Category: Guest Contributor

An interview with our Guest Contributor, Ruth Lightbody

"Those facing inequalities, sometimes multiple inequalities, are often easy to ignore due to the complexity of their situation, the difficulty of forming a solution and a lack of understanding from governments, organisations and programmes."​

We were thrilled to catch up with our latest Guest Contributor, Ruth Lightbody, to discuss community engagement, democracy and the ethics of lived experience. 

Ruth is a Senior Lecturer in Politics at Glasgow Caledonian University. Ruth’s research interests are deliberative democracy and community engagement, and how they can be used to implement policy changes which tackle social inequalities. Ruth was awarded a Fellowship at the Scottish Parliament to develop an evaluation framework for measuring deliberative principles and practice within the Parliament. Her recent publications have focused on the role of experts and evidence giving in deliberative processes, and she is currently undertaking research on parent and baby groups, and their role in developing community resilience and wellbeing.

Please note, all views reflected are the individual’s own, and not representative of their employer. 

Ruth, Can you share with us how you became interested in your research areas of playgroups, community engagement & deliberative democracy, experts, and evidence giving?

In 2018 I had my first daughter and my second in 2021. This was a fairly challenging time for me following pregnancy related illness, distressing births and subsequent trouble with feeding and sleeping.  I became quite isolated due to experiencing high levels of anxiety and intrusive thoughts. I started attending playgroups and the women that attend and run them became my solace at this very difficult time.

Here was a safe place for parents to come together to share their experiences, combine their knowledge, lighten each other’s load with a sympathetic ear and cup of tea. I myself, found an increasing confidence in my ability to cope as a parent as we exchanged stories, reflected each other’s struggles, supported each other, while sharing in the joy of our beautiful children and all the laughter and frustration that comes with them!

The connection with my own work, which explores participation and deliberative theory, was compelling. I was excited to find these informal social supports in my own community and in doing so, recognise this invisible work being undertaken, mostly by women, which was going unnoticed by policy makers.

As a senior lecturer in Politics at Glasgow Caledonian University, you’ve made significant contributions to research. Could you highlight one of your most impactful research findings? 

In 2017 I conducted research looking at examples of community engagement and participatory processes in order to determine the inequalities in community engagement and how these might be overcome. Community engagement is when citizens and groups are actively involved in the future of their communities. I highlighted that groups which have been known in the past as ‘hard to reach’ are now more appropriately recognised as ‘easy to ignore’. 

Those facing inequalities, sometimes multiple inequalities, are often easy to ignore due to the complexity of their situation, the difficulty of forming a solution and a lack of understanding from governments, organisations and programmes. 

While this work was impactful, and the report went on to inform how many organisations and policy actors speak about inclusion and accessibility, the biggest impact for me was how these findings have come to underpin all my work since.

As someone involved in research on experts and evidence giving, what advice would you share with policymakers and practitioners in ensuring decision-making is evidence-based, especially in areas concerning child welfare and domestic abuse prevention?

Much of my research has surrounded deliberative democracy.

Deliberative democracy is a form of democracy that focuses on how decisions are made, through informed discussions and reasoned exchange of views. In deliberative democracy, participants are supported to become informed on important societal and political issues, and they are supported to discuss their ideas and perspectives in a setting which is inclusive and accessible.

Often the process will ask participants to reflect on how policies and laws affect them, how they can be improved, what the realities are for the everyday person and their families. For evidence-based policy making, it is vital that the voices and experiences of families affected by those policies are heard and that they are part of the conversation. Deliberative democracy facilitates this. A really important study recently undertaken by my colleagues Professor Nancy Lombard and Dr Katy Proctor is a key example of how survivors and families affected by domestic violence can inform important legislation. They heard from people about their experiences of the criminal justice system and this powerful video helps tell the women’s stories.

A key point to consider is how lived experience experts are supported while taking part in these processes. Providing testimonies, giving evidence, sharing experiences can be triggering, upsetting and exhausting. Their input must be valued and respected. Participation should, where appropriate, include a monetary recognition of the person’s labour. Further supports include signposting or directly providing counselling, mental health support or ensuring that the person taking part is not endangered in any way from participating.  This may include engaging people at community level, in a space which feels comfortable and safe for them.

Considering your research in playgroups, how do you see early childhood interventions contributing to the broader goals of promoting healthy family dynamics and preventing domestic abuse?

While my work can’t speak to interventions which prevent abuse, what I have found from researching playgroups is the warmth, companionship and solidarity their members feel from being part of the group. A big part of this is having somewhere safe to go – even if it is just for an hour, once a week – developing friendships and connections for them and their children, being able to turn to those social networks/friends when crisis hits in their private lives, and that stability for children to return to a familiar space every week which is engaging and non-threatening. Those taking part in our research had experience of crisis: fleeing war, family breakdowns, Covid lockdown, sleep deprivation, birth trauma, and they felt that playgroups had been a key part of surviving that period of their life.

Looking ahead, what are your hopes for future policy directions or initiatives aimed at supporting families, particularly in light of the challenges highlighted by your research?

The future of these groups is uncertain due to a decrease in volunteers. With the cost of living crisis, parents returning to work from parental leave earlier, often two parents working full time, and sole parent families, people are short on time. In the short-term, solutions would include more resources to support volunteers – training, incentives and community funding initiatives which will enhance their role and encourage volunteers to stay in their role for longer. But the decrease of volunteers is more fundamental than this.

Long term strategies are needed if governments wish to rely on a robust community sector and develop resilient communities including encouraging businesses and industries to seriously consider the wealth of research that shows flexible working, job shares and 4-day weeks are beneficial for the economy, productivity and wellbeing. Decisions being made at a local level and proper funding for communities would give volunteers more control and equip them to think long term.

Finally, it is worth considering the introduction of a Universal Basic Income, such as the participation income model, which could potentially support people to take on community and voluntary roles without it affecting benefits and instil a wider sense of wellbeing amongst the population.

Thank you for sharing, Ruth!

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk

 

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An interview with our Guest Contributor, Rachael Moss

"To implement a trauma informed approach, its adamant that we live and breathe the principles of safety, choice, trust, collaboration, and empowerment. Our interactions with the world are relational. We are naturally wired to connect with people and seek support from our environments and relationships. I think this is just as important professionally as it is personally."

We were thrilled to catch up with our latest Guest Contributor, Rachael Moss, to explore trauma-informed practice, psychological safety, and lessons in leadership.

Rachael Moss has a degree in Psychology and an MSc in Forensic Psychology. She has over 13 years experience working within community justice, restorative practice, in third sector and statutory services. She has occupied roles as a front-line practitioner, management, including policy and project management. Rachael has experience of working with survivors of trauma, specifically sexual and domestic abuse, and women involved in the justice system. She also has experience of coordinating peer led services and worked on consultations to ensure people with lived experience are represented in the development and evaluation of services. Rachael has a keen interest in the complimentary aspects of trauma informed practice, psychological safety and restorative practice to improve relationships and workplace well-being. You will hear Rachael talking about Glimmers to ensure people are more aware of stimuli and interactions throughout their day, that can bring moments of hope, joy and peace, and help to calm the nervous system. 

Please note, all views reflected are the individual’s own, and not representative of their employer. 

Rachael, within the context of your career, can you share specific strategies or interventions that have proven effective or any success stories that you are most proud of? 
 

One success story that always sticks in my mind is my participation in a service user involvement group. I co-facilitated a cooking class that aimed to build safe, social connection through learning how to cook simple recipes and eat together. This group was proved to be immensely popular and successful but had to be put on hold due to the pandemic. However, I was adamant to find a way of keeping this activity going. I transformed the cooking class to a remote version, which involved dropping off a food parcel and recipe. Our members would cook the recipe and send in photos to share via Twitter, and we found this maintained social connection at a time of significant isolation. Some members cooked with their families or dropped off food to their loved ones. The feedback was always positive and not only promoted connection, but also new skills. Post pandemic, the cooking class has remained in its remote form, allowing more people to attend by alleviating various barriers they would have faced attending the in-person classes (e.g. travel cost, geography, anxiety). I will always be proud of this project and remember the glimmers this brought to people’s days, including my own.

Conversely, can you share any challenges you’ve faced in your sector, and discuss how you overcame them? 

In my experience so far, one of the areas I feel needs improvement is addressing the largely ‘one size fits all’ approach to addressing well-being. Research informs us of some of the challenges with regards to 64% of managers reporting having to prioritise organisational needs over staff well-being. We know that the principles of trauma informed practices are just as relevant for staff members, as they are for people who come through services.

I personally think there is more work to be done in this area and base a lot of this on my individual experiences. For example, if we take a scenario of someone who hasn’t had their needs met in childhood and goes on to experience coercive control in an intimate relationship in adulthood, the workplace could be a daily trigger zone. This is because our workplace is relational, and organisations (in my experience) operate in a hierarchical structure that can often (involuntarily) mimic power dynamics experiences in abusive situations. This is why someone who has experienced coercive control can be triggered by interactions that are disempowering (e.g. repeatedly being ignored via emails, spoken over in meetings, and not being given credit for your work). Being more aware of our triggers and completing daily check-ins with ourselves can help to raise our awareness and begin to name and tame our triggers which is an essential step in a staff members recovery. This graphic raises awareness of some workplace triggers.

In your work promoting trauma-informed practice and psychological safety, how do you advocate for the inclusion of lived expertise in the development and implementation of interventions, policies, and training programs?

The involvement of lived expertise is crucial in the development and implementation of interventions, policies, and training. I think there is concern out there that we could re-traumatise people. This concern is valid and shouldn’t be ignored. However, in my experience so far, anyone I have ever worked with in this capacity has told me that the involvement has benefited them. We should not forget the importance of professional experience and the fact that many professionals will have their own lived experience and may choose not to disclose this. Professional and lived expertise should work in harmony and be underpinned by robust processes and effective and consistent support. For example, this could include effective planning, debriefing and the inclusion of safety and stabilisation plans.

“Trauma” as a term is everywhere these days, often colloquialised on social media. Is there one thing you wish everyone understood about trauma and its impacts? 

If I were to choose something I wished everyone understood about trauma and its impacts, it would be that trauma is a unique and individual. No two journeys are the same. I think we can focus a lot on what has happened to people, which is key, but we also need to be more aware of things that don’t happen to us, that should, which include our needs not being met. This is also trauma and I believe more awareness of this could help people develop a more rounded understanding of themselves. This can be hugely healing as it can help to alleviate deep feelings of confusion and shame. It can give people a ‘lightbulb’ moment and provide them with an opening to completing the necessary steps to be more attuned to their authentic selves.  This is what I write about in my recent blog – looks can be deceiving. I think a lot of people will have experienced trauma, but maybe don’t see it as that, or don’t feel like they can speak out. Trauma should never involve a hierarchy.

At The For Baby’s Sake Trust, we take a trauma-informed approach to breaking intergenerational cycles of domestic abuse; how do you integrate trauma-informed principles and practice into your working and personal life? 

To implement a trauma informed approach, its adamant that we live and breathe the principles of safety, choice, trust, collaboration, and empowerment. Our interactions with the world are relational. We are naturally wired to connect with people and seek support from our environments and relationships. I think this is just as important professionally as it is personally. I think we need to constantly evaluate everything we do against the principles of trauma informed practice. I have recently done this to make a substantial change in my life that has been of significant benefit to my life. I checked in with myself and asked:

  • Do I feel safe, physically, and psychologically in my environment and interactions?
  • Do I trust my current situation? Is it transparent? Are people my friends or foes?
  • Am I involved in a meaningful way? Do I have choices (where possible)?
  • Are my relationships and interactions safe? Do I have a voice and am I involved in making decisions?
  • Is my current situation one that plays to my strengths and offers me a safe place to thrive?

Doing a check-in against the principles can be one part of the jigsaw to helping you create safety and stability.

I am also an enthusiastic fan of Dr Dan Siegal’s Window of Tolerance model of emotional regulation. I have used this to gain a deeper understanding into how I can manage triggers, work towards being the best version of myself and maintaining a healthy balance in my nervous system.

Reflecting on your own professional journey, what are some of the most valuable lessons you’ve learned about leadership, resilience, and maintaining passion and purpose in the face of adversity?

  • Lesson 1 – Leadership

For me personally, the lessons I’ve learnt on leadership is that it requires safe, consistent, and effective support. It also requires continuous development and personal self-reflection. Leadership requires good boundaries and the ability to mitigate your own burnout. Lastly, leadership requires accountability – we need to keep our promises and apologise when mistakes are made.

  • Lesson 2 – Resilience

The most important lesson I have learned regarding resilience in the face of adversity is to never ever let the task of self-care fall of our to do list. The biggest lesson I have learned is boundary setting. Boundary setting is hard, especially when we have experienced trauma bonding and operate in the fawn defence response. However, you can practice boundary setting with the support of a safe and trusted person.

  • Lesson 3 – Passion and Purpose

With regards to maintaining passion and purpose in the face of adversity, the lessons I have learned are the importance of engaging in peer support, but this must be with safe, trusted people that bring glimmers to your life. Be as persistent as you can and know when it’s your time to walk away. Walking away is never a failure – this demonstrates incredible strength and courage.

Looking ahead in your career, what aspirations do you have for advancing trauma-informed practice? 

My aspirations to advancing trauma informed practice include my work as an associate trainer for Epione Training and Consultancy. I feel very blessed to be part of an organisation that educates and shares knowledge on trauma responsive practice.

In addition, I believe that there are many approaches that share similar or complimentary aspects to trauma informed practice. I personally believe that workplace wellbeing could be improved by implementing a unique blend of trauma informed practice, psychological safety, and restorative practice. I think these approaches have the potential to ensure people accountable, strengthen relational cultures, give people a voice and feel safe and empowered to thrive in their workplaces

Lastly, I will continue to talk about glimmers and identify as many as possible in my dairy interactions and encourage you to also try this!

Get acquainted with your glimmers!

Thank you for sharing, Rachael! 

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk

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An interview with our Guest Contributor, Laura Walton

"We have to see families being prioritised in government policies and projects, as we have so much evidence of the significant impact poor early childhood experiences can have on a baby and their continued life; which can impact not just their life but future generations."

We were thrilled to catch up with our latest Guest Contributor, Laura Walton, to take a deep dive into the current state of maternity care.

Laura Walton is a Midwife at the Princess Royal University Hospital (PRUH), and she won the Midwife of the Year Nursing Times award this year. Laura won the Midwife of the Year award in recognition of her work to support women and birthing people who have tokophobia, an extreme fear of childbirth, or are experiencing high anxiety about birth. To support women and birthing people, Laura set up the ‘Birth with Confidence’ classes. The classes have reduced anxiety for women and birthing people, and feedback from the classes has shown that fewer women and birthing people request a caesarean section, are more able to enjoy their pregnancy, and think positively about birth after attending the classes. The impact of these sessions has also influenced other NHS Trusts in South East London and from around the UK to run similar classes. Laura has also organised multidisciplinary-led sessions on mental illness in pregnancy with psychologists, psychiatrists, midwives and other healthcare professionals. Alongside this, Laura created and trained sexual trauma champions at King’s, who work together to improve care for those with lived experience of sexual trauma when accessing maternity care.

Please note, all views reflected are the individual’s own, and not representative of their employer. 

HUGE congratulations on receiving Midwife of the Year. What specific accomplishments or contributions do you believe led to this recognition?

Thank you so much! I was really blown away to be nominated let alone win and the other nominees were equally amazing. I work with so many incredible midwives that it felt a bit odd to be singled out but I was really thankful for the recognition. The project that was highlighted most in the nomination was my passion and development of trauma informed care within maternity and in particular the workshops I developed for first time mums struggling with significant birth anxiety.

As a midwife, what motivated you to advocate for the recognition and prioritisation of mental health support within the broader framework of maternity care?

Firstly, just the recognition that suicide is and has continued to be for many years; the leading cause of death in women having a baby from 6 weeks to 1 year postnatally. It’s a statistic that is unbearable to read every year the MBRRACE reports are published. Secondly, I feel so passionately about improving mental health care in maternity; mostly because of the women and birthing people I have the honour of caring for. Being able to see the impact that mental health conditions has on their experience of motherhood and attachment to their baby as well as how much their lives can be changed for the better when the appropriate support is offered; this encourages me to keep working hard and speaking out about the need for better perinatal mental health care.

In your experience, what are some of the most effective strategies or approaches for addressing the mental health needs of expectant parents within the healthcare system?

Continuity of midwifery care is something that has been significantly impacted by the severe midwifery workforce shortage across the country. Yet when it’s able to be provided to families there are numerous benefits for supporting mental health needs of parents. Where a woman is able to develop a trusting relationship with a known midwife/small team of midwives; she is more likely to feel able to be honest about how she’s feeling, to feel listened to and support is therefore more likely to be implemented earlier; which can help reduce the longevity of a mental illness. Sometimes this can also prevent the need for more intensive perinatal mental health support. Raising awareness is also something that can feel like a small thing but the more perinatal mental health is talked about; the less of a stigma it can become and this can reduce the shame that many families feel when they are suffering with a mental illness. When we are able to educate women and their families more on what to expect during pregnancy and the early postnatal journey from an emotional wellbeing point of view; this enables them to be able to feel reassured about what is normal as well as feel empowered to seek support where needed. One example of this is teaching more women and families about intrusive thoughts – they are extremely common to experience after having a baby but very rarely talked about and therefore this can be terrifying for parents when they do experience them. 

 

The For Baby’s Sake Trust focuses on holistic support for families. How do you integrate mental health support into your practice to align with this mission?

I’ve been so excited to read about the work that For Baby’s Sake is doing as holistic support is vital in order to get better outcomes for families and in particular the early life experiences of children. We know from recent MBRRACE reports that many women who died due to suicide in the perinatal period had experienced trauma either in childhood or adulthood. A high proportion of these women had been exposed to complex trauma such as domestic abuse and substance misuse and many of them had not received a mental health diagnosis. Whilst screening for history of trauma and domestic abuse during pregnancy is still so important; the learning from this report really highlighted the need to ensure trauma informed care is a part of every healthcare professionals practice and it has been and continues to be a passion of mine to see trauma informed approaches being offered to everyone accessing maternity care. Ensuring I am educated in trauma informed care and then sharing this knowledge with trauma champions within the maternity unit I work in has been my first step towards this.
 

How do you collaborate with other healthcare professionals, such as health visitors or social workers, to ensure comprehensive support for women during pregnancy and childbirth?

I am so thankful to work in an area where we have built a really positive working relationship with other supporting agencies outside of maternity such as Health Visiting and Social Care. We work closely by meeting on a monthly basis to discuss any families which might benefit from enhanced support and also I love when we get to meet with the families together as a team around them. It shows the mother and her family that we are all working together to advocate for the things she needs and gives her a voice and helps her to have more positive outcomes for both her and her baby. It also helps to avoid miscommunication and disjointed care which can be so distressing and frustrating for families.

 

From a policy perspective, what changes or improvements would you like to see implemented to better support women’s mental health during pregnancy and childbirth?

Thinking outside of just perinatal mental health care; we have to see an improvement in the social difficulties which so many families are facing; particularly with the cost of living crisis. Many women who come to see me and are suffering with mental health difficulties are also battling with poor/unstable housing, financial difficulties and social isolation. It can feel so helpless as a professional as I have no influence over these factors but see how much of the time; these are what are impacting on the mental wellbeing of a mother. Providing mental health support is an important element of care but if they are still left in a home that is unsafe or not suitable for their needs for example; it risks only having a very small impact. We have to see families being prioritised in government policies and projects as we have so much evidence of the significant impact poor early childhood experiences can have on a baby and their continued life; which can impact not just their life but future generations.
 

The For Baby’s Sake Trust emphasises the importance of early intervention and prevention in supporting families. How do you incorporate this preventative approach into your work with expectant mothers experiencing challenges?

I think as I have touched on above; access to information and dispelling myths around perinatal mental health difficulties is a very important starting point to preventing deterioration of mental health difficulties in families. If parents are able to feel empowered to know what mental illness is, where they can seek support if needed and an assurance that they will not be judged or left feeling like a bad parent; it can help to ensure mental health support is accessed at the earliest opportunity. Also working alongside supporting agencies and supporting families to access these is a vital element of early intervention. There are many needs families have that I might not be able to meet in my role as a mental health specialist midwife but there are many organisations that can. Having positive and close working relationships with third sector organisations in my area means I can support families to access peer support such as Befriending services, groups that improve social isolation or address perinatal needs such as Dad mentoring, creative journaling for mental health etc. These third sector organisations are vital for reducing social isolation and enabling parents to realise they are not alone in the difficulties they are facing and there is help available.

 

In your opinion, what are the most significant barriers or challenges that pregnant women face when accessing appropriate care, and how can these barriers be addressed at both the individual and systemic levels?

I think barriers in accessing holistic support for the many needs that families face in the perinatal period are a huge component as I’ve touched on. If we do not take a holistic view of women’s needs, we can be in danger of trying to only meet one need and expecting this to fix things when all of the barriers being faced impact on her mental and physical wellbeing. It’s why organisations such as For Baby’s Sake are so vital as whilst maternity professionals who usually lead on care in pregnancy are experts in maternity care; we need the expert organisations such as yourselves to support us to provide input and advice for the other elements of care that are vital to a woman’s holistic wellbeing. When talking about barriers; I also can’t not highlight the
disparities in care faced by women from non White backgrounds. We know that Black women for example are 4-5x more likely to die having a baby than White women and Asian women are nearly 2x more likely to die than White women. By working together and listening to organisations such as the amazing Five X More and The Motherhood group and I’m sure there are many more; I am hopeful we can work towards a future where all women receive the same care irrespective of any protected characteristics.
 

Looking ahead, what advancements or developments do you anticipate in the field of maternity care, particularly concerning mental health support?

It’s been exciting to see the development in the last year or so of Maternal mental health services which are focused on providing psychological support to families who have experienced the loss of a baby, experienced trauma related to the perinatal experience, Tokophobia and mothers who’ve had their baby removed through care proceedings. It’s been a very much needed source of support to families for so long and I’ve had the pleasure of seeing the enormous impact this psychological support has had on the families who have benefited from it. Many of these services are overwhelmed with referrals so there is still lots of work to be done but I’m excited to see how they develop over the coming months and years and the positive impact this will have on women and their families. I’ve also noticed the growing third sector organisations offering support for women and families in the perinatal period such as The Survivors trust who I’ve had the pleasure of working closely with on improving trauma care and birthing plans, Maternal OCD and Neurodivergent Birth just to name a few. These groups of women have for too long had their voices not heard and therefore the emergence of these incredible charities and organisations really supports our role in maternity to better individualise care and ensure women and birthing people have access to specific support that can address their individual needs and help them feel less alone.

 

How do you ensure that your practice remains up-to-date with the latest research and best practices in maternal mental health, and how do you envision incorporating future advancements into your work?

I follow as many organisations as I can on social media and am always really excited to read new research which can help change our practice and make things better. I’m also really privileged to have had the opportunity to both attend and present at conferences where networking with other professionals with the same passions can help me to grow and develop as a maternal mental health midwife. I have a close relationship with all the other mental health midwives that work in neighbouring trusts and we are always sharing new ideas and pieces of research we have found as well as my local perinatal mental health team who are amazing and constantly inspire me. Mostly though, I find any changes I support to make in practice come from feedback from the women and families I care for. I am constantly in awe of how women sacrifice their own needs in order to provide the best care to their babies despite the most challenging circumstances and it is their journeys and experiences that usually grow new ideas for better practice. One group of women I haven’t touched on much so far and would love to see improvements in care for are our population of young mothers. We know again from MBRRACE that their risk of suicide in the perinatal period is growing and yet those who are under 18 years old mostly do not have access to the amazing specialist care provided by perinatal mental health teams. I’d love to see this change as I have seen first hand the life changing differences these teams can offer and believe that being a younger mum shouldn’t be an exclusion to accessing this specialist support.

Reflecting on your journey to becoming Midwife of the Year, what advice would you offer to aspiring midwives? 

I think from all the things I have learnt throughout my career I would have 2 pieces of advice. Firstly, it can feel overwhelming sometimes when you feel really passionate about making positive change but face barriers related to difficulties within the NHS system and it can feel like you’re not making much of a difference. But you are, even when you might not see it. Women and their families remember their midwives for life and even if they don’t remember your name or what you looked like; they will remember how you made them feel. Finally; individualised care is so so important and the best way to provide this is to listen to the woman and her partner or family. We can quite often make the mistake of grouping women into their circumstances and assuming that for example; all women facing domestic abuse will have the same wants and needs for theirs and their babies life. But everyone is different and what works for one family might not work for another. Therefore if we as midwives can just take the time to listen and hear from the women themselves about what they need to help them thrive as mothers; it not only makes our job easier but ensures the care we are giving is meaningful and actually going to help make a difference. Being an advocate for a woman and ensuring her voice is heard is one of the most rewarding parts of my role!

 

Thank you for sharing, Laura! 

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk

 

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An interview with our Guest Contributor, Louise Hamer

"To advocate for children, it’s first important to acknowledge the unspoken divide that exists between children and adults as members of society."

We were thrilled to catch up with our latest Guest Contributor, Louise Hamer, to chat all things nursing, safeguarding and children’s rights. 

Louise is Deputy Designated Nurse for Safeguarding Children and Children in Care at Lancashire and South Cumbria ICB.  Louise first qualified as a paediatric nurse 20 years ago, specialising in CAMHS and Health Visiting before moving into specialist safeguarding roles in 2016.  Louise is passionate about the children’s rights agenda and developing a trauma informed approach to capturing the voice of the child within safeguarding practice.

Please note, all views reflected are the individual’s own, and not representative of their employer. 

Thank you so much for sharing your insights and journey with us today, Louise. Can you tell us more about your proudest moment working in Nursing and Safeguarding?

There’ve been so many moments in my career where I’ve felt proud to be a nurse, but a highlight has undoubtedly been meeting Mike, one of the founders of @Lads­_Like_Us.  Mike is one half of Lads Like Us and together with Danny they provide Trauma Informed training to multi-agency professionals all over the country.  In the training, Mike and Danny reflect on their lived experience to consider how childhood trauma impacts mental health, substance misuse issues, offending behaviour and parenting.

I attended their training in March 2023 and realised I’d supported Mike and his family when I was a Health Visitor in 2016.  I introduced myself to Mike and was surprised to learn he remembered me too.  Mike talked positively about the impact working with me had had on his life and how early help support when his baby was born, enabled him to access services that changed his perception of parenting and developed his confidence in being a Dad.

As a Nurse, particularly working in safeguarding it’s not always been easy to see the difference I’ve made.  Meeting Mike was such a humbling experience and validated my whole career.  The relationship I developed with Mike when I was a Health Visitor was an intervention in itself and really showed the power of compassion and human connection.  Mike and I have since spoken about our experience at the institute of Health Visiting’s national conference and been inundated with support from practitioners who felt inspired and motivated by our story.

As a children’s rights advocate, how do you integrate your principles into your work in the healthcare sector?

To advocate for children, it’s first important to acknowledge the unspoken divide that exists between children and adults as members of society.  Children are sometimes seen as ‘mini adults’ or ‘developing people’ with adults considered superior to children.  This divide creates an imbalance in power between adults and children and can impact on how the rights of children are acted upon in a range of settings including healthcare.  By anchoring my work to the Children’s Rights Agenda supported by the United Convention of Rights of the Child (UNCRC, 1989), I have a sound framework to support children’s advocacy.  By adopting a human rights based approach to safeguarding, I am able to promote a culture where children are valued, prioritised, seen and understood.  I challenge language that feels discriminatory towards children and question whether the same practice would be acceptable for adults.

The principals of the UNCRC (1989) are equally applicable to health, social care, police and education and provide an important reference point to my safeguarding practice since it involves working with partners across a range of settings.

What strategies do you employ to ensure that the voices and needs of vulnerable children are heard and addressed effectively within the healthcare system?

One of my favourite quotes is from Professor Dumbledore in Harry Potter who says, “a child’s voice, however honest and true is meaningless to those who have forgotten how to listen.” Through my different roles in CAMHS and Health Visiting, I’ve worked with children of all ages and developmental ability.  I understand that ‘voice’ is so much more than the spoken word and all children, even very young infants can communicate their needs to someone who knows how to listen. 

As adults it is our job to ‘tune in’ to children’s voice, to truly listen and consider all forms of communication, including behaviour and emotional health as a form of expression.  From a safeguarding perspective, this is particularly important when working with children who are especially vulnerable through a lack of voice.  For example, non verbal children including babies or children with S.E.N.D, children who speak English as a second language, children who are cared for in residential settings or children whose behaviour can present as challenging and interpreted as a sign of mental disorder rather than an expression of distress.

What advice would you give to someone looking to stay updated on the latest developments and best practices in safeguarding children and promoting their rights, particularly considering the evolving landscape of child protection and welfare?

There is so much transformation taking place across the safeguarding system at national and local level, it can be overwhelming at times and there is a danger of becoming a passive participant in the process.   It’s important to stay up to date with transformation outlined in legislation and statutory guidance such as The Domestic Abuse Act (2021), Working Together to Safeguard Children (2023) and then pause, and consider the impact on your role, your organisation and your local safeguarding partnership. The landscape is constantly evolving so it’s vital that we look ahead, anticipate challenge and build in ‘thinking time’ so we can embrace change and creatively adapt to new ways of working.

On a more practical level, there are newsletters that as a practitioner you can sign up to for example CASPAR from the NSPCC which means you receive regular practice updates through your inbox. The Child Safeguarding Practice Review Panel produces an annual report, sharing national learning from Child Safeguarding Practice Reviews (CSPRs) as well as annual publications on key topics such as ‘It Was Hard to Escape’ (2020), ‘Myth of Invisible Men’ (2021) and ‘Multi-agency Safeguarding and Domestic Abuse’ (2022).  There is also an NHS Futures virtual platform where health practitioners from across the country can share best practice and generate discussion on key topics.

Collaboration is often key in ensuring the holistic well-being of babies and children. Can you discuss a successful collaboration you’ve been part of between healthcare professionals, social services, and other stakeholders to support a child in need?

As a Health Visitor working in London, I was based in an integrated children’s centre.  The centre was in a housing estate and was a real community hub. There was a café on site and health professionals were based in the centre from Health Visiting, School Nursing, Midwifery and Speech and Language Therapy.  Health professionals worked alongside colleagues from the local authority including Family Support Teams, Citizens Advice and Housing.  There was a range of activities available throughout the week which developed relationships with the whole community and supported early help for vulnerable children and families in a space where they felt ‘at home’ and safe.  There was an early help panel in place where vulnerable families could be discussed on a weekly basis and referrals supported into children’s social care if statutory support was deemed necessary.  As multi-disciplinary teams we were able to predict vulnerability through a trauma informed lens and work proactively with services to safeguard children and families.

The For Baby’s Sake Trust emphasises the importance of early intervention and support for whole families. How do you incorporate this approach into your work, particularly in identifying and addressing potential risks to children’s well-being at an early stage?

For me the starting point in supporting families is acknowledging the transition to parenthood is difficult for everyone.  Becoming a parent is a stressful life event in the same way as a bereavement, moving house or getting divorced but is something framed as a time of joy and celebration. 

Becoming a parent can be emotionally overwhelming for a lot of people but something that isn’t given enough time for them to process. There is little space as a new parent to talk about those mixed emotions where someone might feel excited and hopeful at the same time as scared, anxious, frightened or alone.  It can be hard for parents to admit that their relationship is under strain, they’re experiencing financial difficulties, housing worries or have started looking back on their own childhood in a way that they’ve never done before. 

For some people who are already vulnerable, the transition to parenthood is even harder. As professionals, it’s important for us to build trusting relationships with ‘parents to be’ so they can talk honestly with us about their worries and fears for the future.  It’s possible to identify vulnerability associated with poor mental health, drug and alcohol use, domestic abuse for example, and put as much support in place as early as possible to prevent harm rather than respond to an incident once it’s occurred.

How do you prioritise self-care and manage the emotional demands of working with vulnerable children and families?

It’s been important for me to recognise that as a practitioner, I’m a human being first and foremost and working with children and families involves bringing my heart to work. There should be an emotional impact when working with vulnerable children and families.  Acknowledging that I’ve had a bad day or something has been distressing, doesn’t mean I’m a flawed practitioner- I don’t need to toughen up! 

What I do need is access to restorative, safeguarding supervision- a safe space to reflect on the impact of my safeguarding work.  Supervision is something I’ve always valued and prioritised. It’s given me the confidence over time to recognise sensitivity as my superpower rather than a weakness or area of development. I care about what I do and am proud of the passion I’m known for in safeguarding children and families.

I’ve learnt that my mental health doesn’t look after itself and that if I don’t look after myself then I can’t look after other people.  I run regularly and have a whole team of people who support me to ‘show up’ and be emotionally available for vulnerable children and families.

Thank you for sharing, Louise! 

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk

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An interview with our Guest Contributor, Leonie Boniface

"If you are passionate about making a difference to the lives and babies of children then you are so needed! Giving children the best start in life means a future generation of healthy adults."

We were thrilled to catch up with our latest Guest Contributor, Leonie Boniface, to get an insight into a day in the life of a health visitor, and to learn more about family centred practice. 
Leonie Boniface (RN, BSc Hons, PGDip) is a Health Visitor and Specialist Community Public Health Nurse. She’s part of the iHV Advisory Forum, and won iHV SCPHN Student Health Visitor of the year 2023. Leonie is deeply passionate about supporting the transition to parenthood and breastfeeding.
 

Please note, all views reflected are the individual’s own, and not representative of their employer. 


Leonie, congratulations on your recognition as the Institute of Health Visiting SCPHN of the Year 2023! Winning such a prestigious award must have been a significant milestone in your career. Can you walk us through some of the key moments or experiences that have shaped your journey as a health visitor and advocate for children’s voices?

Thank you very much, it was a privilege to win the award – I am still in shock eight months on!

I knew I wanted to be Health Visitor from being a student nurse in 2015, I have always been passionate about the care of young children and their families, there is so much evidence that tells us the Early Years are so important with regards to brain development, relationship formation and reducing inequalities in later life. I knew I wanted to try and improve the lives of children support their families on giving them the best start in life.

As a registered Adult Nurse, Health Visitor, and Community Nurse Prescriber, your career encompasses a wide range of experience and responsibilities. How do you balance these various roles to ensure holistic and effective care for the families you serve?

Even though as Health Visitors our focus is on the child, being an adult nurse by background has given me the skills and confidence in also supporting parents. Whilst I worked on A&E I often cared for victims of abuse, domestic violence and mental health so I felt this gave me an advantage to my health visiting practice as it was an area, I was familiar with. As a community nurse prescriber, this skill runs alongside our health visiting qualifications so if during a new birth visit for example, if we notice a baby has oral thrush or areas of eczema, we are able to prescribe treatment, this not only treats the condition early but also saves a trip to the GP.

Can you describe a typical day or week in your role as a health visitor, and the range of services you provide to families?

Every single day is different. An example of my working week could be:

  • On duty where I am based in the office, answering calls from parents and other professionals. Whilst on duty we follow up any police reports, liaise with social care and support parents who have recently taken their child to A&E.
  • A new birth visit where mum is struggling to breastfeed so we would spend some time observing a feed and complete a whole breast-feeding assessment.
    A six- eight-week visit, baby isn’t gaining as much weight as he should, so we put a feeding plan in place and book to reweigh the baby.
  • Attend safeguarding meeting for a family open to social care and needing extra support.
    Write up records from visits and meetings.
  • Run well baby clinic where parents bring their babies for weighing and general advice, could be around feeding, mental health, housing, skincare, or immunisations.
  • Visit an expectant mum who is nearing the end of her pregnancy and struggling with her mental health, complete work around attachment and bonding, healthy brain development and ensuring right support is in place. Liaising with perinatal mental health midwives and the GP.
  • Attend urgent strategy meeting for a child who’s been subject to harm, gather health information, liaise with professionals, and make a plan to safeguard the child.
  • Complete records, answer emails from GPs, social workers, and nurseries.
  • Run ‘introducing solid foods’ group for parents with baby’s coming up to 6 months, the session includes delivering the most up to date advice on weaning babies whilst answering parents’ concerns and questions.
  • Home visit to family who have just moved into the area, they don’t speak English, they have no clothes and no milk for the baby. We use telephone interpretation service to communicate and get in touch with local charities and food banks to try and source supplies for the family. Make necessary referrals to access the right support to try and close the poverty gap. We spend the afternoon collecting and delivering food and clothes to ensure the children are warm and fed.

Our caseload is normally over 300 children per health visitor, we manage the caseload individually ensuring all core contacts are up to date, any health needs that are outstanding are supported to be met, we support parents/ carers with their own mental health, abuse, housing, poverty etc, the list is exhaustive.

Family centred care is a cornerstone of your practice. Can you elaborate on how you integrate this approach into your interactions with families, and how it contributes to promoting the transition to parenthood?

The key to being a good health visitor is your ability to build a trusting relationship with the family and to really search for those health needs. I always ensure I let the family ‘lead’ the visit, I am a guest in their home and to provide effective transition to parenthood parents need to be able to open up and trust you with their feelings. There is a real stigma in the community that discussing mental health or domestic violence means an automatic referral to social care and their children will be taken from them but that is not true. If parents are able to be open and honest with you from the beginning that is when you can provide early intervention and prevent certain situations from escalating.

In your capacity as co-chair of iHV SCPHN networking meetings, what initiatives or discussions have you facilitated to support professional development and collaboration among health visitors and other healthcare professionals?

As part of my role with the iHV SCPHN network meetings we hold three virtual meetings per year on Zoom. All the student Health Visitors across the UK are invited to attend where we discuss certain topics from an academic point of view and placement. The most recent meeting discussed managing time effectively, independent visiting and what to do when a universal visit becomes a little more complex. We receive really good feedback from these meetings as students find it useful hearing from students who have recently finished the course.

The field of healthcare is ever evolving, with policies and guidelines constantly being updated. How do you stay abreast of these changes, and how do you ensure that your practice aligns with the latest evidence-based approaches?

Thankfully I am really passionate about my job, and I enjoy reading all about new policies, interventions and guidelines so whilst I appreciate not everybody enjoys this it is something I find time for in the evenings. Twitter / X is great for health professionals, there’s always someone sharing the newest guidance or a new development, I will often save it and go back to it.

In your role as a health visitor, you likely interact with various services and professionals beyond the healthcare sector. Can you discuss why collaboration with other services, such as social services, early childhood education, and charities like The For Baby’s Sake Trust, is essential in ensuring comprehensive support for families?

Working in partnership with other services is crucial as a Health Visitor. Each service and professional has a different background, knowledge base, experience and whilst we all have our own priorities whether it be health, education, housing etc we are all focused on the family. It’s essential to communicate and to really put the child and family at the centre of everything we do, in doing so enables us to give children the best start in life and supports parents to be happy, confident parents.

Drawing from your expertise, what are some key policy initiatives or changes that you believe could positively impact the health and well-being of families in our community, particularly in the context of early childhood development?

I would love breastfeeding rates to rise, breast milk is amazing for the health and development of your baby yet there is such a stigma when women breast/chest feed in public!
When I visit parents not many new mums understand the benefits of breastfeeding for both her and her baby. I would love for breastfeeding to be promoted wider such as on the TV, radio, billboards, in nurseries and health centres. Whilst formula milk is needed for those who chose to bottle feed or can’t breastfeed for other reasons, I believe we need to educate the public a lot more on the benefits of breastfeeding and even more so during a cost-of-living crisis. It’s a win win!

Reflecting on your journey as a health visitor, what advice would you give to aspiring healthcare professionals who are passionate about advocating for children’s voices and promoting family-centred care?

Being a health visitor is more than a job, it’s not a tick list, it’s not task orientated – it’s holistic, it’s listening, it’s being there at a time in need and really educating and supporting families. Being able to support children and families is a real privilege and it is the most rewarding yet challenging role. If you are passionate about making a difference to the lives and babies of children, then you are so needed! Giving children the best start in life means a future generation of healthy adults.

Thank you for sharing, Leonie! 

If you’d like to be involved in our Guest Contributor series, please email daisyobrien@forbabyssake.org.uk

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