Pregnant Looked After Young People

1. Introduction

The number of Looked After young women becoming pregnant each year, and who are the responsibility of Kirklees Council, is relatively small. However, when pregnancy occurs it is important that Family Support and Child Protection respond in a clear and co-ordinated way, to ensure that the needs of the mother and the expected child are properly addressed.

All expectant mothers who are Looked After - either by virtue of being Accommodated or subject to a Care Order - will require support, which may need to be provided from a variety of sources. The welfare of the expected child must also be addressed at as early a stage as possible to ensure that potential risks to the child and/or future support requirements are identified, and plans put in place to meet those risks or requirements.

However, not every pregnant Looked After young woman should be referred for a Pre-Birth Assessment. Such referrals should only be made where there are identified concerns about the welfare of either the young woman or the unborn baby.

2. Providing Support to the Expectant Mother

All young women who are pregnant and Looked After are likely to be vulnerable and should be referred by their social worker to appropriate agencies for support. Advice should be sought from relevant agencies including Health, Youth Service and Education.

3. Case Accountability

If a young person in care is pregnant (or partner of a young person in care becomes pregnant), consideration should be given for the need for a pre-birth assessment and a referral made to MASH if felt necessary.

The Social Workers responsible for the Looked After Young Person should decide whether a Pre-birth Assessment is required or not before making a referral to MASH. This should take into account the needs of the mother; her history, her contacts and likely risks to the baby. In the case of Looked After young men becoming fathers, the same issues will need to be considered. 

All Pre-birth Assessments will be completed by the Pre-Birth Assessment Team unless the case of other siblings is already open to the Assessment and Intervention Service.

The Pre-Birth Assessment Team case holder and his/her manager will have lead responsibility for co-ordinating the Assessment. The relevant Social Worker/ Team Manager from the Looked After Team/Leaving Care Team/Children with Disability Service should be kept informed of the progress of the Assessment.

If the case of other siblings is already open to the Assessment and Intervention Service, the allocated worker from Assessment and Intervention Service will be responsible for completing the Pre-Birth Assessment.

If older siblings are still subject to on-going proceedings or if care proceedings have been completed within the last 6 months and there is a likelihood of further legal proceedings in respect of the new baby, careful consideration needs to be given as whom would be the appropriate worker to undertake the Pre-Birth Assessment. There will be a balance of factors including:

• The value of having a worker to undertake the Assessment who has a detailed knowledge of the history;
• The quality of the relationship between the worker and the expectant mother;
• The wishes and feelings of the expectant mother;
• The value of having an independent view to present to the Court.  

4. Recording Assessments

1. Where a Pre-Birth Assessment is undertaken by the Pre-Birth Assessment team, this will be entered into the system and follow the usual procedures as relate to all cases;
2. Where the Assessment will continue beyond the 45 day timescale, because there is a need to monitor/continue work as the pregnancy progresses, this will be viewed as a 'specialist assessment';
3. If the case transfers to the Assessment and Intervention Service any additional follow on.

5. Assessment of Needs of the Unborn Child

The Assessment process should begin as early in the pregnancy as is possible. Workers need to be mindful that the baby may be born earlier than anticipated and should allow sufficient time to conduct the Assessment and put in place the appropriate birth plan. At the latest the Assessment must be started 12 weeks prior to the expected date of delivery. During the course of the Assessment the Social Worker should discuss with the Midwife the progress of the pregnancy and any changes to the anticipated expected date of delivery.

The purpose of a Pre-Birth Assessment is:

1. To consider whether additional support is needed to promote good enough parenting and plan accordingly;
2. To determine the extent of risk to the forthcoming child;
3. In conjunction with other relevant agencies, to formulate a plan in response to this risk.

The depth and type of Pre-Birth Assessment will vary. In some situations, it would be a duplication of previous work to undertake a detailed Pre-Birth Assessment as the circumstances may already be well known and little may have changed; in other situations, there may be some significant differences from the past to justify a different approach to the expected child.

Consideration should be given to the need for a Practical Parenting Assessment running alongside the social worker's assessment.

In conjunction with the social worker's Pre-Birth Assessment it may be appropriate to commission other type of assessment to be undertaken which will provide a holistic overall assessment of the parent's capacity to parent a new-born child. Such assessments should be undertaken by the relevant agency/professional if a parent(s) have:

• Suspected drug/alcohol misuse;
• Learning difficulties;
• Psychiatric history;
• Chronic or acute medical conditions which may impact on their physical ability to care for a child.

The Assessment will determine whether the expected child is likely to be a Child in Need to whom services should be offered via or other agencies, or is potentially a child who will be at risk of Significant Harm. The Assessment will also address the needs of the expectant mother.

If the Assessment indicates a relatively low level of concern e.g. the expectant mother is in a stable and supportive placement; has engaged positively with Family Support and Child Protection regarding her pregnancy; and has the potential to provide safe care for the child, then the Looked After Team/Leaving Care Team will ensure that all relevant services are made available to the mother and, subsequently, the child. All assessments will be read by, discussed with, and 'signed off' by the  social worker's Team Manager. The development of such planning and support will also be scrutinised within the independently chaired Statutory Review process.

If the child is assessed as potentially being at risk, or is subsequently felt to be at risk, then the Pre-Birth Assessment Team should convene a Strategy Meeting to plan further action. The Team Manager would ordinarily chair this. The Child Protection & Review Unit should be informed of the intention to hold a Strategy Meeting and whether the circumstances make it for them to chair the meeting. If the mother was 13 years or younger at the time of conception, a Strategy Meeting must be convened.

The Strategy Meeting will in most cases determine the remit of a Pre-Birth Assessment, which will need to be undertaken to address the risks in detail. Therefore, other professionals who might contribute to an Assessment should be invited to this meeting including the local Social Care Service if the expectant mother is placed 'out of authority'.

If other siblings have been the subject of proceedings in the past the assessment should actively consider the need for legal advice in relation to the unborn child.

6. Outcome of the Pre-Birth Assessment

The Pre-Birth Assessment will determine whether the expected child will be viewed as a Child in Need in which case services will be mobilised, or a child who potentially meets the threshold for a Child Protection Plan or proceedings.

Where the outcome of the Assessment indicates that the situation can be managed via the provision of appropriate support services, that outcome should be presented to a Child in Need Meeting.

Where the outcome of the Assessment indicates that there should be a Child Protection Plan is likely to be met, and which may also include the possibility of care proceedings on the baby, then the case holder will convene an Initial Child Protection Conference. A representative from Legal Services should be invited to the Case Conference without exception.

Where there is clear information during the Pre-Birth Assessment that, on a balance of probabilities, care proceedings will be instituted or that the child will need to be accommodated and placed separately at birth then the Pre-Birth Assessment Service should take lead responsibility for the identification of the placement on the basis that there will be a probable conflict of interests between the needs of the child and the needs of the mother.

If the expected child is made subject to a Child Protection Plan and / or there is a recommendation for care proceedings, then the Assessment and Intervention Service will take responsibility for the provision of a social worker to manage either the Child Protection Plan process once the child Protection Plan has been devised or the legal process once the proceedings have been initiated and the first Interim Care Order hearing has taken place.

Before the child has been born and irrespective of the outcome of the assessment and the future plan there should always be a Pre-Birth Planning Meeting between Family Support and Protection and key professionals to agree how to manage any risks identified including contact between parent and child. This applies as much to children in need, those in need of protection and those subject to care proceedings. This meeting should be chaired by the Team Manager responsible for the case.

Where social workers in Family Support and Protection are completing a Pre-birth Assessment, and any sibling(s) of the child(ren) have previously been made subject to care orders or are subject to applications for care orders, legal advice should be sought on completion of the assessment.