Pre-birth - A Stage 2 risk assessment for use in pre-birth assessments.
- Pre-birth risk assessment is a version of the Stage 2 for use in pre-birth assessment.
- Pre-birth risk assessment introduces unique challenges in prediction of harm, in particular if there are no other children in the household.
- It includes additional analysis tools to support pre-birth assessment.
Risk assessment in Pre Birth is different to the usual Stage 2 Risk Assessment. Whilst similar in format and content, it is an assessment on the likely future impact of conditions on the unborn child, when born. It is predictive as the child is not yet born and future harm cannot yet be evidenced.
For example, in comparison with Risk Assessment (Stage 2) the professional opinion about parental capacity focusses on capacity to meet the child’s needs and protect from harm, once the child is born. In the areas of child’s needs, to what degree are the unborn child’s needs met and/or likely to be met once the child is born. It is possible that a pregnancy is well managed with midwifery overview and support; but that a previous baby’s health needs was neglected. In utero substance misuse may be another example where risks due to substance misuse by mother may be greater whilst the child is unborn; diminishing after birth.
Pre Birth Risk Assessment is very similar in format to the Stage 2 Risk Assessment. It provides a comprehensive assessment of several areas that once analysed, provide the basis for a Pre Birth risk assessment. These include the evaluation of the impact of parental capacity to meet an unborn child’s needs once born; against the degree to which the child’s needs are likely to be met. Any harm that is identified is categorised against the definition in the Children Act 1989 and the likelihood of harmful effects continuing is considered. The risk assessment concludes with a ‘Reason for decision’ summary. Additional questions that may assist analysis include:
- Is this unborn child safe in the care of these parents/carers?
- Will this new-born baby be safe in the care of these parents/carers?
- Is there a realistic prospect of these parents/carers being able to provide adequate care throughout childhood?
The Pre Birth Risk Assessment (Stage 2) has been integrated into several child protection processes. For example, as precursor to the completion of the Social Work Report to Initial Case Conference. The risk assessment integrates into the social work report to Conference concluding with the analysis section. It has been formally adopted by some Authorities in their multi agency pre birth procedures.
The “Assessing risk factors in unborn children’ supplement is an additional tool which can be used when completing a Pre Birth Risk Assessment. It informs parenting capacity by identifying the factors which increase or lower risk in unborn children. This information is structured across 7 different themes including the abusing parent, the non-abusing parent and family issues. The presence of a lowering or elevating indicator doesn’t not necessarily indicate harm or absence of harm but draws attention to some of the key areas associated with poor outcomes for children and families.
If there are other very specialist areas of concern indicated in the Pre Birth Risk Assessment, other tools are available. For example, a parent’s capacity to change or in neglect cases, the objective condition of a home and the impact of this on a child. A range of other specialist tools have been catalogued from a range of sources to provide this focus on a specialist areas. In some examples, new tools have been developed or existing tools modified or updated for practical use. See Specialist Assessment Tools for more information.