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Where are we at with Postnatal Support in the UK?

Updated: Apr 16

Katherine Whitby | Registered Paediatric Nurse | Health Visitor | Baby Massage Instructor | Mummy of Two | Founder of Baby Steps


I rarely like to get into discussions that are potentially political or controversial as I just like to support my lovely families on their journeys as new parents, but I feel I need to start this conversation with you.

Katherine in her scrubs on an A&E shift, loving her job

I will have been in the NHS for 30 years next year (how did that happen?!) and I am so proud to be able to say that.  Despite every challenge it has to endure it continues to offer us an incredible Health Service.  All due to the people who dedicate themselves to it.  However it’s struggling.  It’s been struggling for a long time but what I’m seeing and hearing is, it’s like never before.  


While this is not a new conversation I am surprised it is not hitting the headlines more.


I am concerned especially since the pandemic, parents are not aware of what post-natal services used to be or ideally should look like. The lack of services is not being challenged or questioned enough.  Families are not getting the service they need. It will take a lot to improve them due to cuts, lack of funding, staff burnout and shortages.  We don’t wave a magic wand.  However it's so important parents feel they can share their experiences, feel supported (my door is always open), say how hard they are finding being a new parent and perhaps their care wasn’t as they hoped.


90% of new mothers said they felt lonely and 54% felt they had no friends

I started Baby Steps in 2006 due to significant strains on the NHS Health Visiting Services.  I was working in central London and could see the need for a relaxed, friendly service addressing common parental concerns.  That was 18 years ago!  



katherine whitby of baby-steps at her studio in Surrey


A generation ago, new parents and babies would have had weekly visits from the Health Visitor for 6 weeks.  When I qualified as a Health Visitor in 2004, this was no longer the case.  By then parents received just a New Birth Visit when the baby was 2 weeks old and were invited to attend a weekly Baby Clinic run by a Health Visitor like myself.  Weaning talks were full to the rafters with around 25 parents at each one, so no one could hear or had a chance to ask questions. 


In 2006, Baby Steps was born and I have been running it alongside NHS work ever since to give support, confidence, reassurance and peace of mind to ensure you feel relaxed and enjoy your baby.  


Fast forward nearly 2 decades, throw in a pandemic along the way and where are we? 


Many of us no longer have family locally, possibly even in the UK.  We are very much focused around the ‘Nuclear family’.  As a parent of two myself, the phrase ‘It takes a village to raise a child' makes me feel sad and lost at sea as nowadays where is the village?  No wonder so many of us struggle to juggle all we do, along with the expectations we feel from society and unrealistic images on social media creating negative pressures.  


The hormonal, emotional and physical changes women experience becoming a mother, known as Matrescence, are one of the biggest periods of transformation in a woman's life.  It has a monumental impact on her identity in society and her relationships. 


new mums struggling with lack of post-natal care

In a recent BBC report a new mother said “There's not much focus on you as a mum”.  In an article in the Guardian Rhiannon Lucy Cosslett found 90% of new mothers said they felt lonely and 54% felt they had no friends.  This can lead to postnatal depression which potentially affects her relationship with the baby and the baby’s development.  Many parents have support from postnatal groups and Whatsapp groups but this does not fill the gap of specialised professional support on your journey. 

   

My youngest child has just turned 12 and the service feels unrecognisable to 2012.  Back then I had visits from midwives in the first week as I was under their care for 28 days.  The Health Visitor came to visit between 10-14 days and I was invited to a weekly Baby Clinic. 


Shortages in midwives means the new norm is new parents no longer have home visits from a Midwife.  I hope some of you reading this did, but sadly the parents I meet usually haven’t.  This leaves new parents having to travel to clinics often post surgery or sutures, trying to establish feeding and perhaps not being able to drive.  At the very least they are navigating the early days of using a carseat, travelling with a newborn, what to bring, worrying the baby will need feeding, all while being exhausted.


mum, baby and midwife an important relationship

The BBC reports currently 1 in 5 Midwifery posts are unfilled.  The Royal College of Midwifery has advised Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system.  The College said a recent survey warns of a ‘midwife exodus’.  The results of its annual member experiences of work survey shows those midwives who either have left or were considering leaving, more than eight out of 10 were concerned about staffing levels and two-thirds were not satisfied with the quality of care they are currently able to deliver.


Now the majority of Health Visitors are having to concentrate their time on safeguarding issues and vulnerable families again due to cuts in funding and staff shortages.  If there is a Baby Clinic, it is no longer usually run by a Health Visitor but an Assistant.  Parents are usually diverted to a central ‘hub’ or advised by text.  


The Institute of Health Visiting’s (IHV) State of Health Visiting report highlights a national shortage of around 5,000 health visitors in England, with 79% of staff saying health visiting services lack capacity to offer a package of support to all children with identified needs.  The cost of living crisis has increased the rates of the use of foodbanks, perinatal mental health issues, domestic violence and homelessness, were also cited as key concerns by professionals.


upset mum and crying baby, support for new mums is lacking

These are families who have additional needs but what about support for every new parent?  80% of health visitors said that other services were also stretched.  82% of Health Visitors reported an increase in children with speech, language and communication delays while 7 in 10 health visitors said they had seen an increase in child behavioural problems.  With no baby clinics parents have less chance of building a relationship with their Health Visitor  to pick up these potential issues.


Generally there is less chance of continuity and a relationship with your GP, Health Visitor and Midwife. Since the pandemic we have seen yet another increase in parents attending A&E with their babies and children as they are unable to get GP appointments.  They may have been only offered a phone or online appointment.  This has resulted in occasions when I have seen babies who are very poorly coming into triage as they have not been seen face to face by a GP and become really unwell.  As well as an even busier department.  


Again GPs are experiencing massive staff shortages, burnout, lack of funding.  1 in 6 appointments for the GP have a 2 week wait. They are managing tens to hundreds of calls a day. I was asked for the first time by my GP if I could go privately as a 6 week referral is now 6 months.  Luckily it was non urgent for me so I will wait but for those who can’t? 


Parents naturally turn to the internet for advice but can be bombarded by an overwhelm of information, often conflicting and poorly sourced.  ‘Dr Google’ can induce massive anxiety!

I always advise parents in A&E or on my Baby & Child First Aid courses to trust their instinct.  Something which I really notice is being lost these days with apps and the overwhelm of info.



  

111 provides an incredible service which I recommend and have used as a parent myself but often you need to see a health professional face to face to be reassured.  


What have your experiences been?  I really hope you are reading this and are saying out loud ‘No, my experience was amazing’!  There is never any doubt about the wonderful service each individual health professional is endeavouring to provide.  I absolutely standby how truly incredible the NHS is and how lucky we are to have it.  Every shift I am beyond proud. I feel so grateful for all the care my family and I have received.  Recently my mum was diagnosed with Stage 4 lung and brain cancer and has had THE most amazing care.  


However I have noticed a huge shift in what services parents are able to access and how they are supported in my work with Baby-Steps and in the NHS.


I would love to hear about your experiences.  I hope you have received good care and love hearing positive stories but equally would love to support those who need it.


What support would really help you? How can we move forward with this to help you? Also get further advice and support at the Maternity Voices Partnership


I look forward to hearing from you,


Katherine x


 

If you'd love some support or know a new mum that could do with a helping hand please do reach out. I support my lovely families in a number of ways...

3 ways to work with Katherine Whitby at Baby-Steps


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