The following pathway should not be read as stand-alone and MUST be read in conjunction with Section 3: Pathways.
During the antenatal period the Midwifery Service is the accountable professional and lead for the care of the mother and the unborn / newly born child(ren) and works as part of the Health Child Programme (HCP) team. Partner services will work collaboratively with the Midwife to provide continuity of care between the Antenatal and postnatal period. The Health Child Programme focuses greater emphasis on the antenatal period and for preparation to parenthood.
Support pregnancy planning for mothers/partners with pre-exisiting conditions.
Management of pregnancy planning in relation to pre exisiting conditions including past history of mental health issues.
Continuity of care and wellbeing of pregnant mother.
Care of vulnerable mothers/unborn.
Ongoing liaison with MW, GP and mental health services team.
Midwifery team to notify health visiting team of pregnancy, includes assessment of maternal mental health using three WHO questions and clinical
judgement, including needs of father and referrals to other agencies and action plan; this should be a particular consideration for women and fathers with complex social factors (NICE 110).
Previous mental health issues (see MH categories tab/sheet).
Following assessment categorised as low:
GPs to be involved in all cases where there is a past history of mental health issues.
GP should be consulted to provide necessary background if the mother has an identified issue Children’s social care (CSC) should also be involved.
Care of vulnerable mothers/unborn baby.
Clinical need for diagnostic tests for abnormality and subsequent provision of appropriate care pathway with partner professionals.
Appropriate care of vulnerable mothers/unborn baby.
Referral to specialist pathways as required to ensure appropriate specialist care ensure HV are notified of referral.
Appropriate care and support of vulnerable mothers/ unborn baby.
Co-ordination of service.
Support for the family to make informed decisions and aid parental mental health.
Early Support Programme (piloted in Essex - need details of the service) - for children with identified complex needs.
Facilitate information sharing & support joint working.
Receipt of notification of pregnancy from midwife.
Following initial Midwifery assessment, provide notification of pregnancy to the Health Visitor detailing information relating to issues such as:
Core Purpose 1, 2, 3
Delivery of (targetted) additional support.
Delivery of evidence based early intervention attachment programmes e.g. Mellow Bumps to Babies. To improve parenting competencies, boost self esteem and enhance children’s wellbeing.

Vulnerable families who need multi-agency support. TAF/C.
Targeted services initiated via a CAF with a lead professional/agency.
Support for vulnerable /targeted families as part of a multi-disciplinary/agency team.
Reduce risk of/actual child abuse/neglect
Core Purpose 1, 2, 3
Targeted support for Hard to reach families.
Outreach home visiting family support.
Access for hard to reach families.
Core Purpose 1, 2, 3
Targeted early intervention and consultation to reduce the need for more complex service intervention and risk of/actual child abuse/neglect.
Social Work early support for individual vulnerable/targeted families.
Facilitate Joint working and support integrated care planning.
Face to face appointment with HV & MW as required.
DoH recommends the visit from HV service to deliver the promotional guide visit be undertaken from 28 weeks. In higher risk pregnancies this visit can be before this
Facilitate Joint working and support integrated care planning.
Joint antenatal appointments for vulnerable women this may include various combinations depending on identified needs of the individual by MW & HV.
For women with identified vulnerability e.g. maternal mental health, learning disability, fetal developmental issue, obstetric issue, domestic violence, an individualised postnatal care plan should be developed with the MW and HV.
Follow-up Antenatal Visit to provide additional support, advice and information and signpost/refer to other appropriate services as required.
Partnership Collaboration
Referrals and Signposting