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ABSTRACT
Protecting an unborn baby from abuse and neglect presents particular challenges for professionals due to the uncertainties about appraising future harm and functioning of family relationships. This systematic narrative review synthesises studies of professional decision making by health and social care professionals regarding child protection of an unborn baby. Five bibliographic databases (ASSIA, CINAHL Plus, Ovid MEDLINE, PsycINFO, Social Care Online) were searched using an explicit and robust search; papers identified as relevant were appraised for quality and combined using a narrative synthesis based on the main themes in the papers. Ten papers met the inclusion criteria, including qualitative studies, surveys and randomised trials of the effectiveness of decision support tools. The papers identified the following case risk factors relating to risks to an unborn baby: alcohol abuse; ante-natal care; previous children in care; domestic violence; drug abuse; lack of education; employment issues; unrealistic expectations of the baby; housing issues; learning disability; feelings about pregnancy; low socio-economic status; mental illness; mother’s childhood experiences; lack of parenting capacity; physical disability. There were several papers on developing risk assessment tools. A few papers focused on risk assessment and decision processes including engagement with pregnant women. There was some discussion of psychosocial supports for risks in pregnancy. There is useful published material on the range of risk factors, and more limited material on the development of assessment tools and on decision processes. The psychosocial supports that might be provided to the pregnant woman as decision options is an area for future research.
Acknowledgements
The authors would like to acknowledge the support of Mary Rose Holman, Sub-Librarian, Ulster University in designing the literature search methodology. PhD Scholarship funding by the Department for Employment and Learning, Northern Ireland is gratefully acknowledged.
Disclosure statement
No potential conflict of interest was reported by the authors.
Additional information
Notes on contributors
Helena Mc Elhinney
Dr Helena Mc Elhinney completed her Ph.D. in 2017 and is currently employed as a researcher. She has a background in psychology, health promotion, public health, teaching and business development and management. Her research interests include child protection, mental illness, domestic violence and adverse childhood experiences. She has published in peer reviewed journals and developed and published an online instruction manual for researchers on her innovative method for using Qualtrics with factorial survey. She sits on several advisory/steering committees in Ulster University, Queens University Belfast, Administration Data Research Centre Northern Ireland and the Northern Ireland Statistics and Research Agency.
Brian J. Taylor
Brian J. Taylor is Professor of Social Work at Ulster University where he leads the research cluster on Decision, Assessment, Risk and Evidence Studies in Social Work. He joined the University after 10 years’ experience in practice and management, and 15 years in training and organisation development in health and social care. Brian is a Fellow of the Academy of Social Sciences; a Senior Fellow of the School for Social Care Research at the National Institute for Health Research, London; and a founder member of the Board of the European Social Work Research Association.
Marlene Sinclair
Professor Marlene Sinclair holds the first personal chair for midwifery research in the island of Ireland and is the Head of research at the Maternal Fetal and Infant Research Centre at the Institute of Nursing Research. She is a registered midwife and nurse with almost 30 years of research experience including management of over 30 research projects, 250 published outputs (includes 78 peer-reviewed research papers), completion of 24 Ph.Ds. and current supervision of 8 Ph.Ds. She has been a successful collaborator in obtaining over €15m in research funding. She established the International Doctoral Midwifery Research Society and is the founder and editor of the Royal College of Midwives Evidence Based Midwifery Journal.