Guidance
Strengthening our response to unborn and newborn pēpi
When we receive a report of concern for a newborn or unborn pēpi, we work with their family, whānau, hapū, iwi and family group using the same processes we use for all assessments or interventions with additional considerations to strengthen our response.He ngākau kōrero – our hearts speak of the sacred potential of children
The Oranga Tamariki Act 1989 principles state:
- the primary responsibility for caring for and nurturing the wellbeing and development of pēpi lies with their family, whānau, hapū, iwi and family group
- the rights of tamariki and children to be cared for and nurtured through whakapapa and whanaungatanga is fundamental to working relationally with whānau or family. The rights of tamariki and children are enshrined in UNCRoC and apply to all tamariki.
United Nations Convention on the Rights of the Child (UNCRoC)
Assessment is used to inform whānau or family in their understanding and to support family, whānau, hapū, iwi and family groups and professionals in their decision-making. Assessment requires us to understand the unique complexities of all situations, and there are some additional considerations in our response to unborn and newborn pēpi.
Te Ao Māori
Tamariki Māori are born into whānau, hapū and iwi. Traditional Māori parenting has been described as a kinship parenting system with whānau investing in the long-term development of mokopuna to meet their full potential through cultural practices to ensure their safety and wellbeing. Moko can be translated as tattoo or blueprint and puna refers to a wellspring – therefore the mokopuna is regarded as a reflection of their tūpuna.
The underlying belief is that mokopuna are gifts from Ngā Atua (gods) and tūpuna through their genealogy, which means that they are tapu, special and protected under specific rules and any negativity expressed to them is violating their tapu. A mokopuna is the centre of whānau life. Mokopuna are born tapu and as infants depend on their whānau to protect and care for their development and safety. This requires tapu restrictions that guide behaviours as a protective mechanism.
Tihei mauri ora is an expression used to describe the breath of life at birth – a physical transformation connected to Ngā Atua.
Tiaki mokopuna is a cultural protective principle that asserts the collective roles, responsibilities, and obligations to care for, make safe, support, and protect pēpi. The principle is founded in customary beliefs and, when applied within the whānau context, has the transformative potential to guide and strengthen strategies for mokopuna care and safety. The principle of tiaki mokopuna reintroduces the notion that mokopuna are taonga.
Tiaki mokopuna integrates 4 functions described as key to the care and upbringing of mokopuna Māori:
- the significance of mokopuna
- tamariki belong to whānau, hapū and iwi
- the rights and responsibilities for raising children are shared
- children have rights and responsibilities to their whānau.
Tiaki mokopuna also promotes the care, safety and protection of Māori children within extended whānau networks, moving out to trusted community members, service providers where support is required and, lastly, on some occasions, to a statutory child protection worker.
Wāhine Māori play a specific role within cultural practices used for protecting whakapapa and advancing long-term sustainability of whānau, hapū and iwi. Tāne Māori influence the health and wellbeing of their offspring and posterity. Both mareikura (female) and whatukura (male) contribute to tiaki mokopuna. Kaitiaki roles for wāhine and tāne Māori are essential in modelling healthy relationships and behaviours for mokopuna to create safe environments conducive to their strong, confident development.
When wāhine are hapū, they can be in a highly vulnerable state. The wellbeing of the mother, both antenatal and post-natal, is the primary protective factor for shaping the hinengaro (brain) systems of mokopuna so they can form close and healthy emotional relationships with significant others in the future.
Tiaki mokopuna strategies founded on cultural beliefs, principles and customary practice include the strengthening of whānau participation, building relationships and increasing cultural knowledge to advance whānau capacity to care for mokopuna. These establish a cultural safety net to protect and advance the tapu and mana of pēpi.
Whakawhanaungatanga interactions within whānau, hapū and iwi ensure hapū and breastfeeding women are cared for by the collective. All her needs are taken care of and her needs are tapu to protect and support her ability to breastfeed.
Reference sources
Dr Moana Eruera and Dr Leland A Ruwhiu:
- Ngā Karangaranga Maha o Te Ngākau o Ngā Tūpuna Tiaki Mokopuna: Ancestral Heartfelt Echoes of Care For Children
- “Eny, Meeny, Miny, Moe” catch hegemony by the toe. Validating cultural protective constructs for indigenous children in Aotearoa
Pacific communities
The child is a gift from God to a Pacific family, a source of joy and pride, the realisation and embodiment of the next generation. The child is immediately associated with the identities and legacies of their parents, ancestors, people, lands and cultures. The child traditionally belongs to a collective. By birth right, a child is entitled to their kin and vice versa.
A child conceived in marriage or accepted partnership is usually a protected one, whereas the position of a child who is not wanted or conceived outside of an accepted relationship can be precarious.
An unplanned pregnancy may lead a pregnant young woman to conceal the newborn to avoid alienation and punishment. The perceived downfall in status and pride for the young woman and her family is worse if the pregnancy is the result of abuse by a family member or someone highly respected by the family. Despite this background, the arrival of the new life often has the effect of melting away damaged pride and shame. It is common for members of extended families to rally around to support and protect the new parent (often the mother) and child.
After the birth, the mother rests for up to a month while the extended family begin their role in the child’s life by helping care for them and the recovering mother.
Often the umbilical cord and/or placenta are ceremoniously buried according to the wishes and aspirations of the family for the child. Traditionally these hopes are often in relation to the wellbeing of the family, community and church.
Individual Pacific nations support and celebrate pregnancy and birth in ways that are uniquely appropriate to their culture. It is therefore important you seek cultural advice on the best way to approach and work with Pacific mothers and expectant mothers and their newborn or unborn pēpi.
Reference source
Disability considerations
Disability includes physical, psychosocial, cognitive, sensory, and intellectual impairments.
Unborn or newborn pēpi of disabled parents and unborn or newborn pēpi with disabilities have the same rights as everyone else to an ordinary family life and to create and maintain families. Our goal is to support both disabled parents to successfully care for their pēpi and those caring for a disabled pēpi, within the context of their whānau or family and support networks.
Parents and their pēpi should not be separated just because of a disability of the parent or pēpi. Our assessment and plans need to consider the parents’ strengths and how these can be developed in their parenting role, and how their disability needs are being met or could be met.
When the parents are engaged with disability services, we work closely with the parents and services to share appropriate information and develop joint plans that address the safety needs of both pēpi and the parents. Joint plans include roles and responsibilities and are living plans that are reviewed with our partner agencies as agreed or as required.
When the parents are not engaged with specialist services, and we believe that a referral is required, then we talk to the lead maternity carer and agree next steps with the consent of the parents.
If we are unsure of the parents’ capacity to understand and participate in processes and decision-making, we talk with their advocate or someone who knows them. The Regional Disability Advisor is available to provide advice and support.
Practice considerations
Upholding rights
- When we respond to a report of concern for an unborn or newborn pēpi, our work needs to uphold whakapapa and whanaungatanga. The connection between pēpi and their family, whānau, hapū, iwi and family group needs to be maintained and strengthened. The primary role in caring for and protecting pēpi lies with their family, whānau, hapū, iwi and family group.
- The family, whānau, hapū, iwi and family group of pēpi should be supported, assisted and protected as much as possible and as early as possible, and any intervention should be the minimum necessary to ensure the safety and protection of pēpi.
- The rights of the pēpi – right to safety, whakapapa connections, care, protection, their whanau or family, relationships, culture – need to be balanced with the rights of the parents, family, whānau,
hapū, iwi and family group to have the key role and responsibilities and opportunity to provide safe care for their pēpi. - No pēpi should be separated from their parents based on a disability of either the pēpi or one or both of the parents.
- Seek to understand the cultural practices of the family, whānau, hapū, iwi and family group and their roles and responsibilities of tiaki mokopuna in the preparation and application of traditional practices. Seek advice from cultural experts if needed.
- Throughout assessment and intervention, we need to understand, recognise and incorporate whānau tikanga and cultural practices around pregnancy, birthing, collection and burial of the afterbirth and Pito (connection to the umbilical cord), naming and the care of a newborn pēpi.
Early engagement with the right people
- Early engagement and planning with family, whānau, hapū, iwi and family group is necessary to promote safe and family-led decision-making, to support, strengthen and assist parents and whānau or family to care for their pēpi.
- Ensure this engagement includes the father of the pēpi and his family, whānau, hapū, iwi and family group and support their engagement in planning and decision-making.
- We need to recognise that in some circumstances the mother may deny the pregnancy and/or present only at the time of birth of a pēpi. In these circumstances we need to consider that engagement and planning will be compromised and consider ways to ensure that it is effective.
- When a report of concern is received late in any pregnancy, all attempts must be made to follow these guidelines as closely as possible within the limited timeframes.
- The inability of pēpi to communicate through language means our usual processes and engagement approaches for understanding their voice do not work. We need to think about how we ensure that we have ensured their ‘voice’ is heard throughout each stage of our involvement.
- We consult with kairaranga a-whānau and Pacific cultural advisors to assist with our engagement, drawing on their cultural expertise and community networks.
- We work in collaboration with our hospital practice leader, who will be able to guide us on the interface with the district health board protocols and processes, to ensure appropriate information sharing occurs, clear roles and responsibilities are established, and effective early joint planning happens for pēpi.
Supporting families with babies | orangatamariki.govt.nz
Working with our Health partners
- Pregnancy and newborn care are an area of speciality in the health, social service and community provider areas. Early and close collaboration with other professionals (including the lead maternity carer) and community supports involved with the whānau and family group is critical to building an understanding of the needs, issues and opportunities for safety and protection within the family, whānau, hapū, iwi and family group.
- The lead maternity carer has the key role in supporting the mother’s choices and care of pēpi. Maintain ongoing engagement and work with the lead maternity carer to ensure the mother has access to information and support to enable her choices.
Supporting families with babies | orangatamariki.govt.nz
Keeping a focus on pēpi and whānau or family in our assessment
- We need to focus on the vulnerability of the pēpi in the context of their whānau or family and how the whānau or family can protect the pēpi. This necessitates extra vigilance when assessing their protective and care needs.
- There are some areas of risk that are specific to or increase the risk to unborn or newborn pēpi. Our assessment needs to understand and respond to these areas. We use the practice triggers for vulnerable infants to guide our assessment of needs.
Practice triggers – vulnerable infants - Our understanding of needs is to be based on a Tuituia assessment that considers the pēpi, their family, whānau, hapū, iwi and family group, and their social context. We need to ensure that we actively seek out current information pertaining to the parent’s circumstances.
- Use the child and family consult tool to identify and consider indicators of safety and strengths and to support thinking and analysis at any point in the social work assessment, planning, intervention and review processes. Relevant professionals should be invited to case consults.
- Throughout the pregnancy, the mother of the pēpi is also likely to be extremely vulnerable and we need to identify and provide any supports she may need. Consider antenatal health supports, such as regular antenatal care, assistance with alcohol and drug abstinence, and smoking where necessary.
- When parents have experienced childhood abuse or neglect, have themselves been in care or had tamariki previously removed by Oranga Tamariki, we should use a trauma-informed approach in our assessment.
Trauma-informed theory
Promoting resilience (PDF 3 MB)
Subsequent child provisions and care and protection resource panel
- Subsequent child provisions may apply when working with parents who have been convicted under the Crimes Act 1961 of the murder, manslaughter or infanticide of a child or young person who was in the person's care or custody at the time of the child or young person's death.
Policy: Subsequent child - Consult with the care and protection resource panel in all cases and as soon as practicable after an investigation has started and at subsequent stages when required.
Care and protection resource panel
Making decisions with family, whānau, hapū and iwi
- Decision-making processes should include hui ā-whānau or family meetings, and family group conferences. These should occur at the earliest opportunity before pēpi is born. This helps to identify the plan and what supports are required, and to enhance the rights, participation and decision-making of te tamaiti and their family, whānau, hapū, iwi and family group.
Safety planning
The safety and risk screens should be completed after engagement with whānau or family and others who know them and their pēpi when a social worker believes there are care and protection concerns. This will help identify if immediate action is needed to secure the safety of pēpi by working with family, whānau, hapū, iwi and the family group.
All attempts must be made to build safety with a view of keeping pēpi with their parents or, if this is not possible, with family, whanau, hapū, iwi or the family group.
A safety plan may be required to create safety for pēpi before holding a family group conference.
A clear and robust safety plan must be evidenced, developed and shared with all relevant people. The plan should include what the worries are, what safety and oranga look like, who will be providing care to the pēpi and what supports are in place.
A birth plan may be in place which will include the details of the safety plan. This should be developed together with the parents, family, whānau, hapū, iwi, family group and other relevant people. This may include details of any birthing arrangements, legal orders, transition plans if required and discharge meetings in place.
In some circumstances there will be safety concerns that need to be carefully considered to support breastfeeding. Consider how a safety plan can be used to address concerns sufficiently to support breastfeeding or to ensure other ways to connect and nourish pēpi if pēpi is not breastfed.
Oversight by practice leader and supervisor
Practice leaders are required to maintain oversight of all cases on their site of unborn pēpi (defined as a tamaiti at any stage of development who is carried in the womb) and newborn pēpi (defined as from the time of birth to 12 weeks).
This oversight includes:
- a focus on ensuring the casework is consistent with practice standards throughout our work with pēpi and their family, whānau, hapū, iwi and family group – this includes the appropriate use of Te Toka Tūmoana and Va’aifetū
Practice standards
Working with Māori: Te Toka Tūmoana
Working with Pacific peoples: Va'aifetū - practice leaders completing the monthly Quality Systems template confirming their oversight of all unborn and newborn pēpi at their site (this template documents key information gained through their oversight, including any themes, follow-up or action taken as result).
Day-to-day casework supervision remains the role of the supervisor.
Practice leader oversight provides confidence that:
- practice responses are taken at the right time
- assessment is thorough and holistic through our involvement
- plans include wider maternal and paternal whānau or family and key professionals
- our social work practice remains robust in ensuring timely and thorough implementation and review of plans.
Legal intervention
Removing a pēpi from their parents or caregivers is a significant and traumatic event, undertaken only when pēpi cannot remain safe in the care of their parents or caregivers.
Interim custody is only to be used to secure the safety and wellbeing of pēpi when all other intervention options have been exhausted.
Without notice section 78 interim custody applications are reserved for exceptional urgent cases where all other options to ensure the safety of pēpi have been considered but are unavailable and the delay caused by making an on-notice application would create risk to the safety of pēpi.
Pathways to care: Emergency actions
Policy: Without notice application for interim custody of a tamaiti or rangatahi
If this action is being considered, site manager approval is required based on practice leader and regional litigation manager endorsement of the rationale for the application.
If the removal of pēpi from the care of their parents or caregivers to secure safety is necessary, we need to ensure that this occurs in a way that reflects the concept of ngākau maharatanga me te ngākau aroha.
Ngākau maharatanga me te ngākau aroha – a period of quality time that encompasses consideration, empathy, sympathy and love.
Engagement, planning and collaboration about how this could happen to minimise trauma and reflect the above concept is required. This should include discussion about how parents and whānau or family can spend time with their pēpi in a way that is right for them with support people present, and how and where orders will be served in collaboration with the lead maternity carer and the district health board, if the pēpi has been born in a hospital setting. As this forms part of the story for pēpi it is very important that this period of quality time with parents and whānau or family is recorded, ensuring you record the circumstances with accuracy and respect.
We need to ensure that parents and whānau or family are provided with support and clear information on the next steps. We need to ensure all parents, whānau and family groups who have had pēpi removed from their care have access to appropriate advocacy and therapeutic support that focuses on their needs to help them with the separation from their pēpi.
Support should also be provided to social work staff through debriefs and supervision.
Supporting and maintaining breastfeeding
We need to fulfil Article 24 of the United Nations Convention on the Rights of the Child (UNCRoC) – tamariki have the right to enjoy the highest attainable standard of health. We can share knowledge and provide support for parents around the benefits of breast milk and breastfeeding.
It is important to support caregivers in maintaining breastfeeding for pēpi.
Care
Where a pēpi is unable to be cared for by their parents, develop a detailed transition plan outlining how a care transition will occur, including details of the proposed caregivers, who will be involved in the transition and how, and where this will occur in collaboration with the parents or caregivers, the lead maternity carer and the district health board if pēpi is in a hospital setting.
Consider a care option where a mother and pēpi can be safely placed together if this is possible. This will allow breastfeeding to be most effectively supported. This may require a safety plan to be in place.
It is important to support caregivers in maintaining breastfeeding for pēpi.
If the pēpi is unable to be cared for by their parents or family, whānau, hapū, iwi or family group, seek a culturally appropriate placement.
All pēpi in care need to have an All About Me plan in place, detailing how their identified needs will be met and supported.
All About Me plan to meet the needs of tamariki and rangatahi
All caregivers caring for pēpi require a caregiver support plan, detailing what support they will receive and who will provide the support.