Dealing with change as an expectant or new parent

Family Links is a national charity dedicated to empowering children, parents, families and schools to be emotionally healthy.  We were honoured to have them as Oak sponsors of our event in Manchester in October 2016. This is their third post for our blog series, and has been written for Growing Families by their Training Lead, Rowan Smith.

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Change, in its many guises, is inevitable and unavoidable. It happens all the time throughout our lives, whether it’s major or minor; positive or negative; planned or unexpected. However, parents going through pregnancy and looking after infants could be experiencing the most intensified period of change of their lives, and it’s important to be prepared and equipped with the right skills to cope with these changes.

The changes expectant and new parents can experience are varied and can happen on physical, emotional and social levels. The most obvious external change during pregnancy can be the mother’s bump, but pregnant women may also experience other changes that are less noticeable to other people, such as fatigue, sickness and raised body temperature, amongst others.

For both mothers and partners, emotional changes may occur during this time such as feeling stressed or anxious, feeling more maternal/paternal, and positive or negative feelings around body image. Social changes may also occur, such as possibly wanting to go out less frequently, which may be linked to some of the physical changes mothers can experience. Pregnant mothers may also notice an increase or decrease in their sex drive during different stages of pregnancy. These are just some examples of things that expectant parents may go through, and changes are likely to be different for every parent.

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Once the baby arrives there are also lots of other changes to consider. The way parents perceive themselves can alter as they as they have a new role as a mother or father, in addition to being a couple or a single person. There are also very practical considerations to be made around how extra jobs will be shared when the baby has arrived, in addition to pre-existing jobs around the household. A significant change for couples may be that as parents, two different sets of morals and codes of living are converging as you begin to raise a child together. It’s important for couples to discuss and agree how to bring up their child before the baby arrives, so that decisions aren’t being made when emotions are running high.

When it comes to preparing for these varied, significant and different changes, the most important thing is to plan and if you’re in a couple, to plan and communicate. Think about what might happen if a certain change does occur, and prepare for what you might do in that situation. For instance, an expectant mother might want to consider whether she’s going to breastfeed or not and what this might be like, while a couple might want to discuss the options around feeding; who will feed the baby when, and what are the practicalities of doing this? If expectant parents plan around how they might manage changes and different situations, it may be easier to refer back to what you decided together before the change occurred. This can be more helpful to parents and couples than making decisions in the heat of the moment, or when the baby is crying and you might be tired or stressed.

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For parents it can also be important to not underestimate that the little changes can be really hard. Infants change so quickly that it might feel like as soon as you’ve gotten to grips with the stage your baby is at, they’ve already moved onto the next stage. There may be a parallel between excitement for the new stage your baby has reached, but also a genuine need to mourn the stage they’ve left behind.

Practitioners working with new and expectant parents can offer support in preparing mothers and fathers for change. It’s often an issue of “you don’t know what you don’t know”, so for practitioners to open up the conversation can be very important, so parents can think about what is coming and how they might deal with it. For example, practitioners can pose hypothetical questions such as: “How are you going to manage getting the food shopping in when the baby arrives?” or: “How will you decide who soothes or feeds the baby when they wake in the night?” This allows expectant parents to discuss and think about dealing with different aspects of being parents that they might not have thought about otherwise.

Opening up conversations around these practical, emotional, social and physical changes that many parents experience can really help and support mothers and fathers in preparing for when their baby arrives. Practitioners can also offer guidance and ease worries by normalising the different changes that parents might encounter, so that when it does come they can look back to what they decided and discussed before, and know that other parents also experience the change that is happening to them.

By planning, discussing and making decisions about how to cope with different aspects of pregnancy and looking after a new baby, parents can be better prepared and more confident to deal with the changes that a new baby can bring.

 

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Rowan Smith
Training Lead
Family Links
November 2016

Your Human Rights in Childbirth

Thank you to everyone who joined us for our inaugural Growing Families event in Manchester on Thursday 6th October.  Whilst we reflect on the feedback and think about what happens next, we are delighted to continue with our blog series.  Our thanks to Rebecca Schiller of Birthrights for this piece on your human rights in childbirth.

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You may not feel like it at times but you are the same rational, adult human you were before you took the job of incubator for new life. The idea behind the human rights in childbirth movement is nothing more than that. Human rights principles and the legal framework that makes them powerful insist that you are treated with dignity and respect during pregnancy and birth and are never simply as the means to an end.

All public bodies and servants (like hospitals and the doctors and midwives who work in them) must ensure your human rights (as set out in the Human Rights Act 1998 and a series of national, regional and international agreements) are adhered to throughout your pregnancy and birth.

This is good news for you and your baby as there’s a strong relationship between safe, quality care and rights-respecting care. Care that puts you – the pregnant woman – at its heart is better for everyone.

Remember:

  • You have a right to receive safe maternity care that’s appropriate to your needs.
  • You have the right to privacy and confidentiality.
  • You have the right to equality and freedom from discrimination.
  • You have a right to bodily autonomy during pregnancy and birth. Whatever the situation, whatever the intervention you must be asked for your consent to any procedure and always have the right to say ‘no’.
  • Those caring for you must ensure they explain risks and benefits in a unbiased way that you can understand. They mustn’t only give you generic leaflets or one-sided information but must adapt their discussion to your circumstances and situation.
  • You should be given pain relief when you request it.
  • All reasonable efforts to ensure you can decide where and how you give birth should be made. There shouldn’t be blanket bans on certain women having certain kinds of births. Hospitals can have policies and criteria for birth centres and homebirths but women outside of these criteria should be enabled to access these birth setting if their requests can reasonably be accommodated.

You can find out more about your rights in pregnancy and birth at birthrights.org.uk.

Birthrights provides advice on lawful maternity care to families and healthcare professionals. We offer training on respectful care to midwives and doctors, conduct research into related issues and campaign to protect pregnant women using the human rights framework. You can support our work by hosting a #newchapter book club or becoming a monthly supporter.

Follow us on twitter @birthrightsorg and sign-up to our newsletter.

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Rebecca Schiller
October 2016

A day in the life of a human rights centred midwife

We are so proud to have Birthrights as one of our sponsors for “Growing Families: Facts Fiction and Other Stuff” in Manchester on Thursday 6th October.  Here their trustee, Simon Mehigan, writes for us about what makes a human rights centred midwife.  The image at the top of this piece is the “heart values” word cloud from the #MatExp campaign, put together by Growing Families team member Emma Jane Sasaru.

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Today started as many of my days do with me going straight into a meeting, no time to grab a drink or check my emails. The meeting was discussing how we improve services for women accessing early pregnancy and gynaecology. By redesigning our estate we can improve the journey for these women. How does that relate to their human rights? Well, ensuring women are cared for in an area that’s private and appropriately staffed with skilled nurses and medical staff means women that are suffering a miscarriage or early complications in pregnancy are appropriately cared for and supported. Midwives working in a hospital setting often don’t have any dealings with women below 20 weeks so its important that I make sure that the way in which these women are cared for compliments the midwifery care they receive and promotes the ethos of women centred care. If the care we give is based on the needs and wishes of individual women then we will be meeting their human rights.

Walking round the maternity unit I meet one of our new consultant midwives who talks to me about a women she has been caring for. This woman is very keen to have a vaginal birth but is being discouraged by some of the medical staff who have concerns about her risks. Midwives and obstetricians have an obligation to talk to women about any risk factors they may have. Unfortunately every Dr this woman has met has felt the need to reiterate this woman’s risks factors. As she clearly states “I know the risks, I’ve been told them, I’ve researched them, I just want the best chance to have a good birth experience”. The skill to being a woman centred midwife or doctor is to speak to women on an equal footing. To remove the power dynamic that is so often present in the relationship between health professionals and those they care for is one of the fundamental steps in building a trusting relationship. Trust is, I feel, one of the building blocks of a human rights based relationship with those we care for.

I meet a young woman who has recently given birth to her 1st child but is still here 6 days later. The baby has been under the care of the neonatologists. This intelligent woman has become a mother and has experienced first hand how the “just in case” approach and “Dr knows best” has led her to stay in hospital all this time. She’s a health professional and the work part of her has made her question the doctors, she doesn’t feel the treatment and the investigations her baby has had were necessary, but now she’s a mum and the very rational, logical, evidence based approach she uses every day at work has become clouded by the emotions that come with being a mother combined with all the changes taking place in her body following birth. We talk through how she feels, she comments on how the care she received was great until the baby was born and then it all “got out of control”. She has been told she can go home today so we agree that she will write to me, detailing her experiences as a mum and as a health professional. I can then use that to help me challenge some of the policies, procedures and behaviours that exist in the organisation that don’t support a culture of respecting the human rights of mothers and babies.

My afternoon is spent trying to support the managers in staffing the unit safely, rewriting a job advert for midwives focusing on attracting candidates that believe in women centred care and the role the midwife plays in facilitating choice and helping women and their families to have a positive birth experience. I then respond to a complaint from a woman who feels she wasn’t listened to when she was in pain, didn’t have her wishes respected or her beliefs.

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New book by Birthrights Chief Executive Rebecca Schiller

All of the above makes my day sound pretty depressing but actually it’s full of positive stuff. I see midwives and doctors supporting women, being kind, communicating well and appropriately. I see staff members supporting each other with guidance and tips on how to manage particular situations and I see many, many happy faces of women, their partners and their families who have recently met the latest arrival to their family.

I haven’t laid a hand on a pregnant woman’s abdomen, or caught a baby as its mother pushes it out or helped a new dad figure out how to put a nappy on his new child. That doesn’t make me any less of a midwife nor does it mean I’ve not been able to act in a way that promotes the human rights of childbearing women.

What makes a “human rights centred midwife”?

Kindness, compassion, consideration, respect, honesty and a fundamental belief in a woman’s right to choice.

You know what’s interesting? You could take out “human rights centred” because these are all the qualities that make a great midwife and having spent 22 years working in maternity services the overwhelming majority of midwives I have met have all those qualities. Unfortunately sometimes the services they work in, the culture of the organisation in which they are employed doesn’t support them in demonstrating all these qualities. Fear of litigation, of not following guidelines or of being labelled a “maverick” midwife by supporting choices women make that might not be the norm, make some midwives act towards women in a way that they don’t fell comfortable with. This makes some midwives move on, some leave the profession all together and some give in, become part of the culture.

My words of wisdom…..

Be brave, be strong…….be a midwife…..

 

Simon Mehigan – Birthrights Trustee
Deputy Director of Midwifery
Chelsea and Westminster Hospitals NHS Foundation Trust

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www.birthrights.org.uk