Wednesday, 8 January 2014

RIGHT FROM THE START. The GIRFEC practice model within Maternity Care

Like a lot of this kind of material it is unpleasant reading but if some of it is picked over it can be exposed for what it is: the state tightening its grip on families.

Women saw clear benefits to the GIRFEC wellbeing assessment, in some cases spurring them to think about factors impacting upon their pregnancy that they had not previously considered.

Women can easily be made anxious about their pregnancy; so there is no surprise there. But there is no mention that any women resented the wellbeing assessment or did not co-operate with it or find it useful. This is very strange given that this is a study of three contrasting sites.

GIRFEC is enabling important work to be done with families pre-birth and this has meant the post birth period in hospital is less of a crisis period.

This takes a bit of explaining. Why should the post birth period in hospital be a crisis period?  But I think this is explained next.

This way of working (?) has been supported by standardisation of child protection procedures across Scotland, which can now be initiated between 28 and 32 weeks of pregnancy (Scottish Government 2010e).

So what they probably mean by this way of working is doing a GIRFEC assessment. And this way of working might lead to child protection procedures being initiated pre-birth on the basis of the assessment . Why didn`t they say so at the start? And why does nobody worry that in place of a post-birth crisis this way of working might precipitate a crisis pre-birth for mother and baby?

But then whose crisis were they really talking about?

Highland midwives stressed the importance of this: (?) So you can have that all set up before the birth whereas in the past it used to be a right clamber right at the end. You had the Sheriff coming in and putting that order in place, in the maternity unit when the baby was just born. So hopefully that won’t happen as much.

I see. So you can have all that set up pre-birth: Sheriff, court orders and all. No crisis then? Just snatch the baby when it`s born.

Midwives illustrated this prevented unfortunate scenarios from occurring that in the past led to a lack of trust just at the point it is vital that practitioners build trusting working relationships with parents: In the past, sometimes, social work hadn’t been speaking with us. And (when child protection came in after the birth) you lost that relationship you had. This girl had been engaging with you, she felt you’d been supporting her and then thought: "that midwife, she never told me this was going to happen".

So now the midwife can tell the girl that child protection is going to be involved pre-birth (based on the midwife`s GIRFEC assessment, of course) - and that is better for trust. This is nonsense.

Highland and Lanarkshire both report an increase in two way communication between public health nurses and midwives that creates a picture of the family as a whole. NHS Child Protection Advisors consulted for the study concur and see this as an important improvement.

Surveillance and communication between state agents about a family`s private information from pre-birth and beyond is an improvement?  It`s quite shocking that they think so. Why should mothers comply with this?  And who is going to monitor the surveillance team and their communications before the baby is taken away?

Maternity Care Assistants consulted for the study related that they think their support is valuable and that they provide useful information that contributes to a holistic picture of family circumstances, strengths and weaknesses.

How many people are expected to be in the surveillance team? Since when was it the business of the state to provide a holistic picture of family circumstances?

There is also particular appreciation for improved communication with police. Again the benefits are seen to flow both ways, with better information relating to midwives’ safety being communicated at the commencement of work, and reliable follow up by police of any concerns which midwives communicate to them.

Oh dear! Now we are talking about midwives` safety and the police. Of course, when the baby is removed from the maternity ward the police will be there. The days of building trusting relationships are long gone.


Here is an example of what the agencies want to know and record in connection with one of the wellbeing indicators: inclusion: Nowadays there is only one acceptable way to parent.
Understanding and acknowledgement of (unborn) baby’s right to inclusion.

Consider links to extended family and community.

Language, communication or cultural issues which may impact on inclusion.

Capacity issues such as mental health or shy personality which impact on inclusion.

Geographical location.

Access to amenities, facilities, resources which provide opportunities to integrate.

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