Changing the world one baby at a time

Staring a difficult eight months of pregnancy in the face, not to mention the prospect of raising a baby when she was still technically going through her own childhood, the Wester Hailes girl risked falling into the life of chaos which has become common for so many others across the Lothians in her situation.

However, her pregnancy coincided with a scheme in Edinburgh which pledges to “change the world one baby at a time”, and now 18 months on from discovering the life-changing news, things are looking up for the teenager.

She is one of 148 new mothers in the city aged 19 and under who have been part of the intensive Family Nurse Partnership being trailed by NHS Lothian on behalf of the Scottish Government.

The idea is to take the practices of midwives and health visitors to a new level, providing additional support through the pregnancy and then for the first two years of the baby’s life.

Fathers of the babies are also assisted, from learning parenting techniques to being given help to find employment and a secure home.

It is this additional assistance that has made a difference to Amber and other mums in the initiative.

Since the programme was launched last year, all 148 families have found improved accommodation across Edinburgh, while the full-on, one-to-one support from a trained nurse has improved lifestyle habits and development opportunities for their babies.

Focus is also placed on bringing in other family members, like the new mother’s parents, in being part of the process.

Amber saw for herself the impact having a more personal approach made compared to what is usually on offer.

“The midwife does more clinical stuff and they probably aren’t as available to talk all the time,” she explains.

“I’m more able to talk about body changes and other things with the family nurse. She increased my confidence and gave me lots of great information about going through labour.

“I used to skip meals and didn’t realise that wasn’t the right thing to do. My family nurse helped me think about this and also helped me to stop smoking during pregnancy.”

Nurses are midway through the pilot, and Holyrood – particularly Health Secretary Nicola Sturgeon – is paying close attention to its progress, with a view to rolling it out across the country.

And the early statistics are looking good.

Of the mums who took part, more than half have kicked their smoking habit, and 78 per cent of them were persuaded by the team to give up drinking during their pregnancy.

That, along with nutrition and exercise messages, helped achieve a figure of 94 per cent enjoying a full-term pregnancy and safe birth.

Given the deprivation in which many of those participating live, it is impossible to imagine results anything like as encouraging as this had the Family Nurse Partnership not been in place.

The good news does not stop after birth either. Nearly half are breastfeeding their young, a figure not replicated even in Scotland’s most affluent areas.

That means the infants are given a far better start in life than they would normally be afforded.

But as Amber testifies, it is not just the babies who benefit, as the project is providing guidance and support rather than simply telling the teenagers what to do.

“It’s easy to get fed-up, but after each visit from the family nurse I feel inspired,” she says. “She’s helped bring back my confidence and made me more positive.

“Having meetings and getting lots of good information gives me confidence about feeding my baby – like I knew not to give the baby rice at three weeks old. I’ve stuck with breastfeeding too, as I now know about the benefits it can bring, despite the fact that it can be difficult at times.

“The family nurse supported me to be a mum and not just to allow my mum to take over, I make all the decisions. The praise and encouragement helps you to keep going with changes even when it’s hard. I think I am more confident about asking for help from other people like the GP or hospital.

“They provide good support and I would have been more worried about being a teenage mum had it not been for them, it’s taught me to be a good role model.”

Amber’s experience is shared by almost every mother involved in the project, which is being used under licence from a US academic.

Since its launch, only two of the 148 young mums have dropped out.

It is cheap too – costing £3000 per family, per year. Foster care – a fate which many of these babies could have been destined for had it not been for the project – costs the same amount for only six weeks.

It is now up to those heading the project to persuade health chiefs that this is a worthwhile investment.

“It’s about trying to change the world one baby at a time,” says Val Alexander, Family Nurse Partnership supervisor. “It also helps our teenage population. One social group is our teenage mums who can’t maximise their potential – and of course their babies then follow the same life course as their parents.

“Disadvantage very much begins in the womb – we know there is a link between parenting and child development. This is a solid investment, we are getting to the people who are most in need.

“I think this can change the cycle of poverty by changing the lives of mums who can allow their babies the best possible start in life.”

The project has to run its course – when every child turns two – before being properly evaluated, and that has caused some concern among health chiefs who fear newer teenage mothers who “missed the cut” are being disadvantaged.

It also fits well with NHS Lothian’s bid to reduce health inequalities, which are as stark in Edinburgh as anywhere.

By improving the prospect of young parents – who themselves have decades in front of them – the health board believes an expanded version of the project could potentially save millions of pounds in health and social care costs in the future.

amorris@edinburgh news.com

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