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18.3 Maternity departments

Maternity departments include antenatal, intranatal and postnatal staff. Comprehensive antenatal assessment and care planning for women during pregnancy includes physical, medical, mental health and psychosocial elements. It should also include the collection of information relating to parenting capacity. Maternity staff need to conduct
comprehensive assessments so that appropriate and timely assistance and support can be arranged.

Issues and processes
Nursing staff should, where appropriate, involve
the social worker and doctor in a joint assessment
leading to a thorough psychosocial assessment.
Parents should be involved in this process where
appropriate.
NSW Health NSW Health Services Frontline Procedures for the Protection of Children and Young People • December 2000 49
A thorough assessment of a woman's family, risk
factors and strengths both during pregnancy and the
postnatal period will help identify the supports that
may be needed to make sure that an infant will be
nurtured and protected and families are linked to a
network of services.
Maternity staff should be aware that domestic
violence often begins or escalates during a woman's
pregnancy.When responding to women suffering
domestic violence, you should refer to local domestic
violence protocols. If routine screening for domestic
violence in antenatal services has been introduced in
line with the NSW Health Domestic Violence Policy,
this will be an important child protection strategy.
Maternity staff should also be aware of significant
changes in the mental state of a mother. In particular,
you need to look for signs of post-natal depression
or post-partum psychosis. If there is concern about
the mother’s mental health or behaviour, an assessment
of the care and safety needs of the child should be
made as well as an assessment of the mother’s mental
health and safety.
Pre-natal reports may be made before the birth of a
child if there may be risk of harm after the child is
born. The principle of pre-natal reporting is to
provide an opportunity for early support and
assistance to pregnant women if their child may be
at risk of harm after he or she is born. It also helps
to reduce the likelihood of the need for out-of -
home care.
Pre-natal reporting may be particularly helpful for
pregnant women in domestic violence situations or
with mental health or drugs in pregnancy issues
because reporting can provide the catalyst for
assistance. However, pre-natal reporting should only
be used if there are clear indications that the infant
may be at risk of harm. Reporting is not intended
to be used as a punitive measure against women
under stress. Maternity staff need to involve and
consult with other relevant health services to assist
with the care of the mother and her child.

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