Co-ordinated multi-agency responses required
Pre-birth work requires a co-ordinated multi-agency response. This section highlights the importance of co-ordinated, joined-up pre-birth work and antenatal care for pregnant parents involved with children's social care.
Overview
Key message four: Pre-birth work requires a coordinated multi-agency response
The families who come to the attention of children's social care during pregnancy often have multiple difficulties and have had a lot of adversity in their own lives. In order to provide the support and help that they need often requires a multi-agency response. And of course, midwifery are absolutely core to that ante-natal offer.
What we heard from parents was that often the response felt like a scattergun approach where they were referred to multiple services and that they felt like there was a lack of coordination around the services being provided, that they felt overwhelmed by the number of appointments that they were expected to attend, often in different parts of their town or city, having to travel long distances. This all led to high levels of anxiety and in some cases confusion about what they should prioritise. Understandably, different services viewed the problems faced by parents in different ways, and so that information about what was needed felt confusing to families.
Whilst we have divisions and specialisms in services, that doesn't really work. When we think about the person, it's still the same person regardless of how we choose to split up their problems. So we need to be able to coordinate that response and to deal with that problem holistically and through the lens of the family themselves.
As we discussed in the assessment section, a coordinated plan underpinned by a really robust formulation shared with parents, needs to be in place to ensure that parents understand the response they are receiving and that, most importantly, services are coordinating that response. Given what we know about trauma informed and trauma responsive work, having a key worker that walks the walk with the family that coordinates that response really does help.
And as you'll hear from some of the services in these clips below, there are areas of the country that have navigated that difficult terrain and are offering that level of support.
In keeping with a broader literature, Born into Care highlighted the importance of coordinated, joined-up pre-birth work and antenatal care for pregnant parents involved with children's social care (Mason et al., 2022). The research found that:
- Where messages to parents were not consistent or plans were not shared in a timely way, parents were left feeling confused and this impacted on feelings of trust.
- Challenges such as staff turnover, limited resourcing and system misalignment have often made timely sharing of planning difficult to achieve.
Want to know more?
In the audio clip below, we hear directly from two mothers with lived experience of the pre-birth child protection system, explaining why this key message is so important to them.
Practice spotlight
In this film from the Nuffield Family Justice Observatory, Stacey Coe, Principal Safeguarding Lawyer for the Adult and Children's Services at Neath Port Talbot Council, highlights the importance of providing services immediately on receiving the referrals, and the multi-agency collaboration needed to do this work effectively.
A second film highlights professionals from midwifery and social care in Swansea Council. They describe the mapping meetings they have embedded into the pre-birth period to understand parents and their needs, which is an example of multi-agency collaboration.
Planning for your area
Consider planning a local multi-stakeholder workshop to review the journey of pregnant parents involved with children’s social care across the system (journey mapping). This can:
- Help develop a deeper understanding of local systems.
- Identify opportunities and challenges in multi-agency collaboration.
Explore innovations across the country that ensure a more integrated and coordinated multi-agency response to work with pregnant parents who have children’s social care involvement. These include:
- Co-produced birth plans with midwifery, children’s social care and parents that include parents support needs, preferences as well as safeguarding information.
- Regular joint pre-birth review meetings to ensure important information and updates are regularly shared between agencies.
- Joint multi-agency specialist training to ensure a shared underpinning approach to working with families.
- Joint supervision to discuss and plan around work with families.
- Co-located workers.
- Multi-agency teams. Including specialist case-loading midwives and social workers co-working to ensure continuity of professional and the joined-up provision of maternity care and pre-birth social care work.
Additional resources
Explore sample birth plans from Swansea Council and Together for Children Sunderland.
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Backer, K. D., Rayment-Jones, H., Lever Taylor, B., Bicknell-Morel, T., Montgomery, E., Sandall, J., & Easter, A. (2024). Healthcare experiences of pregnant and postnatal women and healthcare professionals when facing child protection in the perinatal period: A systematic review and Critical Interpretative Synthesis. Plos One, 19(7), e0305738. https://doi.org/10.1371/journal.pone.0305738
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Everitt, L., Fenwick, J., & Homer, C.S.E. (2015). Midwives experiences of removal of a newborn baby in New South Wales, Australia: Being in the ‘head’ and ‘heart’ space. Women and Birth, 28(2), 95–100. https://doi.org/10.1016/j.wombi.2015.01.004
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Marsh, W., Robinson, A., Shawe, J., & Gallagher, A. (2020). Removal of babies at birth and the moral distress of midwives. Nursing ethics, 27(4), 1103-1114. https://doi.org/10.1177/0969733019874503
- 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.