Making a Pre-Birth referral

1.Where a professional has a concern for an unborn baby, the same referral procedure for a Child in Needor a Child in Need of Protection should be followed.


2.Where it is believed that the prospective parents may need support services to care for the baby, the first stage in seeking to clearly identify these and the resources to address them will be to follow Early Help guidance.


3.Where it becomes evident that Early Help is not achieving the desired impact because of lack of engagement or a more intensive plan is required or steps need to be taken to safeguard the unborn child a referral should be made to the British Forces Social Work Service BFSWS JRT / CRT.


4.A Child in Need referral should be made to BFSWS JRT / CRT as soon as the concern is recognised and where possible no later than 20 weeks gestation but ideally by 12 weeks in order to facilitate planning as early as possible. The referral must clearly state the nature of concerns, e.g. parental substance misuse, domestic abuse etc. The referrer must give her/his views on how the parental behaviour is likely to impact on the baby and what risks are present and predicted.


5.Delay must be avoided when making referrals in order to:

  • Provide sufficient time to complete a full and informed assessment and make adequate plans for the baby's protection;
  • 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.


6.The parents should be informed as soon as possible of concerns and the need for assessment. Parental consent should be obtained to refer to the BFSWS JRT / CRT unless this may be harmful to the health of the unborn baby and / or mother, or 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 with services.


Threshold for Enquiries and Pre-Birth assessment^

7.A pre-birth assessment should be undertaken on all pre-birth referrals and a strategy meeting (to include BFSWS Team Manager or Senior Practitioner) held where any of the factors below exist:

  • 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 poses a risk to children;
  • A sibling in the household is subject to a Child Protection Plan;
  • A sibling has previously been removed from the household either temporarily or by Court Order;
  • Domestic abuse is known to have occurred and there are concerns that the level and frequency are likely to have a negative effect on the child;
  • The degree of parental substance misuse is likely to significantly impact on the baby's safety, health or development;
  • The degree of parental learning difficulty is likely to significantly impact on the baby's safety, health or development;
  • There are concerns about parental ability to self care and/or to care for the child, e.g. unsupported young mother.
  • Any other concern exists that the baby may be at risk of significant harm including a parent previously suspected of a fabricated or induced illness in a child.


Strategy Meeting^

8.The need for a Section 47 Enquiry should be considered as soon as possible and, if appropriate, initiated at a strategy meeting held as soon as is practicable following receipt of the referral and completion of a  Assessment. The expected date of delivery will determine the urgency of the meeting and pre birth assessment. 

9.A meeting will be convened following assessment, chaired by a BFSWS Team Manager and involve all agencies with relevant information. The Midwifery Service must be present.

10. The meeting must decide:

  • Whether a Section 47 Enquiry and pre-birth Child in Need Assessment is required.
  • What areas are to be considered for further assessment;
  • Who needs to be involved in the process;
  • How and when the parent/s are to be informed of the concerns;
  • What action is required by community and hospital maternity staff when the mother is admitted to hospital and after the baby is born; and
  • Whether there should be an Initial Case Conference (ICPC) prior to completion of the Child in Need Assessment.


Purpose of a Child in Need Assessment^

11.Assessments are undertaken of the needs of individual children to determine what services to provide and action to take. They may be carried out:

  • To gather important information about the unborn baby and family;
  • To analyse their needs and/or the nature and level of any risk and harm being suffered by the unborn baby or child/ren;
  • To decide whether the unborn baby is a Child in Need (Section 17) and/or is suffering or likely to suffer Significant Harm (Section 47); and
  • To provide support to address those needs to improve the unborn baby’s outcomes to make them safe.
  • To consider the needs of any other child/ren within the family


12.The maximum timeframe for the assessment to conclude, such that it is possible to reach a decision on next steps, should be no longer than 45 working days from the point of referral. If, in discussion with a child and their family and other professionals and Line Manager, an assessment exceeds 45 working days the social worker should record the reasons for exceeding the time limit.


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


Pre-Birth Section 47 Enquiry and Child in Need Assessment^

14.A Child in Need Assessmentcan be commenced at the same time as a Section 47 Enquiry. In addition to parenting capacity and family and environmental factors the assessment must identify:

  • All risk factors;
  • 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;
  • How change will be sustained.


15.A concluding risk assessment must make recommendations regarding the need, or not, for a pre-birth Child Protection Conference which should wherever possible take place no later than 20 weeks gestation.

  • Any other relevant information which was taken into account;
  • Discussions with managers;
  • Decisions taken (clearly timed, dated and signed).


16.Records should be reviewed during supervision with managers at regular intervals, to ensure that decisions are followed through.


Pre-Birth Child Protection Conference^

17.A pre-birth conference is an Initial Child Protection Conferenceconcerning 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.


18.Pre-birth conferences should be convened following Section 47 Enquiries, where there is evidence that the child is suffering or is likely to suffer significant harm and where there is a need to consider if a Child Protection Planis required.


19.This decision will usually follow from a pre-birth Child in Need Assessment and a conference should be held:                                                                                                                            

  • Where a pre-birth assessment gives rise to concerns that an unborn child may be at risk of Significant Harm;
  • Where a previous child has died or been removed from parent/s as a result of Significant Harm;
  • Where a child is to be born into a family or household which already have children who are the subject of a Child Protection Plan;
  • Where a person known to pose a 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 under sixteen about whom there are concerns regarding her ability to care for herself and/or to care for the child.


20.All agencies involved with the expectant mother should consider the need for an early referral to BFSWS JRT / CRT so that assessments are undertaken and family support services provided as early as possible in the pregnancy.


Timing of Pre-Birth Conferences^

21.The pre-birth conference should take place as soon as practicable and ideally no later than 20 weeks before the due date of delivery, to allow as much time as possible for planning support for the baby and family.


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



23.The key agencies involved in the delivery of the child must attend the conference. It is important that this conference makes an informed decision about whether or not the child should remain in the parents’ care and draws up protection plans that link to either decision.


24.In addition to those who normally attend an initial child protection conference, midwifery, relevant neo-natal and support services must be invited.


25.Parents or carers should be invited as they would be to other Child Protection Conferences and should be fully involved in plans for the child’s future.


An Unborn Baby with a Child Protection Plan^

26.If a decision is made that the unborn child should be made subject to a Child Protection Plan, the main cause for concern must determine the category of Significant Harmand the Child Protection Plan must be outlined to commence prior to the birth of the baby.


27.The Core Groupmust be established and meet within 10 working days of an Initial Child Protection Conference and if at all possible prior to the birth (preferably six weekly), and certainly prior to the babies return home after a hospital birth.


28.A core group meeting must be held within five working days of discharge from hospital. During special circumstances e.g. weekends / bank holidays, the key worker or team manager will be responsible for informing each core group member the child has been discharged and the date of the core group meeting agreed.


29.If a decision is made for an unborn child to have a Child Protection Plan, the child’s name (or ‘baby’, if not known) and expected date of delivery should be sent to the HOS BFSWS pending the birth. The Social Work Key worker must then ensure that the name and correct birth date is notifiedto Independent Conference and Review Service (ICRS) and HOS BFSWS


30.If the child is resident outside of the BFG area at birth, the local authority in whose area the child is resident must be advised that the child is in their area and is the subject of a Child Protection Plan.


Timing of Review Conference^

31.The first Child Protection Review Conferencewill be scheduled to take place within 3 months of the Initial conference or within one month of the child’s birth, whichever is the sooner.


Convening the Conference^

32.Initial conferences must be convened within a maximum of 15 working days of the last Strategy Discussion / Meeting or where more than one has taken place, of the Strategy Discussion / Meeting at which the Section 47 Enquiry was initiated. In consultation with the person requesting the conference the Independent Conference Review Service will;

  • Agree the date and time of the conference;
  • Send out invitations to professional representatives, the child and family members as appropriate;
  • Ensure that agencies are informed whether or not the parents have been invited and that they are clear about their responsibilities;
  • Consult with the Conference Chair where there has been a request to exclude or limit the participation of parents or children;
  • Collate and presenting to the Conference Chair relevant written contributions where available within timescales
  • Make any necessary arrangements as advised by the social worker e.g. for trained interpreters to attend;
  • Provide with the invitation an Information Leaflet about conferences for children and parents.



1.         Working Together to Safeguard Children, July 2018, HM Government

2.         Standing Orders British Forces (Germany) 3351, available at: