, and certainly prior to the baby's return home after a hospital birth.

Timing of Review Conference Following a Pre-Birth Conference


The Child Protection Plan only comes in to effect when the child is born and the plan should be reviewed at a Review Conference scheduled to take place within 3 months of the child's birth. The conference chair will determine the date.

Recording of Pre-Birth Child Protection Plan


Where a pre-birth conference has decided that an unborn child is to be the subject of a Child Protection Plan, her/his name and expected date of birth may be placed on the child's social care record immediately and their name and date of birth confirmed at birth.

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