When there are safeguarding concerns regarding an unborn child, local authorities and related agencies can intervene during pregnancy. Such interventions aim to assess the risk to the infant following birth and mitigate potential issues by providing tailored support to the parent/s. If the local authority determines that the concerns are so great that following birth an infant cannot remain safely in his or her parents’ care, action may be taken to remove the baby. 

This rapid evidence review aims to identify key messages from research concerning birth parents’ and professionals’ experiences and perspectives of pre-birth assessment and infant removal at, or soon after, birth. It aims to identify and summarise consistent key messages and provide an insight into system-level challenges. A total of 27 papers (published between 1990 and 2018) were included in the final review. The studies were primarily conducted in England and Australia, but also in Canada, USA, Northern Ireland and Scotland. Most were qualitative (derived from focus groups, questionnaires and interviews with professionals and birth parents) and were largely focused on birth mothers in the community, although two studies involved removals at birth from mothers in prison. A substantial proportion of literature is based on the perspectives of birth mothers with drug and alcohol problems. 

This paper is linked to Born into care: newborns in care proceedings in England (2018) and Borninto care: newborns and infants in care proceedings in Wales (2019), published by the Nuffield Family Justice Observatory, which looked for the first time at the number of newborns subject to care proceedings in England and Wales, using population-level data held by Cafcass. The number of newborns subject to proceedings prompted considerations and questions about, among other things, practice in relation to pre-birth assessments and removal at birth and the legal framework and court decision making in such cases. 

We have also published a report on court decisions in relation to pre-birth assessments and removal at birth. 

Pre-birth assessment and infant removal at birth: experiences and challenges

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