Group Work Case Scenario From the following scenario

Group Work – Case Scenario From the following scenario, would you have any concerns? If so, what would you do?

Case Scenario (Part 1) • 24 year old single woman (K) referred to Midwife by G. P. following positive pregnancy test. • Failed to attend 2 scan appointments and 2 Midwife appointments within 4 week period • (K) initiated contact following missed appointments and gave plausible reason for missing these • New to the area and no medical records immediately available. • Homeless and residing temporarily with cousin who is known alcohol user

Case Scenario (Part 2 • (K) engages with Midwife 2 weeks later. Scan confirms 6 months gestation • (K) shows no real insight into needs of baby or in planning/ preparation for the birth • Records have been accessed from former G. P. (K) discloses she is I. V drug user and goes on methadone programme • Baby is born and Maternal Grandmother offers support to (K) and the baby move to reside with Grandmother on discharge. • At this stage relevant agencies involved i. e. Social Work, drugs worker, health and housing • Early post birth meeting held documented (K) presented as a devoted, attentive and competent mother • 6 week developmental check – The baby noted to be well cared for in a loving environment

Case Scenario (Part 3) • Maintains sporadic engagement with all services • Continues to give logical and rational reasons for missed appointments • Moves into own tenancy decorated and furnished by charitable organisation • Begins a relationship with known drug & alcohol user who is allegedly violent • At 11 months old, the baby is noted by drug workers at home visit to be looking sad, pale and tired and demonstrated little reaction to visitors or Mum • Deterioration noted in condition of house • On subsequent contacts (K) often articulated convincingly that John not at home and being cared for by close friends or relatives

Declan Hainey • Born 17 th April 2008 • Found dead 30 th March 2010 • Exact cause and date of death unknown • Declan’s mother sentenced to a sentence of 15 years for his murder in November 2011 (This decision was “quashed” in April 2013)

SUMMARY OF RISK FACTORS • Substance misuse • Homelessness • Associations with substance misuser/ violent partner • Lack of insight into baby’s needs • Disguised compliance • Lack of effective agency communication • Past history • Little/ tenuous family support • Failing to attend appointments • Marked deterioration in house condition • Late pregnancy presentation • Presentation of the child