Introducing NSPCC Baby Steps Antenatal Programme into SWFT By Caroline Baugh Baby Steps 1 Lead/Family Nurse
Why have a programme like Baby Steps? 42.4 A 2009 Department of Health review of antenatal education found: 31.9 22.4 it is highly medicalised there is limited focus on parenting availability is patchy vulnerable families do not attend Advantaged wards Disadvantaged wards Wards >30% 'Black' or 'Asian' % of mothers who attended antenatal classes by type of area 2
Aims and objectives The overall aim is to: to optimise health and wellbeing and promote protective factors The objectives are to: support parents with the emotional and physical transition to parenthood; nurture healthy relationships by encouraging listening and conflict resolution skills; encourage the development of sensitive, reflective parent-infant relationships from pregnancy; promote healthy child development within a network of supportive relationships.
Baby Steps Key themes
Structure of the programme An extra midwifery session after session 4
Our team in Warwickshire 2 Family Support Workers, 2 Nursery Nurses 1 Children Centre manager 5 Health Visitors Clinical Supervisor Baby Steps Lead Midwife (week 4) Groups are always co-delivered with a Health Visitor and Family SupportWorkerer Groups are currently running once a month in Nuneaton and Bedworth, however plans for expansion during 2018.
Referral criteria for Baby Steps
Reasons for referral within Warwickshire Referral Criteria Met Under 20 not accessing FNP 7% Care Leavers 22% Unemployed / Not in Education or Training 33% 2% Current and Previous History of Social Care Social Isolation 9% Family Crisis / Relationship Breakdown Other 2% 2% 16% 7% Anxiety / Drepression/ Mental Health Concern Special Educational Needs and Disabilities
Ages of clients who attend Baby Steps within Warwickshire 22% 33% 18-24 years of age 25-34 years of age 35-44 years of age 45% 9
Reasons for declining programme Declined Reasons 18% 9% 46% Working complications with pregnancy Transport issues Unable to contact Moved out of area 18% 9% 10
Attendance of Baby Steps within Warwickshire 16 Attendance v Referrals 14 12 10 8 6 No. Referrals No. Accepted Total Attendees 4 2 0 June Nuneaton May Bedworth March Nuneaton March Bedworth Feb Nuneaton 11
Ways of evaluating Baby Steps within Warwickshire Evaluation booklets filled in by participants wk1, wk 6 and wk 9 of course. Evaluation booklets focussed on emotional wellbeing as well as lifestyle choices. Ad hoc Post it note comments from clients during group. Client feedback questionnaire at end of programme. NSPCC recently introduced quarterly audit for all Baby Steps site.
Impact on emotional wellbeing HADS Depression Scoring 11% 89% Depression reduced over programme Depression increased over programme HADS Mental Health Scoring 33% 11% 56% Anxiety reduced over programme Anxiety maintained over programme Anxiety increased over programme
Health and Lifestyle findings Healthy Living - Alcohol Consumption 15% 8% 46% Never Rarely 31% Weekly Monthly Healthy Living - Weekly Exercise 23% 8% Never exercise 1-2 weekly 15% 54% 3-4 weekly 7 weekly 14
Some feedback from clients
A case study of a client within Warwickshire Client A attended programme. Unplanned pregnancy. Not with partner who lived abroad Highly anxious at the beginning of the programme. Scored highly in emotional wellbeing questionnaire. Discussed possible referral to Perinatal team, Spoke with Health Visitor. By end of week 6 client appeared a lot less anxious and back in relationship with babies father. He had moved to England, came to groups. Client A s emotional wellbeing score was notably lower by week 6 and breastfed, strong attachment, No indication of PND by end of programme. Client said she felt Baby Steps had helped her so much. I can answer quite honestly that in my pregnancy coming to Baby Steps has been one of the best choices I have made. The atmosphere is very relaxed, very easy going, not at all like the school environment nobody talks down to you! My confidence has soared since I started coming and I know for a fact I owe this all to Baby Steps and will be forever grateful for all the helpful hints and tips that I have been given that have helped me prepare to be the best parent I can be 16
Challenges on the way Time commitment for Facilitators delivering programme Capacity for midwifery and Children Centres. Difficulties with cross- agency working. Information governance and IT Being able to adhere strictly to licence requirements. Recruitment of families 17
Our success Lots of families in South Warwickshire have undertaken Baby Steps programme and evaluated really well. A central point for referral was introduced alongside a clear referral pathway, revised paperwork. A Baby Steps Lead was appointed within a secondment role in 2016 to lead Baby Steps. Increased referrals throughout 2017. Referrals reflecting criteria. Included as part of South Warwickshire tender and plans to expand programme.
THE FUTURE LOOKS EXCITING Expansion of Baby Steps across identified areas of need across South Warwickshire Train more staff be able to deliver Baby Steps programme. To further increase referrals and attendance. Further develop data collection methods to ensure Baby Steps can be continually evaluated. Continue to work closely with NSPCC to ensure we continue to follow licence requirements/ deliver a effective antenatal programme within Warwickshire. 19
EVALUATION REPORTS 20
Any questions? 21