Getting it right for every child (GIRFEC): case studies

Maternity services

Chloe’s story

Consideration of wellbeing for a teenage parent and her unborn child, focusing on engaging with a prospective named person and information sharing in practice.

Scenario

Chloe is 17 years old and eight weeks pregnant with her first child. She is attending her first ‘booking-in’ appointment with her named Midwife. Her partner Paul, who is 19, is also present.

During the appointment, Chloe tells her Midwife that she has not shared her news with anyone else other than her partner. Chloe states that she is excited about the pregnancy but seems anxious about her future education, expressing that she wants to continue with her school studies.

She also shares with her Midwife that there was a history of abuse and neglect in her household throughout her childhood and she now resides with Paul. She has no contact with her family.

Assessment

Support is offered by maternity services and/or the family nurse to help promote, support or safeguard the wellbeing of young parents and their unborn child, including engaging with the prospective named person and in planning that may lead to a GIRFEC child’s plan when the baby is born, if needed. 

The Midwife considers:

• is anything getting in the way of Chloe’s wellbeing which may impact on her child’s wellbeing when born? If so, what aspects of wellbeing may be affected?
• what sources of information will inform my actions?
• on the information available, what action may be appropriate and proportionate?
• what planning may be required to address Chloe’s wellbeing needs and plan for the wellbeing of her baby when born?

Chloe is estranged from her family, with minimal support networks in place for her both post-birth and later when she returns to school. Should her relationship with Paul break down, there is also a potential risk of homelessness. Using the National Practice Model, her Midwife considers the impact on Chloe and her unborn child being Safe, Healthy and Nurtured.

It may be appropriate to offer additional antenatal care either through core Maternity services or through a specialist team who offer input for families who require more support. Chloe and Paul’s views are important in planning any offer of help. Chloe’s Midwife discusses the role and function of a named person for their baby and informs Chloe of the potential support that her own named person could offer her when she decides to return to school.

Her Midwife uses the GIRFEC information sharing charter to help inform Chloe and Paul about how different services and practitioners will use their information to help identify any support that may be available for them and for their child when born.

With their agreement, appropriate and proportionate information can be shared with the prospective named person to help them begin to engage with Chloe and Paul.

Actions 

Chloe’s Midwife co-ordinates her maternity care plan and liaises with the family nurse team, who provide an increased visiting pattern. She ensures that Paul is included in any plans for antenatal care, as well as offering Chloe individual visits.

The named Midwife provides continuity of care, to encourage the development of positive, trusting relationships throughout Chloe’s pregnancy and in the post-natal period. She liaises with the Family Nurse and Health Visitor at an early stage to consider Chloe’s individualised plan of care and any additional support, including joint visits.

The Midwife works with other agencies, including Chloe’s named person in education, to ensure plans are in place to support Chloe’s own wellbeing. She refers Chloe and Paul to the Health Board’s tailored parenting support classes and offers them information on who to contact at their local authority’ advice service to support their family’s financial wellbeing.

Outcomes 

Chloe fully engaged with her Midwife, attending all midwifery appointments and chose to be referred to the Family Nurse, who will also provide support to both Chloe and her baby from 0-2.

She met with her Pastoral Care teacher at regular intervals, who was able to coordinate online learning and mentoring support through Chloe’s pregnancy. She was supported with access to childcare after the birth of her baby, which allowed her to continue with her schooling and sit her exams.

Reflections

The caring, considered approach taken by the Midwife meant that positive, trusting relationships were established between Chloe, Paul and the practitioners supporting their family. They both felt confident that as new parents, they could turn to various health professionals and local third-sector organisations for help if needed.

More information on ‘Getting it right for every child’ during pregnancy is available on the NHS inform website.