Catherine and I went to a Starting Well Conference last week at the Royal College of Surgeons. It was a conference mainly about pre and post natal care and involved practitioners and service managers from across the UK.
It was an inspiring day so we summariased what we learnt to share with the team:
- Relationships and Trust
Not surprising, but there was a lot of chat amongst service providers on the value of trust over expertise. Mothers have cited that they want to develop a relationship with someone during pregnancy and beyond that is based on trust, respect, and empathy. They want a familiar face.
One midwife said: “It doesn’t actually register with mothers whether we are a good midwife or not, what registers is whether they trust you and believe that you will encourage and support them.”
Questions for us: Who do parents trust? Who else could be or is a positive consistent influence on a family’s life?
- “Hollow Choices”
Giving mothers a choice about where they give birth and how they access available services is a key priority for maternity and postnatal services. However they don’t measure this is any of their evaluation, and they acknowledge that it is often a ‘hollow promise’. Having a promise broken, and having a choice taken away can contribute to experiences of trauma during delivery and has an impact on levels of postnatal depression.
Questions for us: Where can a mother and parent take meaningful control over their pre and post natal experiences and the early period in their child life? What is the emotional journey of the period and where do interventions understand this journey?
During the day we noticed a few moments of tension between different service providers holding different principles and believes about the right and wrong things to do during and after pregnancy. It strikes me that conflicting advice, too much advice, and a myriad or websites and books are enough to build the anxiety of mothers and parents, affecting their relationship with parenthood and their relationships as a family.
Questions for us:
How do these levels of guilt and anxiety differ across cultures, communities and the socioeconomic spectrum? Does right and wrong matter?
There were roughly 120 people at the event, of which roughly 90% were female. Possibly not surprising, but it did expose some interesting issues as people talked about the hierarchical culture of midwifery and health visiting services, as well as the very sensitive relationship people had to their jobs. One Health Visitor Said: “Some midwives and health visitors find it hard to talk to women about diet and nutrition if they themselves are overweight, it feels hypercritical so they often don’t want to bring it up”. There was also little conversation about the role of fathers in maternity services and the role of the wider family.
Questions for us: What is the value of male influence and masculinity to pre and post-natal services? What do dad’s want? What are the future trends in parenting and male involvement
Due to the fact the conference was very ‘service-heavy’ there was a slight gap in conversation about independence, real choice, and enablement. It felt there was a danger of increasing dependency and disablement through the sheer volume of services and support available. It led us to thinking about the parallels between the way a child can be brought up: As independent and able to fall over and get up, or as dependant and never brave enough to fall over.
Questions for us: How did we manage before the invention of maternity services?What are the core components that families value and need during this time?