Information and Instructions

• Referral
• Intake and case allocation
• Child protection concerns for young parents
• Culturally responsive practice
• Engaging with parents and families
• Developing safety networks
• Pre-birth planning with Signs of Safety
• Pre-birth planning meetings
• Post-birth planning
• Pre-birth Program

Referral

When a birthing parent is pregnant and there are concerns for the needs and wellbeing of the unborn infant after birth, you must use the Interaction Tool, the resource Determining Risk Factors for an Infant and refer to Chapter 2.2 High-risk infants in decision making. You should also consider that in circumstances where pre-birth planning commences prior to 12 weeks gestation, there is an increased possibility of the pregnancy potentially ending in miscarriage.


When you assess unborn infants as being at increased likelihood of significant harm after birth, the matter must be subject to a Child Safety Investigation (CSI) and referred for pre-birth planning (pre-birth protocol recorded on Assist) and to Best Beginnings Plus (BB Plus). You must record the pre-birth planning protocol on Assist for the unborn infant. Pre-birth Planning and CSI are parallel processes and should inform each other.      


When conducting a CSI where the proposed outcome is discontinued or unable to complete investigation, Team Leader endorsement and District Director approval is required. For more information, see Chapter 2.2.4 – Conducting a Child Safety Investigation.




All pre-birth planning cases must be referred to BB Plus. If BB Plus are unable to accept a referral (for example the criteria are not met or BB Plus are at capacity), your actions and the rationale for the unsuccessful referral must be documented. It is important that BB Plus discuss whether they have capacity to be consulted during the life of the case.  Where relevant, you must email the relevant district to advise them of the intake and cc PrebirthPlanning@comunities.wa.gov.au into the email.  For further information on the pre-birth planning trial refer to the section 'Pre-birth program' at the end of this entry.

 


You should use an internal Signs of Safety mapping to document clear harm statements (where previous harm has been substantiated), danger statements and safety goals at the point of intake.

Interagency notification

You must advise WA Health that pre-birth planning will commence to plan effectively for the safety and wellbeing of the infant after birth within two weeks once a pregnancy is known or suspected and there are concerns for the unborn infant or one week if at or plus 32 weeks gestation. You may also consult other services to decide on whether there are child protection concerns, for example, Western Australia Police (WA Police) and community service organisations.


The Department and WA Health share information under s.23 of the Children and Community Services Act 2004 (the Act) to assist in determining whether the Department has a role in safeguarding the infant from harm. Consultations between the Department and WA Health may involve:

• requests from the Department to WA Health for information;
• discussing concerns for an unborn infant to determine the level of risk; and/or
• WA Health inquiring whether the pregnant birthing parent is known to the Department, either as a current or closed case.

You have a statutory role to identify risk factors and the likelihood of significant harm to an infant after their birth. When there is an increased likelihood of significant harm to an infant, you must decide whether action is needed to safeguard or promote an infant's wellbeing and whether they may be in need of protection as per the functions of the CEO under s.28 of the Act.


External referral

1. Written referrals can be sent to the Department where concerns are raised for an unborn infant by completing the online link: Child Protection Concern Referral Form. If needed referrers can call the Central Intake Team (CIT) or Crisis Care Unit (CCU). We encourage referrals to the Department to be made as early as possible once the pregnancy is known. 


All external referrals are received by the CIT or CCU.


2. You must contact the referrer to discuss the concerns and adopt a questioning approach in collating information. This includes reviewing relevant information already held about the family on ASSIST. Collated information should be documented in an Interaction Report..

3. You must consider if a referral to an Earlier Intervention and Family Support Service (EIFSS) in the pre-birth planning process is required to support the parents to build their capacity to safely parent. Where a referral is not made you must document the rationale for not making the referral. 


Internal referral


​1.  Internal referrals are considered for:

• active Intensive Family Support (IFS) cases
  

• parents who have children in the CEO's care, are expecting another child 
  

• children in the CEO's care who are parents or expectant parents.

Where the Family and Domestic Violence Worker (SCPW FDV) responds to incidents of FDV and identifies an unborn infant at risk, they must record an interaction for both open and closed cases and progress to CSI (pre-birth protocol) if the concerns meet the Interaction Tool threshold.

 

2.  You must use the Interaction Tool to determine whether or not a CSI is required. If a CSI is required then the intake should be completed and pre-birth planning protocol recorded. 


3.  You must intake investigations relating to a child in the CEO's care (as the parent-to-be) that meets the threshold for intake and their unborn infant in a new family group (the parent to be and the unborn).


Late referral of concerns

There are many circumstances when the Department receives a referral where concern is identified for an unborn infant during the later stages of a pregnancy (post 20 weeks gestation). This can include circumstances when a birthing parent presents in labour or the infant has already been born.  Use the Interaction Tool to determine whether an intake to CSI is required.

When these referrals are intaked to CSI for pre-birth planning, you must make every effort to undertake as much planning as possible before the birth of the infant.  If the CSI has been intaked after the birth of the infant, you must make every effort to complete post-birth planning as soon as possible. This includes the period the child remains in the hospital setting.


Late referrals may not allow enough time to facilitate pre-birth planning meetings.  In these situations it is important to complete as much planning as possible within the available timeframe. This should still include a collaboration with the parents, WA Health and any other appropriate people or services to ensure that worries are shared, decisions are made in a timely manner and plans are outlined to promote the infant's safety.

In cases where a birthing parent is in labour and there are concerns for the infant's safety after birth, you must conduct an immediate assessment using the Interaction Tool to determine whether further investigation is required.

The steps for this include:

• You (or CCU after hours) must consult with WA Health and gather information on any safety concerns for the infant, their siblings, the birthing parent and any other relevant parties.

• You must gather information from Assist, Objective, FDV triage application and any other available stakeholders, regarding any safety concerns for the infant after birth.

• You and your team leader must assess the information available and identify the likelihood of significant harm occurring to the infant after birth. Where necessary, and in collaboration with WA Health, you must develop preliminary safety plans for promoting the infant's safety after birth until a more thorough investigation can be completed. Depending on the level of risk present, this could include planning for the level of supervision required (if any) and whether there are to be any restrictions on visitors.

• Where there is the possibility that parents or others may attempt to remove the infant from hospital, you should consider actions that can be taken to maintain the infant in hospital. This includes the use of s.37 (requires district director approval). 
  

Referral to a different hospital

When a pregnant birthing parent is open for pre-birth planning and subsequently transferred to a hospital that is not her local hospital in order to give birth, pre-birth planning must continue with the parents, their family and safety network and the new hospital.  


If the parents are based in a regional location, you can request the next closest district to provide short-term support to the parents. 


Support from another district and/or the country liaison officer could include assistance to get to and from pre-birth planning meetings, antenatal appointments and/or other appointments.  


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Intake and case allocation

​

Child Safety Investigations involving pre-birth planning or high-risk infants must not be placed on the monitored list. They must be actively case managed for the life of the investigation.

If…	Then…
A child in the CEO's care is pregnant and a CSI is intaked for pre-birth planning for their unborn infant	A different child protection worker (to the child in the CEO's care) should be allocated the CSI for the unborn infant

Districts can allocate cases involving pre-birth planning in accordance with workers professional judgement and assessment of what is in the best interests of the unborn infant at that time. When separate case management is required, you should consider if the case should also be allocated to a different team entirely.

The table below is a guide for case allocation.     

Scenario	Child Safety Team	lntensive Family Support​	Children in Care Team	​Best Beginnings Plus
New case - family unknown to Department	Yes	​Yes (after consult)	​	​Yes
Closed case – family known to Department - previous concerns for other children / siblings	Yes	​Yes	​	​Yes
Open case – current involvement with IFS		​Yes	​	​Yes
Open case - other children in the CEO's care		​Yes (after consult)	​Yes	​Yes
Open case - parents are children in CEO's care	Yes	​Yes  (after consult)	​Yes	​Yes
Open case - parents are children in CEO's care and there are child protection concerns for the parents	Yes	​Yes (after consult)	​Yes	​Yes

 

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Child protection concerns for young parents

Things to consider: 

• When a young birthing parent is pregnant, the risks associated with FDV increase. the birthing parent may be in need of support, guidance and/or intervention to minimise the risks posed by the perpetrator and safeguard or promote the safety of both the birthing parent and the unborn infant.

• A child or young person (including one in the CEO's care) who is about to become a parent may themselves need protection because of sexual or other forms of abuse. You should consider the legal age of consent for sexual activity, whether the young person had the capacity to provide consent, whether the young person has been a victim of sexual abuse and/or whether it is likely the abuse will continue.

When the parents-to-be are children are under 18 years of age (including children in the CEO's care)


When you identify a pregnancy and the parent-to-be is a child (under the age of 18 years) and/or a child in the CEO's care, you must use the Interaction Tool to determine whether an investigation is required into whether the parent-to-be has experienced any harm, or there is a likelihood of harm as a result of the abuse. this assessment should consider both parents individually if thye are under the age of 18. 


The determination about whether an investigation is required for the parent-to-be should be made separately to any determination about whether an investigation is required for the unborn infant. 

When the parent-to-be is a child in the CEO's care


An intake for an unborn child of a parent who is in the CEOs care should only be progressed on completion of the interaction tool with a recommendation to progress to intake. Consultation with your team leader is important when the score sits between 4.5 and 5.5. The score is a recommendation, the final decision to Intake or not is based on professional judgement. For further information see: 2.2.2 Processing referrals and interactions. 


If you decide that CSI's should be conducted for both the parent-to-be and the unborn child, they must be:

• intaked to two separate CSIs
• intaked to two separate family groups, and
• allocated to two separate case managers 

 

Intaking parents and their unborn infants
	Parent-to-be	Unborn infant
CSI required	Intake to family group that includes: biological parents of the unborn infant (child that is the parent-to-be) parents of the parent-to-be siblings of the parent-to-be other adults who have day to day responsibility for the parent-to-be.	Intake to family group that includes: biological parents of the unborn infant (child that is the parent-to-be) the unborn infant siblings of the unborn infant other adults who will have day to day responsibility for the unborn infant
Purpose of CSI	To determine whether the parent-to-be has experienced harm or is likely to experience harm as a result of abuse.	To conduct pre-birth planning and determine the likelihood that the unborn infant will experience harm following birth.

 

Where the parent is in the CEO's care they will already be a part of a family group; a separate family group should be created for the unborn infant. 


For more information about family groups please refer to the Family Group Position Paper.    

Where the young parent-to-be is a child in the CEO's care and you have concerns that they have experienced harm, you must consult with the Duty of Care Team regarding the concerns and the next course of action. Refer to: Chapter 2.1 Responding to concerns for child in care, and the Advocate for child in care.

 

You should allocate the two separate CSIs to two separate case managers when a young parent is in the CEO's care.  This is to promote unbiased and balanced decision making in relation to both matters. It also preserves any already established relationship between the child in the CEO's care and their case manager. Decisions as the result of the pre-birth planning may not be viewed positively by the child in the CEO's care and it is critical every effort is made to maintain their relationship with their case manager. For example, Sally (14 years old) is in the CEO's care and Karen has been her case manager for two years. Karen discovered that Sally was pregnant and used the Interaction Tool to determine that two separate CSIs were required for Sally and her unborn infant. Karen will be completing the CSI to determine whether Sally has experienced harm, but her colleague will be completing the CSI and pre-birth planning process for the unborn infant

     

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Culturally responsive practice

 


Cultural safety occurs when a person is not in fear of racism or discrimination.  They feel spiritually, socially, emotionally and physically safe to be themselves. You can 'set the scene' for cultural safety by approaching parents in a respectful and non-judgemental way, not 'speaking down' to the parents and showing a genuine interest in what they have to say.

Where an unborn infant's parents are Aboriginal and Torres Strait Islander, and/or from a culturally and linguistically diverse background (CaLD), you must consult with an Aboriginal Practice Leader (APL) or other relevant senior Aboriginal officer and/or the Cultural Diversity Team in the Specialist Child Protection Unit (SCPU) as soon as possible to gather information to assist in engaging with the parents and in delivering culturally responsive practice.


Where there are cultural considerations which may prevent both parents from engaging with the Department (for example pre-birth planning is sometimes regarded as 'women's business' only), you should seek guidance from the APL and/or the Cultural Diversity Team in SCPU, other staff or resources to plan for how to best to engage both of the parents, including the father.


Working with Aboriginal and Torres Strait Islander families

You must open your meeting with an Acknowledgement of Country as a way of paying respect to the Aboriginal and Torres Strait Islander people who are the custodians of the land where the meeting is taking place. An Acknowledgement of Country from our staff is part of the empowerment strategy to encourage self-determination and supports keeping culture at the heart and securing a strong foundation at the start of our work with families. We must remember also that some of the families we work with are off Country. Refer to the Aboriginal Cultural Hub for further information.

You should review the Secretariat of National Aboriginal and Islander Child Care (SNAICC) resource Stronger Safer Together - a reflective practice resource and toolkit for services providing intensive and targeted support for Aboriginal and Torres Strait Islander families.

When working with Aboriginal families, you should, in consultation with the APL, use the Tindale Map to identify (where possible) each parent's cultural group and languages spoken.  Access the Tindale Map from Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS).  

Where families have experienced intergenerational trauma and multiple contacts with child protection directly or indirectly, you must acknowledge the past by starting with an acknowledgement of Country and by actively listening to and  developing a working relationship with the family for the conversations to begin. This might include a statement such as:          

"Please could you share your story with me tell me about yourself and your family so I can understand how I can support you. I would like us to work together…"

  


 

You must use interpreters whenever required, to communicate clearly with parents.  For more information refer to Language services - Managing interpreter issues in child protection practice.

 

Working with Culturally and Linguistically Diverse families

Parents from culturally and linguistically diverse (CaLD) backgrounds may have experienced trauma, sexual assault, violence and loss and grief in their country of origin and/or refugee camps, resulting in post-traumatic stress, anxiety, depression and/or other mental health difficulties. The effect of this trauma can inhibit some parents from bonding with and caring effectively for an infant, and can also make it more difficult for them to engage in support. 

Pregnant and new birthing parents from CaLD backgrounds can be at heightened risk of anxiety, depression, post-natal depression, social isolation,  Intimate Partner Violence (IPV) and FDV. 


Protective factors and strengths for CaLD women and families can include:

• having the ability to move around the community freely (others not controlling movements)
  

• having friendships outside of the home
  

• engaging with neighbours, services and others in the community
  

• having access to transport when required (including access to public transport), and

• having their own phone and access to finances. 

Where parents may have a background of trauma, you should approach them with empathy and recognise their difficult experiences. Where the parents choose to share this experience, you should listen with genuine interest and allow the parents to tell their story.

Harmful cultural practices can include female genital cutting or mutilation, arranged or forced and early marriages, and the payment of dowries. These practices can correlate with IPV FDV.  You should have separate conversations with parents to screen for harmful cultural practices and IPV/FDV.

When gathering information about cultural practices (including harmful cultural practices, and where relevant, religious practices), use a naïve enquirers approach to 'fact check', for example:

"If you were giving birth in your home country, who would be with you?... What would happen after the nfant is born?...  Who would give you the most help?" "In your home country, if a Mum was feeling very, very sad after giving birth, what would happen?" "Would someone in your situation (e.g. arranged marriage) be able to go out on her own / catch public transport / go to the shops?"

 

You must use interpreters whenever required, to communicate clearly with parents.  For more information refer to Language services - Managing interpreter issues in child protection practice.

 

Where required, you should refer parents to appropriate trauma informed support and mental health services:

• Humanitarian settlement program and specialised intensive services (available to those on some visa types): https://www.dss.gov.au/settlement-services-programs-policy-settlement-services/humanitarian-settlement-program
• ISHAR Multicultural Women's Health Services: https://www.ishar.org.au/
• Association for Services to Torture and Trauma Survivors: http://www.asetts.org.au/
• Public mental health services: https://www.mhc.wa.gov.au/getting-help/public-mental-health-services/

Note: services may not work with a pregnant birthing parent in addressing their trauma until after baby is born as it is generally considered inappropriate for trauma to be addressed during pregnancy. 


Naïve enquirers' approach

You should use a naïve enquirers' approach with parents, to gather information about their cultural practices, religious beliefs, family 'norms' and parenting practices, including screening for IPV/FDV. When working with Aboriginal and CaLD families, and you are unsure about how to use a naïve enquirers' approach, consult with specialist staff like the APL and/or the Cultural Diversity Team in SCPU.

Consider the family's experience of trauma, intergenerational trauma and possible past contact with child protection systems. 

For example, you can 'fact check' with parents and families what the cultural expectations are for them according to gender:

"What kind of role do men take in your family?" "I would like to talk to Dad but I know it might not be culturally appropriate for him to speak with me.  Who is the best person to talk to Dad?"

 

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Engaging with parents and families

​You must work to engage and partner with the unborn infant's parents, family and safety network to promote the unborn infant's safety and wellbeing after birth. This includes efforts to engage with the unborn infant's father (or other parent). Efforts to engage with parents should commence as soon as an intake occurs – this can be as soon as you become aware of the pregnancy and does not need to wait until any specific gestational age.


Pre-birth planning must include pre-birth meetings with the parents, family, relevant staff from WA Health and safety network members to assess the risks to the unborn infant after birth and develop a safety plan to promote the infant's safety after birth.

Both parents have equal rights and must be given equal opportunity to engage with the Department to promote and safeguard the infant once born.

 

Key actions you must take:

1. Notify both parents that a CSI is being undertaken.

2. Meet with the parents to advise them about the pre-birth planning process and discuss the draft harm statements (where applicable), danger statements and safety goals. Explain the meeting process, the parents' right to legal representation (assisting them to access this support), identify a safety network of people who can attend the meeting to support the parents.

3. If the parent is in the CEO's care, a referral to legal services must be completed by contacting an appropriate legal service (such as Legal Aid or Aboriginal Legal Service) for the young parent, prior to the first meeting. 
   

4. Give the parents sufficient notice to attend the pre-birth planning meeting. You should assist the parents with transport options if they identify this as a barrier to attending meetings.
   

5. Working closely with the parents to identify a network to help develop a robust safety plan for when the infant is born.
   

6. Provide the parents with information about the effects of shaking an infant, risks of co-sleeping and assess the infant's sleeping area to make sure it is a safe sleeping environment.
   

 

You must consult with an APL when working with an Aboriginal or Torres Strait Islander family. It can be helpful to use Family Finding tools to locate and engage with other family members who might be able to talk to the parents on your behalf.

 

Barriers to engaging with parents:

When there are barriers to engaging with parents, such as when they have avoided contact with the Department and/or they have had other children removed from their care, you may need to try active engagement strategies such as:

• Initially engaging with other family members or community Elders or leaders, and seek their support in engaging the parents.

• Communicating in a respectful, encouraging, supportive and non-punitive manner.

• Maintaining frequent contact, regardless of whether the parents continue with contact.

• Trying joint outreach with another service known to the parents.

• Providing practical, material support early; including supporting with transport if this is a barrier.

• Making sure that parents can engage easily (for example, avoid arranging meetings that parents have to travel to).

• Asking where the family would like to hold the pre-birth meetings and supporting this where any risk is able to be managed.   

• Consider a professional only meeting to work collaboratively to develop strategies to promote engagement. If parents cannot be engaged after these meetings, they can be used to consider what planning needs to occur with the hospital when the parent attends to birth.
  

Incarceration of the birthing parent or the other parent should not impact the pre-birth planning process unnecessarily. For example, a birthing parent incarcerated at Bandyup Women's Prison should not prevent pre-birth planning meetings occurring.  The Department has a designated Family Links Officer position who acts as a conduit between districts and the prison.  The Family Links officer can support the birthing parent through the process and link in for pre-birth meetings. You should make efforts to engage with fathers in prison via official visits. When working with CaLD families, and unsure about how to plan for how best to engage the parents and deliver culturally responsive practice, consult with specialist staff in the Cultural Diversity Team in SCPU. Additional resources and cultural/religious information is also available on the Culturally and Linguistically Diverse (CaLD) Hub on SharePoint.

Your engagement with the parents is essential to pre-birth planning and this should commence as early as possible. You should not be waiting until the first pre-birth meeting at 20 weeks gestation to engage with the family, engagement should occur as soon as practicable after the case has been intaked for pre-birth planning. 


Early engagement helps to assess the risks to the unborn infant after birth, provide support to the parents to increase safety and refer the parents to appropriate early intervention support services (EIFSS). The key to success is building working relationships with parents and wider safety network.

Engaging the parents, family and safety network should include face to face contact and home visits wherever possible (rather than relying on telephone contact). This includes:

• visiting parents who are incarcerated
• a key person from the parents' network who can speak on their behalf, and 
• engaging with and involving fathers or other parents in pre-birth planning.  
  

Children's attachment to their father is critical for many reasons; the child's ongoing physical, social and financial security, and attachment to the father's extended family. Before attempting to engage fathers who may be absent, use the FDV Risk Assessment Tool. 

You should approach parents with kindness and respect, create opportunities for them to explain 'their story' and for parents to feel they have been heard. This may create an opportunity to explain what has happened historically, including childhood experiences, rather than focusing solely on what has led to the current worries.

You should plan around any identified risks in engaging with either parent to ensure they are given the same opportunity to work with the Department.

Parents' whereabouts are unknown

You must make reasonable efforts to locate both parents.  If you are unable to locate either parent and subsequently their unborn infant because they have relocated, are transient, or are avoiding contact with the Department, responses vary according to the reported concerns.  Some actions that should be considered to try to locate the parents include placing an Alert with WA Health hospitals where the birthing parent might present to give birth in metro areas or where they are most likely to present in regional areas.  

Following approval from your team leader, when contacting WA Health hospitals to place an alert you should include:


• instructions for WA Health staff to contact the Department if the birthing parent location becomes known 

• provide your name and position as well as that of your Team Leader, and 

• provide as much information as possible including the birthing parent's due date and any risk factors which may be present. Where the due date is unknown, you should provide a suspected due date to the hospital to assist birth safety planning.  
  

To place the hospital alert: 


• in the metropolitan area direct contact with metro hospitals is required.

• for regional hospitals (WACHS): contact the WACHS Operations Hub – Duty Operations Manager via email at WACHS.OperationsHub@health.wa.gov.au. This email is monitored 24 hours per day, seven days per week.
  

When contacting WACHS, use the WACHS Unborn Child At Risk Alert Template in related resources. Ensure the template is fully completed before sending to the WACHS Operations Hub.




• for private Maternity Hospitals (this includes Joondalup Health Campus and SJOG Midland): make direct contact with the relevant hospital as private hospitals will not have access to public hospital alerts

Generic state-wide alerts cannot be requested with the Department of Health at this time.




Other actions to locate the parents include:


• Make enquiries in the parents' community and with senior Department workers, for example APLs or an Aboriginal Elders.

• Place a broadcast alert on Assist within 24 hours, outlining the concerns for the infant and the best course of action if the parents are located during business hours and after hours.
  

• Request WA Police place an alert on their system.
  

• Request address or contact information from Centrelink. Completing a Centrelink information request is required prior to sending an interstate alert. For information on how to request this information from Centrelink, see Chapter 4.2 Working with other agencies - memoranda of understanding and information sharing.
  

• Consider undertaking a Connect for Safety for the family if they are known to be transient and may have relocated from another state. For more information, refer to Chapter 2.2 Connect for Safety. If a potential match is identified, follow the existing information exchange processes outlined in the interstate Child Protection Protocol and CPM 3.4 Interstate and New Zealand Liaison.
  

• Alert other states where it is suspected the parents have gone interstate via the Department's Interstate Liaison Officer WAInterstateLiaison@communities.wa.gov.au
  

When you are not able to locate the parents and they have not participated in pre-birth planning, you must collaborate with WA Health and exchange information regarding the circumstances for the parents. You should make a preliminary assessment based on the available information and put in place contingency planning for the birth which should be shared with any hospital you believe the parents may attend to birth.


For more information on the use of alerts in case practice, refer to Chapter 4.2 Case Alerts.

If the Assist history check indicates a family or individual is known to be transient or has spent time another state, check the Objective file for any previous Connect for Safety searches or an Interstate Liaison request to exchange information. If there is no information on file, or where the information on file is likely to be out of date, consider conducting a Connect for Safety search. For information on how to conduct a Connect for Safety search, refer to Chapter 2.2. Connect for Safety.







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Developing safety networks

A safety network is a group of people who care about the unborn infant and are willing to engage with the Department to address the concerns for the infant's safety. A safety network of people is used in safety planning to promote the infant's safety following birth, through the provision of supports to the parents, positive role modelling of parenting skills and coping behaviours, and by monitoring the safety and wellbeing of the infant.

You should encourage the parents to bring along as many people as they can to participate in the safety network. A robust safety network can be an indication of the level of support available to the parents and/or the child and may equate to safety for the child.

It is important to encourage parents to think about who they consider a part of their safety network, you can ask questions such as:

"If you were in hospital sick, who would you want the doctor to call?"  "Who could you rely on to babysit if something came up?" "Would it help if I phoned Aunty Joan first and explained what is happening/ask her if she can help?"

The safety network is intended to provide lifelong connections for the infant, regardless of who has primary care of the infant. You should:

• use integration tools from the Family Finding Manual to develop genograms and ecomaps with parents to identify supports within the family and community, and

• work with parents and families to develop and strengthen the safety network. 

Some parents may become isolated from potential supports and feel shame in contacting them. You can ask the parents whether they would like help contacting potential support people. Supports should be a combination of facilitated (agency support services who can visit the family usually during business hours) and naturally occurring (extended family, friends and neighbours who can visit the family ad-hoc and whenever required).

Always keep in mind that the parents and their safety network are the main attendees of the pre-birth planning meetings. Having lots of professional workers in the room can be overwhelming for the family.




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Pre-birth planning with Signs of Safety

Signs of Safety should be used throughout the pre-birth planning process.  Adapt the Signs of Safety tools according to the needs of the parents. This planning is recorded as part of the "what needs to happen" or "next steps" column.

Before the first pre-birth planning meeting, you and your team leader should complete an internal Signs of Safety mapping, analysing all the information available.  Past harm will not relate to the unborn infant but may relate to older siblings who have substantiated harm recorded relating to the same abuse type being investigated in the CSI for the unborn infant. 


You must develop draft harm statements (where applicable), danger statements and safety goals and discuss these with the parents before the first pre-birth meeting to reach a mutual understanding.


Any danger statements or safety goals created must relate to what we are worried will happen to the infant after birth, not while in utero.

You must correlate any concerns during the pregnancy with what we are worried will happen to the infant after they are born, in the context of the abuse types. For example:

Scenario	Example Danger Statement
The CSI is open for the abuse type of neglect and we are worried that there is a likelihood that physical harm will occur after infant is born.	The Department is worried that mum and dad can't keep the house clean, have food in the house and look after their own basic needs. If this continues after the infant is born then they might not be able to keep the infant clean, watch the infant enough and know when the infant needs help. This could lead to the infant getting sick, hurt or dying.

 

The purpose of pre-birth planning is to undertake planning in consultation with the parents, family and network members, WA Health and other professionals.  This planning is recorded as part of the "what needs to happen" or "next steps" column.

Actions recorded as part of the plan should:

• relate to the danger statements and safety goals identified - it is misleading to ask for actions to be undertaken that do not relate to our reason for involvement in any way

• maintain a focus on the legislative grounds for the Department's involvement - focus on the abuse type and subsequent harm being assessed, and

• show a link between actions and behaviour - what behaviour change is expected as a result of the action, for example, a parent can attend drug and alcohol counselling successfully, but if they still neglect to feed, bathe and supervise their infant then what has been achieved?

Planning should extend beyond the birth of the infant and outline what will need to happen for the infant to remain in the parents' care. Plans should outline measurable actions which should occur during the pregnancy, for example:

• Preparation for the infant (securing safe accommodation, sourcing a cot and baby items, exploring childcare options).

• Attending antenatal care.

• Evidence of behavioural change.

• Developing and enacting a person safety plan (relating to FDV).

• Safety network people taking a role with the parents.

All notes from the meetings and the plan must be written in plain language, with pictures if necessary, in a way that the youngest person involved in the planning understands. These minutes can only contain what was discussed in the meeting and must be provided to everyone who attended and saved on file.


You should work with parents and safety networks to develop safety plans that promote the safety and wellbeing of the infants after their birth.  Safety plans can include a visiting schedule where the infant is seen by the safety network as often as is necessary. Visiting schedules should be written in plain language in a way that is understood by the parents, for example, a calendar could be used, with a photo of the person who is visiting attached to the day of their scheduled visit.

Signs of safety tools that you might be able to use during pre-birth planning include: 

• Form 255 Three column Signs of Safety mapping
• Three houses – Version 1 and Version 2
• Words and pictures – questions for the parent and questions for the child
• Safety planning.
  

Pre-birth planning is an opportunity to use and adapt the Signs of Safety tools to the needs of the family over time.  "The Meeting Map" is an example of Words and Pictures - a culturally appropriate tool to engage with Aboriginal and non-Aboriginal families.  It encourages the use of pictures as representations for each stage of pre-birth planning alongside conversation and yarning. 

Other useful resources can be found in:

• Chapter 2.2 Signs of Safety – child protection practice framework
• The Department's Signs of Safety Knowledge Hive 
  
• Blurred Borders.
  

 

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Pre-birth planning meetings

   

There may be instances where pre-birth planning meetings are not in the birthing parent or unborn infant’s best interests, e.g. where the birthing parent has a significant trauma history and the process will cause further distress. In these cases alternative planning must be considered; this should include the hospital as well as consultation with the Aboriginal Practice Leader for Aboriginal families, and/or the CaLD Team for CaLD families. Document a clear rationale (with Team Leader endorsement and District Director approval of the decision) on the case file, and use other Signs of Safety tools.

 

Pre-birth planning involves interagency meetings with the parents, their family and safety network, the Department, WA Health and, in some cases, the parent's legal representatives (and requires that you be flexible to allow for their attendance). The meetings should be held as close as possible to 20, 26 and 32 weeks gestation to ensure timely decision making, but this timeframe can be adapted according to the best interests of the unborn child.  For example, when there may be an increased risk of pre-mature birth, to coincide with an antenatal appointment or when referrals are received later in pregnancy.


Planning should extend beyond the birth of the infant and outline what needs to happen for the infant to remain in the parent's care. Plans should outline measurable actions which should occur during the pregnancy, for example:

• Preparation for the infant - securing safe accommodation, sourcing a cot and infant items (or identifying how they will obtain these if culturally inappropriate to have prior to the infant's birth), exploring childcare options
  
• Attending antenatal care
• Evidence of behavioural change
• Developing and enacting a person safety plan (relating to FDV), and
• Safety network people taking a role with the parents

Pre-birth planning meetings may be organised by the local district or pre-birth program facilitator.  All meetings should be facilitated by someone independent of the case management to provide independence and objectivity. Facilitators who have had previous line management authority of the family, past involvement with the family or have any other conflict of interest are not considered independent and should not be involved in the process. Best practice is that this includes the current or past team leaders as well as SPDOs who may also be or have been involved with decision making consultations. If there are matters that mean this is not possible (for example due to availability in a small office), then this should be documented along with efforts to ensure independence.


It is also best practice for the same facilitator to manage all three meetings. 

Facilitators should refer to the Opening Statement for Pre-Birth Facilitators for information about how to commence a meeting.

Always keep in mind that the parents and their safety network are the main attendees of the pre-birth planning meetings.  Having lots of professional workers in the room can be overwhelming for the family.

Each meeting should include a range of participants, including:

• parents and their nominated relevant supports
  
• parents legal representatives 
  
• hospital or medical service.
  
• facilitator
• child protection worker
• team leader
  
• a family support service provider
  
• Aboriginal Practice Leader (where possible), and
• BB Plus worker

The district arranges the meetings in conjunction with the facilitator. Meetings are generally held at the hospital the birthing parent attends for their antenatal care. However, if the parents wish the meeting to be held at a different (safe) location, this should be considered in consultation with WA Health and carried out where possible.

The most important work as part of the pre-birth planning process is undertaken by you outside of the meetings. You should use the time between meetings to continue your assessment of the concerns, support the parents to complete the actions identified in the plan and gather credible evidence.

All notes from the meetings, including the plan, must be written in plain language, with pictures if necessary, in a way that every person involved in the planning understands. These notes can only contain information discussed at the meeting and must be distributed to all parties and recorded on file.


First meeting - preparation

In collaboration with the parents, you should develop draft danger statements, harm statements (if appropriate and in relation to previous harm caused to any other children) and safety goals before the first pre-birth meeting. These are to be forwarded to the facilitator one week before the first meeting.

You must meet with the parents to prepare them for the first meeting.  Explain:

• the meeting process
• their right to legal representation and provide information on Legal Aid and/or Family Inclusion Network of Western Australia Inc., and
• the composition of the safety network who can attend the meeting to support them.

 

Preparation	Facilitator	District
Actions	Centralised tracking of case  Quality assurance of information of intake on Assist*  Meeting co-ordination including liaison with hospital *  Setting up of meeting room (technology, white board)    * Activities required by facilitators in pilot with KEM and Fiona Stanley Hospital	Allocation of child protection worker  IFS team leader considers BB Plus referral  Consider additional supports required, including referral to an EIFSS provider Engaging family - SoS and pre-birth process explained  Provide legal and advocacy service information and support with referrals where appropriate. Agreement with family on final danger statements and safety goals  Final confirmation of meeting attendees and their relationship to unborn child Provide a copy of final danger and harm statements, and safety goals to facilitator *

 

First meeting

The first pre-birth meeting is held as close as possible to the pregnant birthing parent being 20 weeks gestation. The purpose of the first pre-birth planning meeting is to share and assess all relevant information in order to reach a common understanding of risk to the unborn infant.

You should share the draft danger statements, harm statements (in relation to previous harm caused to any other children) and safety goals and seek the parents' views. Meeting participants are encouraged to consider activities focused on promoting the unborn/newborn infant's health, safety and wellbeing and support for the parents and family.

The facilitator should develop and distribute a list of next actions to the meeting attendees at the conclusion of the meeting and the formal minutes of the meeting should be distributed to all parties as soon as possible after the meeting date.


Preparation	Facilitator	District
During meeting	Before the meeting you should have a brief conversation with the birthing parnt and other parent is present Opening statement  Ongoing management of room dynamics  Use  questioning approach to elicit strengths and safety within the family  Safety scaling question  Confirm next meeting date  Distribution of next steps before meeting closure	Danger statements, harm statements and safety goals discussed to ensure clear understanding  Consider additional supports required including referral to an EIFFS provider
After meeting	Type up and distribute record of meeting  Update Assist and Objective of meeting outcome   Send calendar invite for next meeting  [	Monitoring and implementing action plan  Follow up on referrals Liaison with hospital re: antenatal care  Information provided on Safe sleeping (SIDS) and Abusive head trauma (shaken baby/infant) to parents – Safe Infant Sleeping information for parents, carers, and families  Home visit to assess sleeping environment – BB Plus safe infant sleeping checklist Review action plan.

 

Second meeting

The second pre-birth meeting is held as close as possible to the pregnant birthing parent being 26 weeks gestation. The purpose of the second pre-birth planning meeting is to review the action plan developed in the first meeting and outline any progress made and/or changes in circumstances which have occurred.

The second interagency meeting should review the family's circumstances, contemporary factors that have increased or decreased risk and detail any progress in addressing the issues of concern. The purpose is to identify the level of potential risk and identify ways to manage it that promotes the safety and wellbeing of the infant when it is born. 

At this meeting, a draft safety plan should be discussed, and efforts made to examine its vigour through scaling questions and testing over a period of time. Key elements of the plan (or non-negotiables) should be made clear in this meeting so parents and safety network members can be sure they are included in their planning. It is important that the safety network understands their individual role and responsibilities in the process.


The facilitator should develop and distribute a list of next actions to the meeting attendees at the conclusion of the meeting or as soon as possible after the meeting date.

Preparation	Facilitator	District
Before meeting	Print off copies of previous meeting minutes	Organise and confirm attendees  Information provided on significant developments (where necessary).
During meeting	Provide a copy of previous minutes  Ongoing management of room dynamics  Ensure equal participation of attendees in meeting  Non-negotiables established Review of previous actions  Action plan including safety plan documenting clear lines of accountability/timeframes  Confirm next meeting date Distribution of next steps for safety plan before meeting closure.	Further identification of safety network Further development of safety plan – refer resources Helping families to develop a safety network; Roadmap: Family owned safety planning  Discussion with attendees that district director approval needs to be sought in relation to safety planning.
Post meeting	Develop and send record formal minutes of the meeting to all participants Updating Assist and Objective with record of meeting. Send calendar invite for next meeting.	Document/type up the family's safety plan (standalone document separate to the pre-birth planning meeting minutes). (Note: On some occasions Districts have incorrectly perceived that the formal meeting minutes are the safety planning document to be taken to DD consultation. This is not the case). Monitoring, reviewing, implementing safety plan   Consideration given to external referrals to support planning District director consultation. Inform parents and other stakeholder of district director's decision prior to final meeting

Unborn infants referred to pre-birth planning will likely be high-risk infants. If not already done so, case workers should use the Interaction Tool, the resource Determining Risk Factors for an Infant and  refer to CPM entry: 2.2.20 High-Risk Infants.


For high-risk infants, any safety plan developed should also include contact details of safety network members (where appropriate), including the local district office and CIT. It should also identify arrangements for who should be contacted in an emergency including the district office number, crisis care number and any arrangements for when the case worker is not available, for example on leave. 


Internal decision making

Before the final pre-birth planning meeting an internal decision-making meeting must occur at the local district where the district director reviews the information gathered including the family's safety plan and makes a decision in relation to the safety following the infant's birth.  


Think about who else you should consult before the meeting or should attend the meeting, such as a: a senior practice development officer an Aboriginal practice leader, and/or the district psychologist.

The district director has delegated decision making responsibility to decide on the next course of action from one of the following options (CSI cannot be finalised until after the infant is born except under dot point 1 (below) where it is discontinued):


1. Further pre-birth planning not required: The Department has assessed there is no likelihood of harm to the infant after birth. A final pre-birth meeting is not required. The Department may or may not remain involved to provide further supports as required. This decision can be made at any point during the pre-birth planning process; however, needs to be following a district director consult and all parties need to be informed. The team leader endorses and the district director approves this CSI outcome.
   

2. Sufficient safety for the infant to go home: A safety plan is developed with the parents, their extended family (where possible) and their support network. The Department remains involved with the family to monitor and test the safety plan and promote the infant's safety and wellbeing.

3. Sufficient safety for the infant to go home under a protection order (supervision): Requires district director approval. A safety plan is developed with the parents and their support network. Relevant sections of the safety plan form conditions set out as part of the protection order (supervision). The Department remains involved with the family and monitors the conditions set out by the court.

4. Insufficient safety for the infant to go home: Requires district director approval. The infant is placed into provisional protection and care prior to leaving the hospital. In most cases, the decision for an infant to enter the CEO's care from hospital is coupled with planning for immediate reunification.

Advising the parents and WA Health of the decision

Following on from the internal decision-making stage and before the final pre-birth meeting, the Department must advise the parents and WA Health of the decision. When a decision has been made for the infant to remain in the parents' care with a safety plan in place, the safety plan is discussed with the parents and safety network and agreed upon.

When a decision has been made to place the infant into provisional protection and care, the Department should advise the parents of this decision. You should also advise the relevant hospital social worker and/or Director of Nursing and/or Maternity Service Manager of the decision, who is then responsible for advising other relevant WA Health staff including community health staff.


In very rare situations, for example there is a significant risk of harm likely to cause death due to the obstetric, psychiatric or social circumstances, (see information in the Bilateral Schedule in related resources) there may be a justification not to inform the parents before the birth of the infant. In these situations, a professionals meeting should take place between the Department and WA Health so that appropriate planning can be completed.


The final decision must be communicated to the family and WA Health prior to the third meeting including the outcome of the CSI. Where a decision has been made to place the infant in provisional protection and care, you should advise WA Health as soon as practicable including a discussion on how to inform the family of the decision. Irrespective of the final decision, a third meeting must be convened to make post discharge plans for the child and family.

 

Final meeting

The final pre-birth planning meeting is held as close as possible to the infant being 32 weeks gestation. This meeting provides an opportunity to plan how to progress the decision made by the Department, bearing in mind the wellbeing of the unborn infant and their parents.

Where possible, the final meeting should be used to plan for any practical measures that need to be taken to safeguard the child which causes the least distress possible to the infant, birthing parent, other patients and staff.  Where the plan is for an infant to be placed into provisional protection and care from the hospital, the final meeting includes planning for the medical care of the infant and birthing parent and development of strategies to minimise disruption to the hospital when the child is removed from the parent's care.


Post-birth meetings are determined with the family and meeting participants on a case by case basis.

Preparation	Facilitator	District
Before meeting	Print off copies of meeting 2 minutes for attendees	Notify facilitator of any significant developments in case since Meeting 2, including the decision and notification of the decision with the family.
During meeting	Document the final version of the safety plan  Confirm attendees understand Director decision and next steps Commence post discharge planning	Provide family with investigation outcome including right of reply.
Post meeting	Distribute a written record of the meeting  Update Assist and Objective with meeting information	Finalise CSI outcome report.

Where having this discussion in the presence of the parents might result in increased risk to the infant, discussions should be held at a separate meeting between the Department and WA Health. When an after-hours response may be required from the Crisis Care Unit, the Statewide Referral and Response Team should be invited to participate in a discussion between the Department and WA Health.

Where it is planned for the infant to be placed into provisional protection and care from the hospital, consider the following:

• The obstetric, psychiatric and social circumstances of the birthing parent and whether these factors may impact on management within the hospital.

• Whether the parents and/or others pose a physical risk to the infant or others.  Plans should outline how safety risks will be managed in the hospital where there are people not permitted to access the ward for safety reasons, how the hospital will manage the situation if that person presents.

• If there is a risk that the parents could abscond from the hospital develop plans to minimise this risk occurring. Plans should outline where parents (or other unsafe people) may abscond with the infant they are prevented from doing so by hospital security. Where a warrant under s.35 has not yet been obtained, a s. 37 (apprehension without warrant) may be required to maintain the infant in hospital.

• The level of supervision, if any, that is required for contact between the birthing parent and infant after the birth. Whether birthing parent and infant can remain on the ward together or if thebirthing parent can visit the infant who may be in the Neonatal Intensive Care Unit, or whether the risks to the infant are so great that the infant requires care in a fully supervised area of the hospital.

• Where contact needs to be supervised, how will this be facilitated?
  

• If the birthing parent is actively using substances and wishes to breastfeed, ensure they are aware there is a risk these substances will transfer to the infant via breastmilk. Different substances and different patterns of substance use will pose different levels of risk to their infant. Safety planning with the breastfeeding parent may be possible where the substance use patterns indicate low risk to the infant (based on medical advice) and where the breastfeeding parent is committed to adhering to a plan that lowers the risk even further. Where a safety plan is in place, the Department will support breastfeeding to succeed (by providing a breast pump and transporting milk) and will regularly reassess the plan to ensure it remains safe. Where the risk is significant and not in the best interest of the child, the Department may choose not to support breastfeeding, particularly once the birthing parent has left the hospital.
  

• Appropriate timing to provide the parents with written advice that the infant is entering the CEO's care.
  




Final meeting documents and safety plan should be distributed within one day to the parents (where appropriate), Health Service Providers and relevant persons and detail the names and contact details for the case worker, team leader and Crisis Care, reasons for decisions and outline ongoing review and monitoring processes. Communities is the statutory agency for the protection of children and has the ultimate decision-making responsibility in relation to the safety and wellbeing of the child.

Where appropriate debriefing sessions with WA Health are encouraged following the pre-birth planning process to review processes, capture lessons learned as well as improvement opportunities.


Planning with the e Statewide Referral and Response Team (SRRS)

Where a birthing parent presents to hospital, goes into labour, or gives birth after business hours, or where WA Health has concerns for a birthing parent, infant or others after hours, WA Health may contact SRRS to advise of the situation and seek direction.

In cases open to pre-birth planning where SRRS may have to respond after business hours for any reason and/or there are specific actions required to manage risks, you should complete Form 190 SRRS After hours action request (in related resources), place on the family Objective file and email the reference and your request to Crisis Care at:


CPFrontDesk_MS-CC_Crisis_Care@communities.wa.gov.au

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Post-birth planning

Post-birth planning should occur throughout the pre-birth planning process, especially when it is likely that the Department will remain involved following the birth of the infant. This is also to be considered when a notification is made for an infant born prematurely and is in the hospital's NICU. Planning for after the birth of the infant should include consideration of:

• whether the infant will require hospitalisation
• who will have contact with the infant
• who will support the parents following the birth
• the Department's role following the birth
• further planning meetings that will need to occur, and
• the outcome of the Department's investigation.

These considerations are particularly important when there is a risk of premature birth or if an infant is born and needs to remain hospitalised or is required to be cared for in the Neonatal Intensive Care Unit (NICU). The brains of pre-term infants are particularly immature and vulnerable, putting them at risk for abnormal brain development and later developmental problems.

The Department must promote physical and emotional closeness between any infant born prematurely and significant people. This could include parents, grandparents, carers or significant others. Physical and emotional closeness between premature infants and significant others is especially important for infants being cared for in the NICU and can significantly increase their chances of survival and recovery.

When the Department remains involved with a family post-birth, you must work closely with the hospital to plan for the safe discharge of the infant. When infants return home with parents and/or families with a safety plan and/or supervision order in place, you must continue to support the parents and monitor and review the safety plan for an agreed length of time.

At this point pre-birth planning is concluded. If not already allocated to the appropriate team, cases should be transferred to IFS (for safety planning and supervision orders) and Care Teams (for infants in provisional protection and care). 


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Pre-birth Program

​The Pre-birth Program is a centrally coordinated model for managing the pre-birth planning protocol across the state.

 The Program aims to:

• provide six dedicated SPDOs who will facilitate meetings across all metropolitan hospitals, and

• collect and monitor data relating to pre-birth planning occurring around the state. A central email inbox has been set up to support this.

Making a Referral to the Pre-birth Program

Assist automatically notifies the Pre-birth Program of the new CSI when the pre-birth protocol is selected at the time of intake. The team will then reach out to the district to confirm delivery hospital; districts can support this process by contacted the team at PrebirthPlanning@communities.wa.gov.au or by responding to this request for information.

If there may be a delay in completing the Assist entry, such as within a child in care team where the Interaction Tool indicates an intake, the case manager should inform the Pre-birth Program Team by email so a facilitator can be considered and reduce further delays.


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