Pre-birth assessments for women who use substances in pregnancy: women and social work views and experiences

Background: There are no clear guidelines on pre-birth assessments for women who use substances in England and Wales. Women s experiences of pre-birth assessment can shape future interactions with services.

Pregnancy can be a turning point for women who use substances but women who have pre-birth assessments may feel stigmatised, overwhelmed, and lack trust in services. Little is known about how women who use substances are supported in pregnancy. Research suggests that social workers lack knowledge in undertaking effective assessments.

This study will help social workers to meet the support needs of women who use substances in pregnancy.

Aims and objectives: Research aim: To explore how pre-birth assessments for women who use substances in England and Wales are experienced by women and social workers, and to develop practice recommendations in consultation with experts by experience based on those findings.

Research objectives: To explore the views and experiences of social workers in undertaking pre-birth assessments for pregnant women who use substances.

To understand women s experiences of pre-birth assessments, including timings of assessments, pregnancy, birth and postnatal experiences. To gain insights into communication and interactions between social workers and women. To understand what support was needed and provided for women before, during and after court proceedings.

To understand the prevalence of women who use substances in pregnancy who undergo pre-birth assessments.

To use learning from this study to co-produce (with women and other stakeholders) best practice recommendations on undertaking pre-birth assessments with women who use substances. Methods: The mixed-method study uses a critical realist approach.

Interviews and focus groups will be undertaken with 45 professionals and 25 women in three local authorities in England and Wales.

We will collect data from each local authority about numbers of pre-birth assessments and how many include substance use to help us understand the prevalence of substance use in pre-birth assessments.

Throughout the study we will adhere to principles of co-production through working with a parental advocacy group and establishing a steering group of experts. This will ensure that the study remains relevant and is disseminated appropriately. Timelines for delivery: The study will take 24 months to complete starting in October 2024.

The timescales are: Month 1-3: Ethics approval, establish steering group, gain Local Authority ethical approvals Month 4-6: recruitment Month 6-12: fieldwork (professional interviews and focus groups) and analysis Month 9-18: fieldwork (interviews with women) and analysis Month 19-20: synthesis of findings; development of recommendations for practice through workshops, write up findings Month 21-24: write up and submission, academic publications Anticipated impact: The study will add to the limited knowledge on pre-birth assessments for women who use or are in treatment for substances.

Dissemination: The findings and practice recommendations with be disseminated through academic and practitioner routes to maximise impact.

The findings will be shared via peer-reviewed journal articles and academic conferences and webinars and workshops for practitioners.