Guest blog: A day in the life of a perinatal programme practitioner
By Nikki Rhys-Jones on 24 April 2019 Maternal Mental health
Nikki Rhys-Jones is a specialist midwife who joined the NSPCC in 2012. Nikki has been delivering Baby Steps, a perinatal education programme, for five years and in that time she has run 69 groups in Swansea and Bridgend. She lives in Cardiff and is a wife and mother to three children and a dog.
My alarm goes off…
After a quick shower I grab some breakfast and check my work phone to see if I’ve had any messages or missed calls from the parents I’m due to see later today at a Baby Steps session. Parents are referred to Baby Steps by the community midwife and from the moment I receive the referral until the end of the programme after baby has been born, I try to keep in touch with the cohort of parents with regular check ins to keep them engaged in the programme. As soon as I’m ready I’m out of the door and into my car, heading for Swansea and the NSPCC service centre where I’m due to meet my Baby Steps co-delivery colleague who is a Children’s Services practitioner.
First things first…
Caffeine! I catch up with my Baby Steps colleague over a cup of tea to find out how she is. Since we started delivering Baby Steps together we’ve developed a great working relationship. There’s such a huge benefit to working alongside someone who brings a fresh set of eyes and new perspective to the work we do with new parents. I’m always learning from her and I couldn’t run the sessions without her.
Once we’ve gone over our plans for the session we set about packing the car. Today’s session will focus on mindfulness and we’ll be using changing baby’s nappy and bath time to help the expectant parents explore techniques for keeping calm and ‘tuning in’ to their baby’s needs. Mums and their partners are referred to Baby Steps for a number of reasons. It could be they’re feeling anxious because of a previous poor pregnancy or parenting experiences or they could be lacking a support network because they’ve just moved to the area. Baby Steps can help any new parents that just need a little extra support to prepare for the changes that come about during the antenatal period and with the birth of a child.
With the car jam packed with baby baths, changing mats, dolls, our laptops, handouts and anything else we need for the session, we set off for the local library. We run the session from a community room there – a central location with good transport links to make it easier for parents to attend.
Setting up for a session…
We like to make the room comfortable, warm and welcoming for the families. This means bringing along bean bags and v-pillows for the mum’s-to-be to use so they’re able to relax for the session. We like to be set up and ready to welcome the families. Sometimes those that have had issues or concerns during the week arrive early, or they might stay after the session for a more personal discussion. We start each session with a group check in where families can share how they have been since we last met. We hear how they have tried out activities we suggested in previous sessions, such as playing music to their baby or focussing and responding to baby’s kicks and movements. Everyone is invited to share their experiences, which helps the group dynamics. Following our first activity we have a break and gather together around a table to sit and have a drink and some snacks. The session today runs from 12.30-2.30pm, so we want to avoid rumbling tummies. Sharing food helps us to model a caring ethos and it helps our parents to think about the importance of planning their future routines with their babies and children sat eating together. It also encourages our group members to get to know each other better, promoting peer-to-peer support, which we know is really important.
During our initial home visit with parents prior to the group sessions, we always ask mum about her pregnancy cravings so we can bring some treats along with us. In this particular group we have one expectant mum who loves strawberries and another who loves crunching on ice cubes, so I’ve brought some along in a flask for her. I remember one mum who loved smelling new carpet. My co-facilitator’s partner worked as a carpet fitter so he would gather lots of samples for her to take along to the sessions!
We can help improve parental mental health…
By preparing expectant parents for the enormous change they will experience when their baby is born and equipping them with skills to help them manage. We focus on parenting as a whole, not just labour and delivery. As a midwife facilitating Baby Steps, I feel honoured to be able to be part of the whole journey with parents and work with them beyond the birth of their child.
So many parents tell us ‘Talk and Listen Time’ at the end of the session, where couples and birth partners engage in active listening, has helped them to overcome challenges together and strengthen their relationship. The NSPCC evaluated Baby Steps in 2015 and this showed that parents’ relationship satisfaction with their partners remained stable throughout the programme. We might expect to see a drop in relationship satisfaction normally because pregnancy and a new baby can have an impact on people’s relationships. For those who had the lowest levels of relationship satisfaction at the start of the programme their satisfaction improved. It’s amazing to see these results in person.
As well as helping to strengthen relationships, Baby Steps gives mums and dads an open and caring environment where they can feel comfortable to admit if they’re struggling with their mental health and know it’s not a sign of weakness. The evaluation showed us that both mums and dads who completed Baby Steps reported a decrease in anxiety from the start to the end of the programme. It also found that mums who completed Baby Steps reported lower rates of adverse birth outcomes such as premature birth, low birth weight and Caesarean section, compared with the general population of parents. How fantastic that Baby Steps can have that impact.
It always gives me goosebumps when…
I think about one mum’s birth experience in particular. We had worked really closely with mum and dad as mum had extreme anxiety around her pregnancy and wasn’t very well. A focus of our sessions was on mindful breathing to help with her anxiety. While she was in labour it was decided she would need an epidural and a caesarean section. As mum waited for the epidural to work its magic she became increasingly anxious and shared how she was feeling with her partner and the consultant. Her partner suggested using the mindful breathing techniques they’d learnt in Baby Steps. No sooner had he done so than the whole operating team were engaged in mindful breathing too!
After we’ve wrapped up the session…
I take a few minutes to reflect on the session with my Children’s Services colleague discussing our thoughts and anything we might need to pass on to the midwifery team or social care team to help support our parents. By working together, we really can provide more integrated care for expectant parents and make a positive difference to their pregnancy journeys.
After making notes on the session, I pack the car up and start heading home for the day. On the drive I think about some of the lovely moments from today’s session that I’m going to share at a training session I’m running next week for a team of midwives and family support workers from a neighbouring area. Delivering Baby Steps myself is fantastic, but supporting others outside the NSPCC to take on and deliver the service themselves is just as good. It means that across the country, more expectant parents will have the opportunity to benefit from the Baby Steps programme.
The NSPCC is supporting others to take on and deliver Baby Steps themselves. If you’d like to find out more about Baby Steps and how you could deliver it in your area, please contact babysteps@nspcc.org.uk or visit nspcc.org.uk/babysteps
Photography by TOM HULL. Children and adults pictured are models. Photo includes a real-life NSPCC practitioner, Nikki Rhys Jones.
Visit Maternal Mental Health Network, a network for health professionals working in perinatal mental health funded by the Department of Health, and implemented by the Royal College of Midwives.
Read the report on "Every mother must get the help they need".