Pre-birth work is a crucial area of practice in social care. However, it remains one of the most complex and challenging to navigate as well as one of the most neglected areas of policy and practice.
There is a better way.
Angela, a mother with lived experience from the Giving HOPE Project
This is the call to action from Angela, a mother who participated in the Giving HOPE Project. Angela spoke to Claire Mason, Research Fellow at Lancaster University, about pre-birth practices for the Research in Practice Pre-birth Change Project. The Change Project resources are designed to support service managers and practitioners to develop their local pre-birth service to bring about more effective and compassionate practice with parents.
In particular, the Change Project draws on learning from the Born into Care programme. This research provided invaluable insights into the rising numbers of newborns entering care proceedings and highlighted systemic issues that require urgent attention.
Findings from the Born into Care research
The Born into Care research series, led by the Centre for Child and Family Justice at Lancaster University and Swansea Secure Anonymised Information Linkage (SAIL) Databank with funding from Nuffield Family Justice Observatory (NFJO), uncovered several worrying trends.
Between 2012/13 and 2019/20, the number of newborns entering care proceedings in England increased from 2,425 to 2,914. In Wales, cases rose from 145 to 241. This reflects not only a rise in overall cases but also an increasing proportion of all infant cases involving newborns. By 2019/20, over half of all infants in care proceedings involved newborns, with the incidence rate for newborns reaching 47.7 per 10,000 live births in England and a significantly higher 68.3 per 10,000 in Wales.
The research also highlighted the prevalence of short-notice hearings. In 2019/20, 86.3% of cases involving newborn babies in England involved less than seven days’ notice between the local authority application and the first court hearing. Furthermore, one in six newborn cases was subject to same-day hearings, with some regions reporting this in one in four cases. Such patterns point to a system under strain which means there often isn’t adequate time for effective pre-birth support and planning, increasing the risk of trauma for families and newborns.
Additionally, a qualitative study led by the Centre for Child and Family Justice explored the lived experiences of parents and professionals where the state intervened at birth. In response to these findings and the Born into Care research, the team at Lancaster University, with the Rees Centre at Oxford, published Best practice guidelines to support practice during the pre-birth period, at birth and in the period after birth.
Addressing the challenges
Building on this work, the aim of the Change Project was to help strengthen pre-birth services in local areas and reduce the pressures highlighted by the research.
The project focused on supporting service managers and practitioners in a number of key areas of pre-birth work including:
- Developing a specialist focus on pre-birth work and collaborative and coordinated responses from multi-agency colleagues in social care, health and midwifery teams.
- Supporting families as early as possible in pregnancy to give the best possible chance of making the changes needed.
- Enhancing practitioner skills in trauma-responsive approaches and in building trusting relationships in order to work more effectively with parents.
Sharing resources to drive change
Following on from the successes of the Change Project, a suite of resources has now been developed to help services improve pre-birth work in their locality. The interactive resources are grounded in evidence from the Born into Care research and other research in this space, offering practical tools and guidance for service managers, strategic leads, commissioners, and frontline practitioners.
The resources are organised into ten key messages:
- Understand and use your data.
- Provide help and support early as you can.
- Pre-birth work requires a specialist focus.
- Pre-birth work requires a co-ordinated multi-agency response.
- Ensure your practitioners have the understanding and skills to engage families.
- Dynamic assessment and support go hand in hand.
- Pregnancy as an opportunity for change.
- Seeing beyond the mother.
- Provide support to minimise the trauma of separation and keep reunification in mind.
- Post-separation support is essential to prevent further trauma and recurrent care proceedings.
Each key message explores core issues, challenges and good practices emerging from research in this area. Films and audio recordings with researchers and professionals provide opportunities to dig a little deeper into the issues and challenges, as well as innovative approaches and examples of good practice in pre-birth work.
The key messages also offer reflective questions, practical suggestions, and ideas to help integrate new perspectives and approaches into policy and practice in your area, supporting the development of effective pre-birth work.
Supporting better outcomes for parents and babies
The importance of improving pre-birth work cannot be overstated. Effective pre-birth services can help parents, reduce the need for care proceedings and the separation of babies from their parents and minimise trauma when separation is unavoidable.
At this year’s Research in Practice children and families Partnership Conference, we will explore pre and post-birth with parents and infants in children’s social care. Building on learning from the Pre-bith Change Project, the conference will explore the evidence on the scale of the issues and showcase positive initiatives from across the country to do better by and with these families.
The Born into Care research has highlighted the urgent need for systemic improvements in pre-birth work. By adopting the resources now available, services have an opportunity to address the challenges identified and make meaningful changes that benefit parents and babies alike.
Pre-birth Change Project
The Pre-birth Change Project brought together academics, practitioners and leaders in children’s social care to discuss local practices, procedures and protocols in relation to pre-birth work.
Improving outcomes through pre-birth work
Pre-birth work requires specialist skills and knowledge to provide effective, trauma-informed support. Explore new Change Project resources to support pre-birth work.
Pre-birth: Change Project
Interactive resources designed to enhance pre-birth services and improve outcomes for infants and parents by driving policy and practice development. These tools are valuable for senior managers, strategic leads, commissioners, and professionals in social care, health, and midwifery services.
Working pre and post-birth with parents and infants in children’s social care: Children & families Partnership Conference
Join us for our children & families Partnership Conference to explore evidence on effective pre and post-birth work and showcase positive initiatives from across the country.
References
- Mason, C., Broadhurst, K., Ward, H., Barnett, A., & Holmes, L. (2022). Born into Care: Developing best practice guidelines for when the state intervenes at birth. Nuffield Family Justice Observatory.
- Mason, C., Broadhurst, K., Ward, H., & Barnett, A. (2023). Born into Care: Best practice guidelines for when the state intervenes at birth. Nuffield Family Justice Observatory.
- Pattinson, R., Broadhurst, K., Alrouh, B., Cusworth, L., Doebler, S., Griffiths, L., Johnson, R., Akbari, A., & Ford, D. (2021). Born into care: Newborn babies in urgent care proceedings in England and Wales. Nuffield Family Justice Observatory.