Lovett Okeke Specialist Health Promotion Health Visitor Practice Teacher
Project Proposal for Integrated Group Antenatal Parenting Preparation Class (Case for Antenatal Parenting)
Content: Brief introduction- Starting point Background/Rationale Driving forces Caution-1001 critical days Policy drivers The Project/Findings/Limitation of research/gap Implication for practice Conclusion
Introduction: My Starting Point Every child is entitled to the best possible start in life Through working with, and supporting families during the crucial early years of a child s life we as health professionals will contribute to making a lifelong impact
Background/Rationale This early year begins from antenatal stage. Pregnancy, birth and beyond (1001 critical days) are key times of changes and development for mum, dad and baby. Parents want the best for their babies and instinctively motivated to protect and keep them safe, particularly in pregnancy. While most parents do well, some may struggle to cope and adjust to their new role to provide their children with the care needed.
Driving Forces Transition to parenthood and the first 1001 days from conception to a child s second birth day has been identified as a very important period that will have an influence and impact on the rest of the life course. Evidence suggests that outcome for both children and adults are strongly influenced by factors that operate during pregnancy and the first years of life.
Driving Forces Contd Information on neurological development, recognition of the importance of bonding and attachment, and impact of stress all make early intervention and prevention imperative. Health messages on the need to quit smoking and alcohol during pregnancy as well as promoting uptake of immunisations and breastfeeding are key as new parents are particularly receptive to learning and making changes.
Caution: The 1001 critical days The 1001 critical days manifesto recognised that too many children do not have the start in life they need, leading to high cost for society. It warns that not intervening now will affect this generation of children and next.
Caution: The 1001 critical days contd Cautioned -without a focus on early intervention and prevention, the cost of managing these issues will continue to rise. It advised that all parents (including the vulnerable) should be able to access antenatal classes which address both physical and emotional aspects of parenthood and baby s wellbeing (infant mental health).
Policy (Healthy child programme, Public health framework, Leading changeadding value, Five year forward view) The transfer of the Healthy child programme to Local Authority commissioning has now placed public health improvement and protection at its fore front).
Public Health Framework Public Health is a system- wide and at scale. It is based on evidence, it is geared towards joint working and holistic approaches, fosters responsibility for leadership at all levels. Builds capacity by engaging with all workers who can contribute to public health outcomes. It is outcomes driven including reduction of health inequalities, embeds sustainable solutions. Supports and enables individuals and communities to have more influence over decisions that affect them and their health and wellbeing. Ensures provision is value for money and cost effective (Public health 2016).
The Five-year Forward View Policy Heralded new models of care and encouraged commissioners and providers to look to adopt new/ innovative ways of working to enable service transformation/ improvement sustainability. Implications: No duplication, No working in Silos, better integration and Complimentary roles
Policy Drivers-Health (Empowerment) Leading change Adding Value (NHS England Framework for nurses, midwives and care staff) Recognises that nursing, midwifery and care staff make a difference to health and wellbeing of people. Each staff has the potential to influence and lead improvement in health care, to contribute to managing challenges and shaping the future of healthcare
Health (Empowerment) As health professionals, we support LA in its public health role by helping people stay healthy, avoid ill health by prioritising children s & family health and development, including in areas of: giving children the best start to life, obesity in children (breastfeeding etc), prevention and early intervention (NHS England).
Study Aim/ Purpose/Method Project: To introduce Integrated Antenatal parent group preparation class to the health visiting service. Aim- better integration with midwives, IAPT and HV team, to deliver Integrated Antenatal group parenting class.
Purpose Adopting new ways of working, contribute varying skills, bring about improvements in client centred service delivery and reduce duplication. Having a group antenatal parenting preparation class will enable all expectant parents to have equitable, accessible client centred care, with focus on early intervention, prevention and transition to parenthood.
HV Service Provision Provide targeted Antenatal contacts to vulnerable expectant parents in their homes. Not universally provided to all new expectant parents, probably due to resources issues.
Research Method (Action Research) The method used for information gathering was by shadowing the IAPT and midwives through participant observation.
Findings My observation - antenatal parenting group by other professionals used discussion and information sharing. Encouraged expectant parents to think about caring for their emotional wellbeing during pregnancy and following birth. Discussions -common mental health problems that can occur during pregnancy and following delivery including anxiety, depression and stigma reduction.
Findings contd Self-help techniques were introduced to the group and available further support were highlighted to the group (IAPT, 09/2016). Focus on health in pregnancy, teaching on bathing baby, information on SIDS prevention, feeding baby and parents were given the opportunity to asks questions on issues they needed further information on (Midwives, 09/2017).
Limitation of Research It is worth mentioning that this finding is based on my observation of one session each (Due to limited time to complete the project) for the two services observed and other topics not mentioned here is discussed in the other sessions, so this finding may not represent the full discussions covered in those sessions. Further observation/research is necessary to capture the full range of discussion from the two services observed.
Gap Identified Mainly focused on new parents. Baby brain needs nurturing (development of baby) Coincides with a new mums account that she would have loved to have been informed of her blind spot. Life after pregnancy with baby.
Implication/Recommendation for Practice Participating in group antenatal preparation class, will enable health professionals to give every child the best possible start in life. Placing the role of parents at the heart of what we do: through activities, information sharing, discussion, practical support, and teaching, to facilitate and build on parent s skills and knowledge to nurture their baby s development including brain development. Offering discussion that reflects the needs of parents as well as their babies, and priorities for public health outcome.
Conclusion Expectant parents have to quickly adjust and learn the needs of their babies and how to care for them. The antenatal class will help these parents to understand and learn the developmental needs and skills involved in caring for their babies as well as helping mothers/dads with their emotional wellbeing/self-care.