About this presentation

2. About this presentation • Brief summary of three quantitative research projects into parents’ experiences of pregnancy and the early years commissioned by the Department of Health • Looks at parents’ needs at different stages of the journey • How they feel • What support they want from health services • What they think of the support they received • Designed to give commissioners and providers an insight into research findings • Can help to inform future service planning

3. Overview of the research • Three qualitative research projects • Healthy Child Programme (May 2009) • Birth and Beyond (May 2009) • The maternity customer journey (June 2009) • Each interviewed a wide cross-section of parents of different ages and backgrounds • Mix of individual, paired and group sessions

4. Key findings • Empathy is essential • Continuity of care matters • Many parents need help to understand their choices • Parents want ‘milestones’ on the pregnancy journey to be marked

5. The emotional rollercoaster of pregnancy

6. Recognising and responding to information needs • Many expectant parents feel overwhelmed by the amount they need to know and the speed at which they feel they need to learn • The NHS is seen as an important source of information • To take advantage of this, health services may want to explore: • what information parents want (see next slide) • when the right time is to give parents information – important not to overload them too early. Pregnancy schedules can be invaluable • how to communicate information – combination of face-to-face with professionals, online, print, group learning (eg antenatal classes)

7. What expectant mothers may want to know Parents told researchers they are interested in information about: • changes to their body and the baby’s growth • screenings and scans • proactive health choices, such as giving up smoking and healthy eating • labour and birth • life choices – whether to continue in their studies or career, what to tell their employer • social non-health issues, such as housing and benefits • becoming a parent – practical advice on feeding, bathing and nappy changing • specific information for partners/fathers

8. Pregnancy: 0–12 weeks • First contact with health services is vital • Parents sometimes feel GPs aren’t ‘excited’ enough • Few realise first contact can be with midwives • Don’t overwhelm with information at this stage • Focus on big things • Direct fathers/partners to information, eg online • 12-week scan is an important milestone – not just clinically, but also emotionally • Parents value first opportunity to see and bond with baby • Some mothers (especially first-time mums) would welcome more contact between first contact and 12-week scan

9. The anxiety of the first 12 weeks

10. Pregnancy: 12–28 weeks • This period has several key milestones/dates • booking-in appointment/assessment • 16-week blood test • 20-week scan • It is also the time when expectant parents start thinking about their birth plan • They want the opportunity to discuss progress and ask questions about • the baby’s health • screenings and tests • their work (including maternity leave) • birth plans and their choices • other sources of information about parenting

11. Pregnancy: 29–40 weeks • Expectant parents are now focusing on the birth plan • Who will be present • Skin-to-skin contact, etc • They are more receptive to information about caring for their baby (particularly first-time parents) – including antenatal education • Many would welcome dedicated classes for ‘people like them’ – first-time parents, younger mums, single mums, etc • They want practical information about birth – eg hospital visits, details on car parking, etc • They may also want reassurance about the kind of support health services can provide after birth

12. Labour and birth • Labour and birth are obviously stressful and emotional • It is important to mothers that they feel • safe in professionals’ hands • informed • able to ask questions • Changes to birth plan need to be communicated clearly and simply • important that parents realise it’s a plan, not a blueprint • When the baby is born, families want • time and space to bond as a family • a starter course in parentcraft to build confidence (practical information about feeding, changing, etc) • reassurance that the baby is OK • information about aftercare for baby and mother

13. The growing child: 0–1 month • Many new mothers find the first few weeks isolating and frightening • They see the postnatal visit from midwife/health visitor as very important • Practical support for mums who are having difficulty breastfeeding • Especially for first-time mums/those who don’t have strong support networks • Mothers find the two-week development check valuable • Check on baby’s health • Check on mother’s health and answer her questions • Some fathers feel they miss out on this as paternity leave has ended – would welcome evening appointment/earlier visit • Mothers also welcome opportunities to get out and meet other new mums

14. Insecure and isolated: the challenges of the first months with a new baby

15. The growing child: 2–6 months • Parents welcome the support they get from health visitors in particular, but can feel unsupported when the visits stop. • Unsure where to turn – particularly about minor illnesses • Need more information about continuing sources of help and support, and how to use health services • Parents recognise the role of the PCHR (red book) in providing a schedule of appointments • Eight-week and three-month immunisation appointments provide contact with health services • Some parents felt that they didn’t have enough information about the immunisations • Few realised that these appointments were also an opportunity to ask questions not related to the immunisation itself

16. The growing child: 7–12 months • By this stage, parents tend to feel more in control • As their child becomes mobile, they begin to worry about safety in the home • Some confusion about who to contact with health issues/concerns • Whether their baby is meeting ‘normal’ development milestones • Drop-in clinics and children’s centres can help • One-year home visit is welcomed and considered to be well timed

17. The growing child: 1–5 years • Range of concerns for parents • Development, especially of speech and mobility • Nutrition • Choice of nursery/pre-school/school • Safety in the home • Little scheduled contact with health services • MMR jab • Two and half year review • Some parents feel they receive the two and half year review too late • Sometimes it doesn’t take place until the baby is 2.5 years old • Important to communicate this to parents

18. Involving partners and fathers • Fathers/partners can play an incredibly important role in the pregnancy/early years journey • Thefather and partner may be two different people • The more that health services can involve them, the better • Consider producing information for fathers • Help them understand their ‘role’ • Involve them in choices (with mother’s consent) • Actively acknowledge their worries and give them opportunities to discuss and resolve them

19. Supporting single mothers • Women who don’t have the support of a partner may need more support from health services • Some may feel vulnerable to being ‘judged’ by health services – and by others • Valuable support includes • signposting to sources of financial help, information on training, employment, childcare, etc • antenatal classes for single mums-to-be • inviting supporters such as parents/siblings to key milestone appointments • Particularly important to think about needs after birth – eg getting home from hospital

20. Supporting younger mothers • Often fear they will be judged and ‘looked down on’ • Vital that younger mothers feel supported by professionals – or risk of them becoming disengaged with health services • This includes support for their decision about whether to continue with pregnancy • Likely to have less knowledge of and confidence about pregnancy and parenthood • Antenatal classes for younger mothers • Signpost to sources of advice on money, benefits, education and employment

21. Parents in minority ethnic groups • Research touched on specific experiences of: • Women who do not speak English as their first language • Somali parents • Bangladeshi parents • Pakistani parents • Black Caribbean parents • Traveller parents • May provide some useful insights for planning maternity services to meet the needs of women in specific minority groups • May also provide useful insights into engaging with fathers from different cultural backgrounds

22. Further details • Download a PDF summary of the research findings at: • URL