Promoting and protecting the health and wellbeing of children from pregnancy

As a parents’ charity, NCT works to promote the wellbeing of babies and children, beginning in pregnancy by supporting women and their partners when they are expecting a baby and in early parenthood.

Last year NCT carried out a survey of women in England and Wales who had had a baby in 2014, 2015 or 2016. Our partner was the National Federation of Women’s Institutes/ Ffederasiwn Cenedlaethol Sefydliad y Merched.

The findings were published in January 2017 as a report entitled Support Overdue: Women’s experiences of maternity services 2017. It is available online at https://www.nct.org.uk/sites/default/files/related_documents/Support_Overdue_2017.pdf . We acknowledge that the women responding from Wales constituted a smaller proportion then those from England, but believe that the themes emerging from the data analysis reflect the views of childbearing women in both countries, although the health systems in which solutions are sought differ.

The subject of postnatal care, covering the period when a new mother is caring for her newborn baby and recovering from the birth, elicited more negative feedback than other areas. Women in hospital said they felt ‘abandoned’, ‘alone and in pain’. Among mothers at home with a new baby, over 18% were unable to see a midwife as much as they needed and, of these, 64% were experiencing problems with feeding their baby.

Delivering improved child health outcomes across Wales (for example prevention of obesity); Supporting effective child development and emotional and social well-being

The difficulties that women describe in obtaining help and advice around infant feeding, as above, reflect a situation of reducing support from professionals due to pressure on their time. In 2016, Vicky Richards, the Royal College of Midwives national officer for Wales, said ‘The highest breastfeeding rates were seen for babies of women resident in Powys Teaching Local Health Board (72%) and lowest for those in Cwm Taf University Local Health Board (50%). There is a clear need for more breastfeeding support, especially for young mothers and to tackle to geographical disparity … Breastfeeding lays the foundations for an individual’s future health and wellbeing. It brings great benefits for society as a whole in terms of reduced spending on ill health.’

NCT welcomes the changes to the collection of breastfeeding data in Wales via the Child Health Database https://www.unicef.org.uk/babyfriendly/what-is-baby-friendly/breastfeeding-in-the-uk/breastfeeding-in-wales/ and we are aware that information on breastfeeding at birth for Wales and its Health Boards is published annually using data from the National Community Child Health Database (NCCHD). It is recommended that these data are used to inform new objectives when the maternity strategy from 2011 is reviewed.

Ms Richards also emphasized that ‘Welsh maternity services [are] facing huge pressures. Wales has an ageing midwifery workforce with many midwives approaching retirement. It is imperative that the Welsh Government takes heed of these issues when planning for midwifery training places in the future’.

This summary of the challenging situation in the midwifery workforce is validated by the comments from women in Support Overdue who found that staffing shortages were severely affecting the quality of care they received. This was especially notable in the postnatal phase when mothers and fathers should be enabled to bond with their children and focus on their needs without stress, conflicting advice and having to make the decision to attend A&E with a newborn because a midwife is not available.

Reducing the adverse impact on the child of psychosocial issues such as poor parenting, disruptive family relationships and mental health issues

Following feedback from our members and other parents in Wales, we were aware of a lack of appropriate services for parents who are experiencing poor mental health either before or after the birth of their children. Unfortunately, mothers who have severe depression or psychosis are no longer able to receive care in a designated Mother & Baby Unit (MBU) since the facility in Cardiff was closed.

NCT organised an awareness-raising event at the Senedd – National Welsh Assembly/Cynulliad Cenedlaethol Cymru - in July 2016, to highlight the plight of mothers and fathers who are left with no support or treatment for their illness. Jenny Rathbone MP hosted the gathering where Vaughan Gething, Cabinet Secretary for Health, came to speak to the many affected parents attending https://www.nct.org.uk/press-release/nct-demands-better-mental-health-support-mothers-wales

Mr Gething listened to the arguments put forward but said that there was not sufficient need to justify restoring the MBU. However, with 34,000 women giving birth each year and a rate of the most severe mental illness at 0.1-0.2%, then 34-68 mothers and babies will need this type of in-patient care.

We urge that further consideration is given to mental health services dedicated to the needs of new parents who must care for a baby as well as themselves.

Summary

NCT is closely involved in the support of parents from pregnancy to early years across the UK. We are keen to work with members and staff at the National Assembly for Wales to help improve services for mothers, fathers and their young families. Please do contact us if we can assist or give further evidence at your Inquiries.