Pregnancy and the birth of a baby can be a magical time for parents, full of hope for a bright future as they bring their newborn home from hospital. But the experience of pregnancy and becoming a parent can also be an anxious and uncertain time- especially with a first child.
Every new parent experiences the huge responsibility of caring for a newborn that depends on them in every way. But for those parents who are struggling to cope, the addition of a vulnerable baby to the household can be overwhelming if help isn't available.
According to recent research from the Local Authority Research Consortium (LARC), parents with complex needs who are given informal help are able to manage better. That is why support from health visitors is so important and why the Government is increasing the number of health visitors to deliver the Healthy Child Programme. This aims to offer all parents support in the first months of their baby's life with increased help for those who need it. But are parents getting the support they need?
While there may be areas for improvement, it is important to recognise that our public health support for parents of newborn and young children remains the envy of much of the world. Still a universal service, which is free at the point of use, and one that is known, understood and largely valued by the majority of the population. But the experience of parents does differ considerably.
Anecdotally, many more affluent parents will report of a light touch from their health visitors with a widespread assumption that health visitors are prioritising those who need help most. But surprisingly, new research from 4Children and Bounty Parenting Club suggests this isn't the case. The survey, which is based on 1,345 mothers who are currently pregnant or have children aged under four years found that it was actually mothers from low income families who are more likely to see health visitors for a shorter time after the birth of their baby than more affluent mothers. The reasons behind this appear to be complex. Certainly professionals report that health visitor time is driven by specific needs such as babies born with a medical condition or mothers who are on the brink of crisis. More broadly we know that health does not discriminate by either income or class, and it may be that the more affluent are better at knowing where to seek help and articulating their need for support. Some lower-income families, including new migrants to the country, may also be less visible to those delivering services.
Mothers are also clear on how midwifery support can improved. In the same survey, two in five mothers said that they would have liked to have had a dedicated midwife throughout pregnancy and birth and over a quarter want more frequent, less rushed appointments. Seeing the same midwife throughout their pregnancy, rather than a different one at each antenatal appointment, can make a real difference to mothers. It is much easier to raise concerns with a midwife they have built up trust with than broach a difficult subject with one they have just met. This helps to spot and act on problems early. The most vulnerable mothers are in acute need of help from the start of pregnancy onwards and any delay in getting the support they need is likely to put them and their baby at risk.
This week (1 July) the Department of Health, alongside its partners, published six early years high impact areas documents aimed at helping local authorities commissioners of children's public health services. These highlight how universal services are essential for early identification of need and provision of support for families. There is already a move towards joined up working in many areas and this will increase as councils work with health and wellbeing boards. 4Children is recommending that midwives and health visitors take up wholesale residence in their local children's centres to ensure parents have co-ordinated help as they embark on their most important role.
Most parents will say raising a family is the toughest thing they've ever done emotionally, practically and economically but also their greatest achievement. It is never too early to help them make parenthood the most rewarding experience of their lives and give families in most need the best chance to flourish.
Anne Longfield OBE
Chief Executive, 4Children