Child protection in midwifery: A case series

Midwives have a professional responsibility to report their child protection concerns to the appropriate authorities according to the UK ‘Working Together’ legislative framework. However, little is known about the actual child protection concerns of staff working in maternity services as few studies have been undertaken in this area. This paper examines the characteristics of 29 pregnant patients consecutively referred to a child protection advisory service by midwives based at one Primary Care Trust. The main areas of concern for midwives were: (i) substance abuse in pregnancy, (ii) domestic violence, (iii) child maltreatment, (iv) mental illness and (v) extreme financial hardship. Following an investigation by a child protection advisor (social worker), no further action was required in just 4 cases. However, only 12 patients (41.38%) were formally reported to local authority social services for on-going child protection concerns. One patient was later convicted of a child cruelty offence after her partner murdered their 3-month old daughter. This tragic case highlights the important role of midwives in detecting families at risk of child maltreatment. It also points to the need for rapid intervention by social services when high-risk families are identified by health professionals.