The Best Beginnings Midwives

1. The Best Beginnings Midwives Presented by, The Best Beginnings Team

2. Who are The Best Beginnings Midwives? • The Best Beginnings Midwives provide an intensive community based preventative approach to women ‘in need’ and their families in the Greenwich Borough, during antenatal, labour and postnatal period • The focus of the work is on reducing inequalities in health and child development

3. How did it all start? • It was reported that women recognised as vulnerable by the CEMACH Report were identified in 30% of most disadvantaged areas of the Borough. The levels of deprivation in these areas mean that many of these women have additional needs.

4. Drivers • The Department of Health • Every Child Matters • Maternity Matters • The National Service Framework • The Teenage Pregnancy Strategy

5. How it was done? • The team of 8 were seconded • Midwives were allocated to specific geographical locations in the Borough • Attached to the Sure Start Local Programmes/Children Centres Midwives tailor the care around individual women’s needs

6. Partners/Agencies Health Social Social Workers Police Women’s Trust Learning Difficulties Team Nursery Nurses Children Centres Housing Council Job Centre • Midwives • Health Visitors • Oxleas - Time Team • Prenatal Psychologist • Breastfeeding Advocates • GP’s • Surgeries • SCBU • Obstetricians/Doctors

7. What are the results? • Since July 2007 we have received over 1438 referrals. So far we have provided support for women who suffer from: • Mental health problems No: 658 • Domestic Violence No: 150 • Social Issues No: 105 • Learning Difficulties No: 40 • Asylum Seekers and Refugees No: 35 • Teenage Pregnancy No: 352 (under 17) • Other No: 98

8. Results • More mothers and babies are staying together • Less mothers are being admitted to the wards • Early discharge home • Less admission to the hospitals • Improvement in breastfeeding rates • Reduction in incident of behaviours associated with risk to infants at birth • Reduction on low birth weight babies • Increase awareness of the local Children Centres

9. What did women say? • ‘My Best Beginnings midwife is lovely and I’d like to say a big thank you for being referred to her……. Best Beginnings really works as I have not felt like I did with my first child (I had depression)’ • ‘My Best Beginnings midwife was brilliant. She made me feel confident, secure and prepared for the birth’ • ‘If it wasn’t for Best Beginnings support I don’t know what I would have done. Now I am happily caring for my baby’

10. The Best Beginnings Team received the 2009 Award for Inclusive service for disadvantage groups and communities Awarded by All Party Parliamentary Maternity Group

11. Recommendations • We have recently merged with two neighbouring hospitals to form South London Healthcare NHS Trust. We recommend that this service is provided throughout three Boroughs • Breaking down boundaries and improving communication between Boroughs • Also, if possible similar care to be offered to all pregnant mothers Best Beginnings Team

12. Real Case Study (Client A) • Pregnant mother 30-35 years old • Moved to our Borough from a different part of the U.K. • Two previous children removed from her care by Social Workers • Suffered domestic violence, severe depression and had a drinking problem • Was described by the Social Workers as can be volatile!

13. Case Study - Result • The Best Beginnings team involvement • Intensive antenatal and postnatal care • Close collaboration and involvement with other agencies: • Social Workers • Oxleas – Mental Health • GP • Health visitors • Children Centres • Women’s Trust

14. Happy National Midwife’s DayBecause of the Midwives like you Mothers like me keep their Babies (client A)