Pre Birth Evaluation Reflective Analytical Study

I was requested to complete a Pre-Birth Assessment in relation to Case BB. The recommendation was made by the Community Midwife to the kids and Households Area Team where I had been on my positioning. THE CITY Midwife's concerns were BB's age, she already got a child who was simply under one year, her partner was at prison and the Midwife was further worried about BB's lack of engagement with medical services specifically ante-natal services. The Midwife was also worried about BB's emotional mind-set. To consolidate what little information was on the referral I contacted BB's current Health Visitor whereby I was at the mercy of a litany of BB's misdemeanours regarding her attention of CA. Although medical Visitor considered BB's care of CA as poor I noted that there have been no interpersonal work input wanted from medical Visitor which medical Visitor had a significant forceful personality. However, I got on board the knowledge medical Visitor provided with an objective brain.

BB is 19 years of age and lives in an area authority house in a rural village with few local amenities. The village is not well dished up with public transport which makes it problematic for BB to access the main town. BB's sole income is gain centered. BB now has two children, CA who is 15 weeks old and LA who is three months old. BB's spouse, BA (who's 22 years) reaches present in jail, serving a word for Assault to Serious Accident. BA is not expected to go back to the house until October 2010. BA is the natural daddy to both CA and LA. My role was to complete a Pre-Birth Evaluation in relation to convening a Pre-Birth Convention if necessary. This is based on the local authority's RISKY Pregnancy Process. My role was also to aid and work in partnership with BB and her family in the longer term.

The context of my practice was that of a statutory role with statutory responsibilities. Therefore, I had to consider how to support the family by examining BB's advantages and pressures as well as promote the welfare of BB's child and unborn child and in the wider sense to keep the family together. Relating to Hothersall (2008) they are principles natural within the kids (Scotland) Function 1995 which themselves derive from broader principles adjoining the privileges of the kids and the importance of positive development as the foundation for a meaningful life. Further to the Healy (2005) highlights that within the practice context it's the legal aspect which includes precedence over other aspects of practice. This includes the fulfilment of legal tasks and tasks.

The Children (Scotland) Work 1995, as stated previously, is the underpinning legislation within Children and Family members. This legislation in relation to parental responsibilities was I thought, pertinent to this case. For example, the responsibilities of your parent to a kid under 16 are lay out in Section 1 of the Act. They are really to guard and promote medical, development and welfare of the child and also to provide appropriate path to the kid according to age group. These parental tasks were important to consider when doing the Pre-Birth Evaluation in response to both BB and her partner BA's capacity to parent or guardian. The Getting It Right FOR EACH AND EVERY Child (GIRFEC) (Scottish Professional, 2005) policy was also crucial in my evaluation. GIRFEC offers a practice model which helps bring about holistic analysis and planning for children, centred after signals of well-being so that a policy is approximately intervention as soon as possible and provision of the right help at the right time. Within GIRFEC is the 'My World' diagnosis model that i used to help me complete the Pre-Birth Assessment particularly with regards to BB's parenting skills with CA. I also utilised Getting Our Priorities Right (GOPR) - A Guide for Employees in Best Practice (Local Authority Child Protection Web Pages). Underpinning this analysis was Safeguarding Children and TEENAGERS - Framework for Specifications (Scottish Executive, 2004).

Within the framework of doing the assessment I used to be aware of the statutory legal responsibility involved and the necessity to work within the construction of current legislation and coverage. During supervision talk was centred around the problem of care and control from the perspective of my practice based on statutory responsibility. Matching to Thompson (2005) to disregard control is to run the risk to be ineffective, while to ignore care can result in potentially abusive and oppressive practice. Further to the Banks (2006) highlights that the reasons for many ethical dilemmas and problems stem from the interpersonal work role as. . .

"a public service profession interacting with prone service users who have to be in a position to trust the employee and be covered from exploitation; and also from its position as part of condition welfare provision based on contradictory seeks and principles (health care and control. . . protection of individual rights and campaign of general population welfare) that cause tensions, dilemmas and conflicts. "

(Finance institutions, 2006, p. 25)

As Banking institutions also highlights, in practice it is the rules of the agency that define who is to be regarded as a service user and provide the context in which the social worker operates. This, for me personally reflects that require to recognize the significance of discrimination and oppression in service users' lives and then for my practice to be ethically sound and develop a participatory approach to my practice.

Considering these tips helped me formulate by domain flipping was going to engage with BB. I needed an understanding of my statutory tasks from a legal and insurance policy point of view and I experienced a knowledge of my own and professional principles in conditions of the tensions triggered by good care and control. Therefore, I had a need to create a working marriage with BB which allows me to develop 'a theoretical understanding of the interrelationship between your individual and world. " (Watson & Western world, 2006, p. 13) This would help me complete a important and insightful assessment of BB's current difficulties with appropriate interventions.

To complete the evaluation, I took into consideration Germain and Gitterman's The Life Model of Sociable Work Practice (1996). Payne (2005) details this model as a formulation of the ecological systems theory which is based on the relationship between people and their environment. The purpose of interpersonal work is to improve the fit between people and their environment by alleviating life stressors and increasing people's personal and sociable resources to permit those to use more and better coping strategies. Payne further points out that practice must be completed through a partnership between employee and service customer that reduces electricity variations between them. The surroundings and the demands of the life span course should be considered a constant element in making decisions.

By utilising Germain & Gitterman's life model of practice (1996) I was able to create an accepting and supportive environment by explaining my role plainly to BB and pushing BB to give her thoughts about the referral. This elicited backdrop information about her marriage with BA and support networks she got within her own expanded family and with BA's extended family. We reviewed the delivery of her second child specifically in respect of how BB felt she could handle CA as well as with the newborn. BB determined this as a fret for her as she was concerned that she would not be able to manage. To make sense of the information Payne (2005) explains resources that people have to be able to cope. These are self-efficacy, self-esteem and self-concept. BB got none of these emotional resources open to her at the moment. Coupled with this she experienced no self-direction in the sense she didn't feel she experienced any control over her life.

To let me elicit further information regarding BB's parenting skills I seen her health care of CA. The 'My World' model which pulls on upon the work of Bronfenbrenner (1979) and motivates practioners to adopt an ecological approach to the evaluation process helped me in this value. By looking at the three domains of expansion and development, what is needed from the folks who take care of me and my wider world I was able to elicit the positives in the situation and the regions of pressure with regards to the safe practices, well-being and development of the kid. Further to the, attachment theory, which relating to Schofield (2002) is "principally a theory for understanding" (Schofield, 2002, p. 29) was also useful in that although directly wanting to increase the quality of interaction between children and caregivers, the child's sense of security, self-esteem and self-efficacy can also be increased by intervening in the systems around the family, for example providing sociable support to the mom or funding a place for the kid within an activity group.

A visit with BA was also organised, who although in prison presented as a significant risk factor due to alcohol usage and increasing levels of violence, albeit the incidents were not in or nearby the house and did not involve BB nor his child. BA was at first uncommunicative that was understandable due to the setting and nature of the visit. Trevithick (2007) shows that asking a variety of different questions is central to interviewing however, before asking a question 'we must be thinking about the answer'. (Trevithick, 2007, p. 159) By careful use of available and sealed questions I could acquire BA's views on the evaluation and gain some sense of a working romance with him. However, what really exposed the dialog was whenever i commented about how CA searched very like him.

BA then began to discuss CA and exactly how he was getting excited about the delivery of his next baby. During the visit I was able to understand how BA supports BB by allowing her the flexibility to manage CA while he does the food preparation and looked after the house. BA went on to clarify that his romance with BB was 'reasonable' but that he was aware he previously let her down terribly especially as she was pregnant along with his second child. BA was aware that he had missed a lot of CA growing up and he did not want this to happen with his second child. BA was also open up about the circumstances resulting in his arrest and he accepted that it was scheduled to a feud between two different villages that were taking place since university. BA confirmed that the whole lot was 'ridiculous' and that he now realised he had a need to 'grow up'.

Taking into consideration the information gained and observations made within my visits with BB, CA and BA I could start to make sense of their environment, their talents and stresses and the tasks each of them had within the house and their community. Intervention at the initial stages of the procedure was I really believe successful with regard to forming a working partnership with BB and also to an level with BA. Further sessions with BB drew further information regarding casual support systems which in the main was her mom. BB's mother was a way to obtain practical support and advice plus they were in contact daily. BB identified her mom as 'her hearing'. Permission was sought from BB to meet with her mom. BB's mom was keen on her behalf daughter to get support from sociable services as she realised how difficult her daughter was finding things at this time.

To complete the assessment and take into account risk factors and strengths I had to analyse and reflect on the information I needed gained. Matching to Helm (2009) these details needs to be analysed before an understanding is developed which allows a judgement to be formed which can result in an appropriate decision or action. Calder (2002) further offers a framework for performing risk assessment by assessing all areas of discovered risk and making certain each is known as individually e. g. child, father or mother, and adjoining environment each worrying behavior should be assessed singularly as each is likely to entail different risk factors. To counteract the chance factors present family strengths and resources also needs to be assessed, for example good bonding, supportive systems.

After an intensive analysis and supervisory conversations I recommended that a Post-Birth Multi-Agency Conference not be convened. However, I advised a further assessment take place when BA comes back to the family home and a Post-Birth Multi-Agency getting together with to go over future interventions be assemble as I was aware that the beginning of the newborn could be a future pressure on BB. Consistent with anti-oppressive practice and collaboration working, I reviewed both the evaluation and suggestions with BB and by letter with BA. Both were given the possibility to put their views across and both were happy to continue steadily to work voluntarily with the section for today's.

The reasons behind my advice were that BB although socially isolated got a strong supportive network with her prolonged family and BA's expanded family. Further to this BB has an in depth and supportive romantic relationship with her mom whom she perceives every day. Matching to Hill et al (2007) an enormous selection of research demonstrates parents in poverty, or facing other stresses, usually manage better when they have one or more close relationships beyond your household and they are activated to provide practical, mental or informational support. Frequently this is casual but, for isolated parents access to family centres or specialists including health professionals can make a great difference to both the parents and the social and psychological health of children. (Barlow & Underdown, 2005)

With relation to CA, BB possessed a good relationship with her princess and was quick to wait to her needs. BB also had a routine set up for CA regarding mealtimes and naps this also included a bedtime workout. CA was getting her developmental milestones (Source: Sheridan's Charts). CA possessed age appropriate gadgets and got the liberty of the living area. BB experienced erected a baby gate to stop CA from gaining access to the kitchen and the stairs. However, since CA began walking, BB has to continually monitor CA due to the open flame and hearth in the living area which is showing difficult for BB.

Immediate interventions included obtaining Section 22 financing to get a safety fireguard and information was obtained regarding BB making applications for certain Start and Healthy Eating Grants or loans. These applications were efficiently created by BB and allowed her to get essential items for the new baby. BB had outlined this as a get worried for her as she was struggling financially. Employed in collaboration with the Community Midwife plans were designed for BB to make the visit to the center on alternative weeks when her benefits were received. The Community Midwife frequented her at home the other weeks.

I believe I managed to create a positive working romantic relationship with BB. Corresponding to Wilson et al (2008) relation-based practice is the emphasis it places on the professional romantic relationship with the service consumer. The social worker and service user relationship is recognized to be an important source of information for the staff member to understand how best to help. In order to make educated decisions and critically evaluate practice, reflection and analysis of information should accept all resources of knowledge which have to be drawn upon. Further to this, a possibly more beneficial, relationship-based and reflective response is always to articulate the service users' feelings by which the service end user can acknowledge their own reactions to the situation. As Fook (2002) highlights:

"Reflective practioners are those who can situate themselves in the framework of the problem and can factor this understanding into the ways that they practice. . .

(Fook, 2002, p. 40)

Banks (2006) also shows that part of the process of learning to be a reflective practioner also entails being aware of one's own position of electricity and how dominant discourses construct the data and beliefs we use to spell it out and work with situations and practice. This has been mentioned in supervision with regards to BB's Pre-Birth examination and to browsing BA in prison.

It is difficult to judge whether areas of might work were effective or not. However, in supervision we reviewed how enthusiastic BB was to gain support and appeared to appreciate the partnership approach. This is discussed in relation to Hill et al's (2007) research and Barlow and Underdown (2005). Small aspects of my intervention, like the provision of the security fireguard were referred to by BB as a 'godsend' and she was pleased showing me the baby items she experienced purchased on receipt of the grants or loans.

Discussion in supervision also centred round the next level of intervention which was after the baby was born. I discussed with BB the chance for CA to attend a local expert nursery one day per week. This might help CA's social and psychological development and at the same time allow BB to invest time with LA. This referral was successful as was increasing the services of a volunteer driver to transport CA. However, CA has only began at the nursery and for that reason difficult to determine if this referral has been effective.

Reflecting on might work overall, I will probably have explored more with BB her public isolation and done strategies to get her more mixed up in community. Further to the resources in this community are non-existent and the parenting groups which were suited weren't available locally. BB was interested but located area of the Family Centre and lack of public transfer negated this. I enquired with regards to Outreach Work but this was not available. Discourse with other acquaintances in the team shown the same theme regarding facilities for the outlying villages. Further conversation in supervision elevated for me the issue of keeping empowering and anti-oppressive practice within this context as assessment should be needs led not learning resource led.

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