Thursday, 14 February 2013

When post-natal support goes right

Having talked to so many mums about the support of health visitors I am constantly amazed at how different the approach is, probably dependent on locality, and the number of babies coming into the world.

I have written before how my health visitor, Charlotte, supported me and the reassurance she offered to me as a first time mum, and then as a mum to twins.
Since moving to South Wales it has become apparent how different the situation is.

There appears to be, in some places, an air of  "if you don't ask you don't get", which is fine if you know what the service is, and, in this case, also having an understanding of what motherhood means- which as a new mum can be an unknown. As a first time parent, and for me without a network of friends with babies, I was clueless. I didn't know whether to trust my instincts and I definitely didn't know what was right and wrong as a mother.

Two things worked in my favour.

Firstly, naivety. When breastfeeding wasn't working for me within the first week I phoned the Midwife Led Care Unit and twice was re-admitted. Still to this day I don't think this is usual practice, I recall loosely being told it was dependent on spare beds. It got me breastfeeding.

Secondly, Charlotte, I'll tell you why in a minute, but at six weeks whilst Charlotte didn't encourage my decision to stop breastfeeding, she understood my reasoning and supported the decision.

At six weeks my questionnaire for PND was on the side of PND, the same thing happened after I had the boys- at ten weeks the questionnaire was near enough the same.

My rationale, I am a highly anxious person where my children are concerned. And my anxieties tend to result in tears, crying, constant crying.
I go blinkered where my children's well being is concerned. I know I am not unlike any other parent in this regard.
But I think the difference is, to me, how different this is to your natural stance.

39 weeks pregnant

Why do I think the approach in Calderdale worked so well.
Because Charlotte visited me pre-children.
At 36 weeks pregnant Charlotte arranged to visit me at home.
I was still working, Charlotte was an inconvenience to my day.
I had only heard bad things about health visitors, so I probably had that influencing my behaviour.
I vocalised that I had no concerns, other than speech development.
My birth plan was a non-entity, I didn't know my pain threshold, so I wasn't against anything, I just wanted to see how things worked out.
Breastfeeding, why of course I'll give it a try, seeing no reason why not to, or why there would be any reason not to.
And this, I think, is the key difference to a lot of other post-natal support.
Charlotte made an assessment of me pre-motherhood.

Before the pressures of motherhood.
Before sleep deprivation.
Before a sense of failure.

Charlotte understood that I am a control freak.

And with hindsight,  a control freak becoming a mother should get alarm bells ringing.

When I hear of other parents who's health visitors don't take them seriously. Don't understand their concerns.
Of course, I understand, and appreciate, the pressures on the front line NHS.
But, it doesn't excuse parents getting a rough deal.
And that's not something to be addressed by the NHS, but by government.

I think it should be mandatory for health visitors to meet with parents-to-be before the birth of the child.
I think PND would be better diagnosed, and I also think the differences between stress, anxiety, sleep deprivation and PND would be better understood.

Charlotte increased her visits as I struggled with breastfeeding, and made sure she was there for feeds to witness the basis of my anxiety.
Charlotte provided me with papers and references to 'fussy babies'.
Because Charlotte had tried to pacify Squeaks where I couldn't and struggled.
Because Charlotte understood I need to read things rather than to 'be told'.
Charlotte supported my decision to formula feed, and witnessed the transformation of Squeaks and I.
And supported the ethos that a happy parent is a good parent.
As opposed to me crying most of the time.

Pregnant with twins

Charlotte came to see me before the boys were born.
And laughed with me, the competitiveness, having to have two this time, as what would be the point of doing the same over.

And Charlotte and I were amazed at how well I coped, at how much I had learned and changed.
And that I had given breastfeeding a go, but as old feelings came back, I had been confident in my own self to make the decision to formula feed.
Until Tiny's pyloric stenosis surfaced.
And whilst a different HV thought there were signs of PND, Charlotte understood that my anxiety had naturally increased, and of course, I was back in a situation I had no chance of controlling.

I cannot believe the difference the support of a great Health Visitor makes.

And I cannot believe how easily it goes wrong.
And how short term savings result in long term re-investment.
And more importantly, cost so many parents their valuable memories and moments never to be recaptured.

The NHS is such a valuable resource, the difference a great NHS makes, saving so much money in the longer term.
This wasn't meant to be a rant about the government.
And yet, those deciding the NHS budgets, should try and take a longer term outlook.

1 comment:

  1. So lovely to hear a good news story of the NHS making a real difference, I never felt the health visitors added much value for me, clearly they did here for you.


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