Introduction

In this chapter the authors consider pre-birth child protection assessment and intervention from the perspectives of social work and midwifery to highlight some of the ethical issues inherent for both professions. Both social work and midwifery have international codes of ethics that shape and guide practice, and in this chapter these ethical codes have been considered from the theoretical perspectives of utilitarianism and value-based ethics.

Child protection practice in the UK is directed by law, policy and guidance that seek to promote the well-being of the child and its family. Where there are significant concerns for a child's well-being or safety, a multi-agency assessment must occur. The information gathered and analysed in an assessment is complex and may be used to inform decision-making processes or to justify expensive packages of family support. When conducting a pre-birth assessment, social workers and midwives may be part of a multi-agency or court process that ultimately decides if it is safe for a mother to retain care of her baby or if the baby is to be removed from her care at birth. The consequences of such decisions can be enormous for all concerned, and so it is essential that professionals have an understanding of the ethical principles underpinning their actions and the tensions therein. Pre-birth assessment in social work has received minimal research or literary attention (Hodson, 2011), and yet findings from serious case reviews in England between April 2007 and March 2011 highlighted shortcomings in the timeliness of pre-birth assessment (Ofsted, 2011). As a consequence of the lack of research, the ethical tensions that are inherent within pre-birth assessment have been under-explored. This chapter seeks to open debates around professional ethics as a vehicle for enhancing or changing practice.

This chapter, which is a part of Part Three and focuses on professional and interprofessional ethics (see Figure 1.1), begins by considering the ethical base of social work and midwifery, looking at the common ground underpinning both professions and factors influencing and impacting on professional ideology. It then moves on to look at how terminology such as ‘unborn child’ highlights some of the ethical tensions and moral arguments central to this area of child protection practice, before finally considering how refocusing on the needs of pregnant women may ultimately enhance pre-birth assessment.