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Methods of working during pregnancy

Watch this video. Professor Jane Barlow describes interventions to support parents in the antenatal period.
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In this video, we examine some of the key methods of working at each of the different levels described in the earlier part of the course– universal, targeted, and indicated. So let’s start at the universal level. One of the most common universal methods of working involves media-based strategies. And we will see in the later section that some of the media-based methods of working that have been developed for the postnatal period include newsletters and websites. However, there’s currently no evidence about the effective media-based methods of working explicitly in the prenatal period. In the UK, another universal level intervention that we use are antenatal promotional interviews.
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These are provided by health visitors to all pregnant women with the aim of supporting a healthy pregnancy and promoting the developing relationship with the unborn baby. But they’re also used to screen for women who may need additional support, such as women who are experiencing anxiety or depression. The promotional interview consists of an hour-long semi-structured interview which is conducted at around 28 weeks of pregnancy and then again at around 6 to 8 weeks postnatal, both interviews being conducted by the same health visitor.
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Another method of working that’s been developed over the past 10 years in response to some of the evidence that we examined earlier in this course are preparation for parenthood programmes, which can be delivered either as part of universal or targeted approach. These programmes are provided to groups of parents. And they typically begin in pregnancy, and continue into the immediate postnatal period, and consist of a weekly two-hour session over the course of around 8 to 9 weeks. Examples of universal preparation for parenthood programmes include Triple P for Babies and programmes that have been developed by a range of voluntary organisations, including the National Childbirth Trust, Bumps&Babies Programme, the Solihull Approach Antenatal Parenting course.
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A small number of group-based preparation for parenthood programmes have been designed for use as part of a targeted approach. For example, Mellow Bumps is a 6-week group-based antenatal programme, delivered between 20 to 30 weeks gestation and designed to support families with additional health and social care needs. The programme is aimed at decreasing maternal antenatal stress levels, increasing the expectant mothers’ understanding of the newborn baby’s capacity for social interaction, and emphasises the importance of early interaction in enhancing brain development and attachment. Similarly, Baby Steps has been designed for use with vulnerable parents and consists of six group-based sessions spanning the perinatal period, complemented by two home visits. Baby Steps is provided by two specially trained practitioners.
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However, possibly one of the most popular methods of supporting women with additional needs are home visiting programmes. Many home visiting programmes are underpinned by Bronfenbrenner’s ecological theory, which emphasises the importance of the interrelationship between the individual and the wider systems within which they are located, such as, for example, the family, school, neighbourhood, society, and wider culture. The focus of such programmes is, therefore, on helping parents to develop strategies to prevent or address problems that can occur within each of these systems and includes, for example promoting healthy behaviours in pregnancy, supporting the mother’s relationship with the baby, and encouraging her to develop her education and delay subsequent pregnancies.
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Possibly one of the best examples of such a programme is the Nurse Family Partnership, which is provided by specially trained nurses to single teenage mothers beginning in pregnancy and continuing until the baby is 24 months of age.
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In terms of women who are experiencing problems such as domestic violence, substance dependency, or severe mental health problems, although there is limited evidence of effective methods of working in pregnancy with these groups of women, good practise should, of course, involves the midwife or another primary care practitioner, ensuring that this high-risk group of women have access to specialist practitioners, such as domestic abuse, substance use, or mental health workers. These practitioners will provide them with the necessary specialist support and ensure that, where appropriate, referrals are made to the relevant Child Protection Agencies, particularly where there’s domestic abuse or substance dependency. Watch the next video, which shows a Nurse Family Partnership home visitor and the mother who she visited.
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And then read the related article, which describes research that has followed up families who received this intervention until the children were 15 years of age. If you would like to know more about other methods of working in pregnancy that are supported by the evidence, you might like to read the additional article that we have provided. Also, please share with us your thoughts about these methods of working in the discussions.

In this video we examine some of the different methods of working in the antenatal period that are explicitly aimed at promoting the parent’s relationship with the unborn baby or addressing problems that might interfere with the development of that relationship indirectly (e.g. difficulty with reflective functioning) or that could affect the unborn baby directly (e.g. maternal stress).

We start by examining ‘universal’ methods of working (i.e. that are provided to all families) with the aim of promoting wellbeing including, for example, media-based interventions such as websites and apps, and professionally delivered interventions such as Promotional Interviews. We then examine some of the ‘targeted’ methods of working in the antenatal period such as, for example, preparation for parenthood programmes and home visiting programmes (both of which continue into the postnatal period). We conclude by describing some of the ‘indicated’ methods of working to support pregnant women who may be experiencing problems such as antenatal anxiety and/or depression, domestic violence and substance dependency.

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Babies in Mind: Why the Parent's Mind Matters

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