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Title: Protecting an unborn baby : Health and Social Care professionals' decision making
Author: Mc Elhinney, Helena
ISNI:       0000 0004 7227 3729
Awarding Body: Ulster University
Current Institution: Ulster University
Date of Award: 2017
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Aim and objectives: The aim of this study was to explore the decision making processes by Health and Social Care professionals where there was a child protection concern in pregnancy. The objectives were to identify and prioritise the risk factors identified by professionals, to explore their experiences of undertaking these types of decisions and to measure the impact of the identified risk factors on decision making. Method: An exploratory sequential mixed methods study was undertaken and data collection was undertaken in three phases. Phase one, included a systematic narrative review of the literature to identify child protection risk factors in pregnancy and a total of ten papers were chosen for synthesis. The identified risk factors informed the development of the focus group schedule in phase two. Four focus groups with fourteen midwives and sixteen children’s services social workers were undertaken in the South Eastern Health and Social Care Trust in Northern Ireland. The information gleaned from the focus groups informed the development of an online factorial survey, which was undertaken in phase three of the study. In total 118 participants, 67 midwives and 51 social workers completed the survey and results were analysed using multiple regression and Analysis of Variance. Results: The findings showed that multi-professional communication, evidence gathering, information sharing and professionals experience was important in the process of undertaking assessments around safeguarding an unborn baby. It was strongly stated by professionals that there was an inconsistency with regards to information recorded on written files compared with those on electronic systems and insufficient resources impacted upon assessment. The factorial survey identified that the risk factors; drug use, alcohol use, age, antenatal care, mental wellbeing, domestic violence and childhood experiences were most influential in regards to the perceived risk of harm to an unborn baby and the need for a referral to children’s services. Previous experience and regulation, guidance and policy were the most influential professional and agency factors influencing decision making. There were no significant differences between midwives or social workers with regards to their decision making. Conclusion: Ineffective access to electronic or written information was identified as a major issue resulting in lack of continuity with record keeping. A lack of resources, heavy caseloads and lack of perinatal mental health training also impacted on decision making. Recommendations include: the need for a region wide centrally administered electronic information system accessed by all Health and Social Care professionals, region wide documentation regarding appropriate procedures for midwives and social workers, the development of a joint protocol between maternity and children’s services, perinatal mental health training and to address staff shortage and lack of resources.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available