Sharing and modifying stories in neonatal peer support: an international mixed‐methods study

While shared personal experiences are a valued prerequisite of the peer supporter–service‐user relationship, they have the potential to create harm. There are challenges in peer supporters being emotionally ready to hear the experiences of others, and how much personal information peers should disclose. As part of an international study that aimed to explore how peer supporters who worked in a neonatal context (providing support to parents whose infant(s) has received neonatal care) were trained and supported, new insights emerged into how peers’ personal stories were used and modified to instil boundaries in peer support services. In this paper, we report on a secondary analysis of the data to describe how peer supporters’ stories were valued, used, assessed and moderated in neonatal peer support services; to safeguard and promote positive outcomes for peers and parents. Following University ethics approval, a mixed‐methods study comprising online surveys and follow‐up interviews was undertaken. Surveys were distributed through existing contacts and via social media. Thirty‐one managers/coordinators/trainers and 77 peer supporters completed the survey from 48 peer support services in 16 different countries, and 26 interviews were held with 27 survey respondents. Three themes describe variations in the types of stories that were preferred and when peers were perceived to be ‘ready’ to share them; the different means by which sharing personal accounts was encouraged and used to assess peer readiness; and the methods used to instil (and assess) boundaries in the stories the peers shared. In neonatal‐related peer support provision, the expected use of peer supporters’ stories resonates with the ‘use of self’ canon in social work practice. Peer supporters were expected to modify personal stories to ensure that service‐user (parents) needs were primary, the information was beneficial, and harm was minimised. Further work to build resilience and emotional intelligence in peer supporters is neede

International insights into peer support in a neonatal context: A mixed-methods study

Peer support is a widely used intervention that offers information and emotional support to parents during their infant’s admission to the neonatal unit and/or post-discharge. Despite its widespread use, there are no comprehensive insights into the nature and types of neonatal-related peer support, or the training and support offered to peer supporters. We aimed to bridge these knowledge gaps via an international study into neonatal peer support provision. A mixed-methods study comprising an online survey was issued to peer support services/organisations, and follow-up interviews held with a purposive sample of survey respondents. Survey/interview questions explored the funding, types of peer support and the recruitment, training and support for peer supporters. Descriptive and thematic analysis was undertaken. Thirty-one managers/coordinators/trainers and 77 peer supporters completed the survey from 48 peer support organisations/services in 16 different countries; with 26 interviews undertaken with 27 survey respondents. We integrated survey and interview findings into five themes: ‘background and infrastructure of peer support services', ‘timing, location and nature of peer support’, ‘recruitment and suitability of peer supporters’, ‘training provision’ and ‘professional and emotional support’. Findings highlight variations in the types of peer support provided, training and development opportunities, supervisory and mentoring arrangements and the methods of recruitment and support for peer supporters; with these differences largely related to the size, funding, multidisciplinary involvement, and level of integration of peer support within healthcare pathways and contexts. Despite challenges, promising strategies were reported across the different services to inform macro (e.g. to facilitate management and leadership support), meso (e.g. to help embed peer support in practice) and micro (e.g. to improve training, supervision and support of peer supporters) recommendations to underpin the operationalisation and delivery of PS provision

Building capacity and wellbeing in vulnerable/marginalised mothers: A qualitative study

The persistence of health inequalities in pregnancy and infancy amongst vulnerable/marginalised groups in the UK. During pregnancy and early motherhood some women experience severe and multiple psychosocial and economic disadvantages that negatively affect their wellbeing and make them at increased risk of poor maternal and infant health outcomes. To explore vulnerable/marginalised women's views and experiences of receiving targeted support from a specialist midwifery service and/or a charity. A mixed-methods study was undertaken that involved analysis of routinely collected birth-related/outcome data and interviews with a sample of vulnerable/marginalised women who had/had not received targeted support from a specialist midwifery service and/or a charity. In this paper we present in-depth insights from the 11 women who had received targeted support. Four key themes were identified; 'enabling needs-led care and support', 'empowering through knowledge, trust and acceptance', 'the value of a supportive presence' and 'developing capabilities, motivation and confidence'. Support provided by a specialist midwifery service and/or charity improved the maternity and parenting experiences of vulnerable/marginalised women. This was primarily achieved by developing a provider-woman relationship built on mutual trust and understanding and through which needs-led care and support was provided - leading to improved confidence, skills and capacities for positive parenting and health. The collaborative, multiagency, targeted intervention provides a useful model for further research and development. It offers a creative, salutogenic and health promoting approach to provide support for the most vulnerable/marginalised women as they make the journey into parenthood. [Abstract copyright: Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

In 2014, the EU funded a four-year European Cooperation in Science and Technology (COST) Action to address the topic of childbirth. The COST Birth Action was a cross-European network, that brought together over 120 scientists, practitioners, activists and policy makers from 34 countries to work on intrapartum care. The central aim was to advance the state of research and practice in a specific area of great clinical and social importance, intrapartum care. The Action used inter and trans-disciplinary approaches to address birth from multiple perspectives and drew on complexity theory and the concept of salutogenesis (wellbeing). This special collection presents six papers produced from the Action and gives a sense of the range and depth of the work conducted. The Collection illustrates the knowledge that can be generated when a diverse group of people come together with a similar goals and perspectives

Psychosocial Resilience and Risk in the Perinatal Period: Implications and Guidance for Professionals Asylum seekers & refugees: A cross European perspective

Bringing together experts in the field, this important book considers the underlying risk factors that create situations of psychosocial vulnerability and marginalisation for mothers, from their baby’s conception up to a year after birth. Adopting a strengths-based approach, the book looks not only at the incidence and impact of disadvantageous circumstances on women but also explores protective factors at an individual, family, community and service level. It identifies promising evidence-based interventions and sources of resilience. With a distinctive focus on social and cultural diversity, Psychosocial Resilience and Risk in the Perinatal Period considers a wide range of personal circumstances and social groups, including women’s experiences of traumatic birth, domestic and family violence, drug and alcohol use and mothering by indigenous, same-sex and disabled women. Throughout, case studies and service user experiences are used to illuminate the issues and illustrate exemplary care practice. International in scope, this book is particularly strong on the implications for care practices and health service delivery within Western models of maternity care. Its applied focus and evidence base makes it eminently suitable for study purposes and professional reference. Of relevance to midwives, health visitors, nurses and social workers, Psychosocial Resilience and Risk in the Perinatal Period’s final chapters focus on developing resilience amongst professionals and multiprofessional and interagency working. Psychosocial Resilience and Risk in the Perinatal Period: Implications and Guidance for Professionals

Caring to make a difference: vulnerable women

We report findings from a mixed-methods study to compare birth outcomes and experiences between vulnerable women who had/had not received targeted support from a specialist midwifery team and/or a third-sector organisation. Sociodemographic and birth-related/outcome data from a 12-month birth cohort were used to explore differences between a) vulnerable and non-vulnerable women; and b) vulnerable women who had and those who had not received targeted support. Seventeen women who had/had not received targeted support were interviewed. Vulnerable mothers were significantly more likely to be younger, from a minority ethnic group, access care later in pregnancy and have a baby born earlier and at a lower birth weight. A higher percentage of women who received targeted support had a spontaneous birth, a vaginal presentation at birth and were less likely to use anaesthesia during labour when compared with unsupported vulnerable women. Targeted support was associated with reassurance, increased parental confidence and wellbeing. Key practice and policy-based implications are considered

‘We make them feel special’: The experiences of voluntary sector workers supporting asylum seeking and refugee women during pregnancy and early motherhood

Background or context: refugee and asylum seekers are over represented in maternal death data. Many asylum seeking and refugee women access maternity care infrequently, or not at all. Little is known about the role of voluntary sector workers in supporting pregnant refugees and asylum seekers. Objective: to explore the experiences of voluntary sector workers supporting asylum seeking and refugee women during pregnancy and early motherhood. Design: a qualitative descriptive study. Setting and participants: individual and focus group interviews in three large urban centres in North West England, United Kingdom. Findings: two main themes emerged. 'Literally through hell and back' reflected the experiences of suffering, abuse and loss recounted to the volunteers by many of the women they work with. 'Bridging the unacknowledged gap' related to the invisible processes undertaken by the workers as they enable the women they work with to over come their marginalised position. This included the difficulties of transience, and lack of enculturation, and to support them in accessing maternity care. Conclusion: voluntary sector workers supporting asylum seeking and refugee women strongly identified with the extreme suffering experienced by many of the women they work with. Through this contact, they become acutely aware of the gaps in provision for such women, and developed unique and innovative approaches to bridge this gap. These findings highlight the need for maternity health system to actively collaborate with, and learn from, voluntary agencies working in this field to improve the support offered to asylum seeking and refugee women

Challenges to and facilitators of occupational epidemiology research in the UK

This study investigated the challenges and facilitators of occupational epidemiology (OE) research in the UK, and evaluated the impact of these challenges. Semi-structured in-depth interviews with leading UK-based OE researchers, and a survey of UK-based OE researchers were conducted. Seven leading researchers were interviewed, and there were 54 survey respondents. Key reported challenges for OE were diminishing resources during recent decades, influenced by social, economic and political drivers, and changing fashions in research policy. Consequently, the community is getting smaller and less influential. These challenges may have negatively affected OE research, causing it to fail to keep pace with recent methodological development and impacting its output of high-quality research. Better communication with, and support from other researchers and relevant policy and funding stakeholders was identified as the main facilitators to OE research. Many diseases were initially discovered in workplaces, as these make exceptionally good study populations to accurately assess exposures. Due to the decline of manufacturing industry, there is a perception that occupational diseases are now a thing of the past. Nevertheless, new occupational exposures remain under-evaluated and the UK has become reliant on overseas epidemiology. This has been exacerbated by the decline in the academic occupational medicine base. Maintaining UK-based OE research is hence necessary for the future development of occupational health services and policies for the UK workforce