Parents’ views on the maternity

journey and early parenthood

What expectant and new parents have told us about
their experiences of maternity and early years care

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Gateway reference 15469

Introduction

The Department of Health commissioned three Home

pieces of qualitative research about the
experiences of expectant and new parents.
The research behind
The three projects explored how parents feel this publication
about the pregnancy and parenthood journeys,
their expectations of the health service and Pregnancy: an emotional
whether they feel those expectations are met. rollercoaster
This short interactive guide captures the main The right information,
findings in a concise and practical style for at the right time and in
healthcare professionals and commissioners of the right way
healthcare services.
Pregnancy:
The key finding is that parents don’t perceive
the health service as a service but as a set of > 0–12 weeks
prescribed interactions at key stages. They need > 13–28 weeks
to be encouraged to be more proactive in > 29–40 weeks
accessing the help available to them. > Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 The research behind
this publication
This publication is a synopsis of case, the journey through pregnancy) and asking Home
three pieces of research into them to plot emotional highs and lows based on
The research behind
parents’ experiences of maternity their own experiences. This allows the
interviewee to define the journey as they see it. this publication
and early years care. The pieces of
research are described briefly here. For this project, the journey was defined as Pregnancy: an emotional
being from the moment someone finds out they rollercoaster
are pregnant through to a month after birth –
The maternity customer the time during which expectant parents are The right information,
journey: from finding out accessing maternity services. at the right time and in
the right way
about a pregnancy to the Methodologies
first weeks of parenthood • Mini-group discussions of 4–5 people
Pregnancy:
June 2009 – The Futures Company > 0–12 weeks
• Face-to-face interviews with individuals
> 13–28 weeks
The Department of Health commissioned The • Paired interviews involving pregnant women > 29–40 weeks
Futures Company to conduct a qualitative research (or mothers who had recently given birth) > Labour and birth
study to find out about the current maternity and their partners
journey for pregnant women and their families. • Confessional scrapbooks (in which participants The growing child:
were asked to complete a series of structured > 0–1 months
The research used a methodology called tasks to produce a personal scrapbook which > 2–6 months
‘customer journey mapping’. This involves helped them to reflect on their journey). > 7–12 months
understanding the journey a person takes (in this
> 1–5 years
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The parents
The sample
The sample was designed to reflect a cross-
What researchers say –
section of ages, social groups and locations. It and what they mean
covered women at different stages of pregnancy Qualitative research explores people’s
and in their first and subsequent pregnancies. experiences, views and circumstances in depth,
It included both fathers and supportive partners
Home
and using their language. It does not measure,
who were not the child’s biological father. or ask ‘how many’. Sample sizes are small, to
Maternity staff (including both community and
The research behind
allow researchers to explore issues in detail
hospital-based midwives) and obstetricians were with individuals and with small groups. This this publication
also interviewed. means that it isn’t possible to extrapolate
population statistics from the data.
Pregnancy: an emotional
rollercoaster
Quantitative research uses a numbered
sample of people to draw statistical The right information,
conclusions. It focuses on measurements at the right time and in
and proportions rather than capturing
emotions or feelings.
the right way

Sample: the group of people whose opinions Pregnancy:

have been captured for a research project. > 0–12 weeks
Depth: a thorough interview. > 13–28 weeks
> 29–40 weeks
Paired depth: a thorough interview > Labour and birth
involving two people.

Triad: a discussion involving a group of three.

The growing child:
> 0–1 months
Mini-group: a discussion involving four or > 2–6 months
five people. > 7–12 months
Mainstream group: socioeconomic groups > 1–5 years
B, C1 and C2. BACK NEXT
The parents
Birth and Beyond: Methodologies
qualitative research • Depths and paired depth interviews

findings • Triads

May 2009 – Research Works Limited • Mini-groups.

Home
The Department of Health commissioned The sample
Research Works Limited to carry out qualitative The research behind
The project targeted people across a variety of
research to map what expectant and new
social groups and circumstances and covered
this publication
parents need from the health service. The aim
a range of geographical locations including
was to find out whether parents’ needs are Pregnancy: an emotional
southern England, the Midlands and northern
being addressed at every stage of pregnancy
England. rollercoaster
and early parenthood. If not, what are the gaps?
At what specific times do parents need more? Expectant parents were interviewed in groups The right information,
What has helped them feel in control of their lives, and individually in the mainstream group. There at the right time and in
supported, confident and able to exercise choice? was a range of ages and stages of pregnancy, the right way
with some women in their first pregnancies and
The research looked at expectant parents’
some in second or third pregnancies. Pregnancy:
preferences in terms of how information should
be delivered, what content it should cover, what > 0–12 weeks
A separate sample focused on less-advantaged
barriers there are to finding out more/earlier and > 13–28 weeks
social groups, including single mothers.
how much partners want to be involved. > 29–40 weeks
> Labour and birth
This sample included 10 individual depth
interviews with mothers (some single and some
The growing child:
with partners, at a range of pregnancy stages),
plus four with fathers with variable involvement > 0–1 months
in the pregnancy. > 2–6 months
> 7–12 months
> 1–5 years
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The parents
A third sample targeted a number of ethnic
minorities (including Pakistani, Somali and Black
Caribbean) and Travellers at a range of ages and
pregnancy stages and involved mini-groups with
expectant mothers and fathers (separately).
Healthy Child Programme:
qualitative research
findings
The sample
The research sample covered a wide
geographical area from London to Manchester.
There were four mainstream parent groups,
including first- and second-time mothers and
first-time fathers, all with varying age ranges
Home
and with children of different ages. A separate
sample consisted of parents of children with
The research behind
this publication
physical disabilities and learning impairments.

May 2009 – Research Works Limited A separate sample looking at people from Pregnancy: an emotional
disadvantaged social groups included young rollercoaster
The Department of Health commissioned mothers (who were interviewed individually and
Research Works Limited to carry out qualitative also took part in group sessions) and young The right information,
research to map what parents need from the fathers with variable involvement in the bringing at the right time and in
health service at various stages from their child’s up of their children. Further samples consisted of
birth to age five. The research was designed to
the right way
groups of single mothers and single fathers.
establish parents’ key needs for information,
Pregnancy:
guidance and support, together with what they Another sample focused on ethnic minority
see as their child’s key age milestones. backgrounds, with group sessions including > 0–12 weeks
mothers and fathers from Bangladeshi, Black > 13–28 weeks
> 29–40 weeks
Methodologies Caribbean, Pakistani and Somali cultures.
> Labour and birth
•• Depths
•• Paired depths The growing child:
•• Triads > 0–1 months
> 2–6 months
•• Mini-groups.
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 Pregnancy: an emotional
rollercoaster
The pregnancy journey is described Home
by many women as an emotional
Did you know?
•• Young parents appreciate support to make The research behind
rollercoaster. Women commonly
decisions about whether to progress with the this publication
describe feeling more emotional pregnancy.
than at any other time of life – •• First-time parents are likely to need more Pregnancy: an emotional
their feelings may include support from the health service than parents rollercoaster
excitement, anxiety, nervousness, in a subsequent pregnancy.
happiness, fear, vulnerability, The right information,
•• High-income parents may lack informal
depression and moodiness. support networks. at the right time and in
•• Teenage parents often feel ’judged’.
the right way

The best way health professionals can build a •• Young mothers often want to carry on Pregnancy:
trusted bond with pregnant women and their working or studying.
> 0–12 weeks
partners is by understanding and empathising ••athers may not feel their relationship with > 13–28 weeks
with the journey they are on. This means the baby starts until it is six months old. > 29–40 weeks
understanding that everyone is different, that •• Strong informal support networks can > Labour and birth
women experience different emotions at become a barrier preventing ethnic minority
different stages of their pregnancy and that parents from accessing services. The growing child:
their emotions may differ from their partner’s
In short, women and their partners want midwives > 0–1 months
and from those of other women at the same
and health visitors to share and support the > 2–6 months
stage of pregnancy.
emotional highs and lows of their pregnancy journey. > 7–12 months
> 1–5 years
BACK NEXT
The parents
If midwives and health visitors do this, expectant
parents are more likely to trust them and follow
their advice.
The need for empathy
Women who are more emotionally vulnerable
are most likely to look for support. They may
feel particularly emotionally vulnerable because:
•• it is their first pregnancy
•• they have had a previous bad experience
of pregnancy or birth
•• they have had a previous bad experience
of the health service
•• it is an unexpected or unwanted pregnancy
•• they have had previous miscarriages or
difficulty conceiving
•• they lack a support network (for example
single mothers and those without close
family nearby)
•• they have been exposed to negative
experiences (for example friends and family
recounting their ‘birth horror stories’).
Fathers and partners may also need support and
understanding of how they are feeling. Fathers’
feelings may range from confusion and denial
to excitement or anxiety over practical issues.
They may focus on specific aspects of
parenthood such as how it will affect their
relationship with the baby’s mother or how they
will provide financially. They may look for ways
to be more involved and may benefit from
information tailored to their needs.
Home
It can help if healthcare professionals are able to
The research behind
allot some time that’s specifically for the father’s
needs, whether this is achieved by seeing the this publication
father alone at a separate appointment, directing
him to other sources of information and support
Pregnancy: an emotional
or simply asking how he is feeling. rollercoaster
The right information,
Continuity of care at the right time and in
Strong, communicative relationships with
the right way
healthcare professionals are key to ensuring
expectant parents feel satisfied, well informed Pregnancy:
and supported in making decisions. Continuity
> 0–12 weeks
of care involving one midwife or a small team of
> 13–28 weeks
professionals is the most likely type of care to
> 29–40 weeks
achieve this.
> Labour and birth
Research shows that healthcare professionals also
value continuity of care, feeling it gives more The growing child:
efficient use of resources, a more rewarding > 0–1 months
professional role and a more supported > 2–6 months
experience for women and their partners. > 7–12 months
> 1–5 years
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The parents
 It’s important for health professionals to support
Pinned up on the fridge? expectant parents in making choices they are
comfortable with, and explain clearly what the
While one carer is ideal, most pregnant
issues are and the implications of the choices
women are realistic and acknowledge this is
being made. Many parents need extra
unlikely to be possible. With a small team of
information to help them make decisions and
professionals, they feel confident one will be Home
may look to health professionals for guidance
available on the day of the birth. Giving
on how to evaluate this information and come
them a list including names, pictures, job The research behind
to a decision.
descriptions and contact details (including at this publication
least one out of hours) to pin on the fridge
Pregnancy: an emotional
can help parents feel reassured.
The right words
rollercoaster
Words such as ‘choice’ and ‘planning/deciding’
come loaded with expectation and should be The right information,
Helping parents used carefully. Sometimes a medical decision
at the right time and in
understand their choices cannot be made on the basis of choice and if
the right way
expectant parents don’t realise this, it can lead
Some pregnant women expect to have choice
to great disappointment and resentment – for
and control over aspects of their pregnancy – for
example if their ‘birth plan’ cannot be followed
Pregnancy:
example which diagnostic tests to have, where > 0–12 weeks
to the letter.
they want to give birth. Others – particularly > 13–28 weeks
younger women, those with less education, first- > 29–40 weeks
time parents and those who don’t speak English > Labour and birth
as their first language – often want to be guided
by healthcare professionals and can be The growing child:
intimidated by choice.
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Marking milestones Summary
Appointments and scans are significant •• Empathy is a key tool for midwives, doctors
milestones along the pregnancy journey for and health visitors.
women and their partners. For example the •• Expectant parents value continuity of care.
‘anomaly scan’ is often seen more as an
opportunity to ‘meet my baby’ than as a clinical
•• Different people feel differently about choice. Home
check. Expectant parents are often excited and •• Expectant parents like to know their
nervous about each appointment, and when healthcare team – which is why the ‘fridge The research behind
health service providers recognise and respond list’ of team members’ names and job titles this publication
to their emotions, they feel supported and can be an asset.
positive. This is therefore an important •• Milestones such as scans are important to
Pregnancy: an emotional
opportunity for a positive engagement with the expectant parents. rollercoaster
health service, especially given the fact that this
may be people’s first interaction with a hospital. The right information,
at the right time and in
the right way
Pregnancy:
> 0–12 weeks
> 13–28 weeks
> 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 The right information, at the right
time and in the right way
Pregnancy and early parenthood is •• labour and delivery Home
an unprecedented time for learning. •• life choices – whether to continue in their The research behind
Many expectant parents feel studies or career, what to tell their employer
this publication
overwhelmed by the amount they •• practical, non-health issues such as housing
need to know and the speed at and benefits Pregnancy: an emotional
which they feel they need to learn. •• becoming a parent – practical advice on rollercoaster
The NHS is seen as a trusted brand feeding, bathing and nappy changing
and where there is conflicting advice •• specific information for partners/fathers. The right information,
on pregnancy and early parenting, it at the right time and in
Most expectant parents believe that the health the right way
is likely to be trusted most. The right service has a critical role to play in informing
information, given at the right time them. If they feel they know where to go for Pregnancy:
and in the right way, can empower trustworthy information, they are more likely to
> 0–12 weeks
pregnant women. feel supported and confident.
> 13–28 weeks
> 29–40 weeks
> Labour and birth
Pregnant women may be interested in
information on any or all of the following: The growing child:
•• changes to their body and the baby’s growth
> 0–1 months
•• screenings and scans > 2–6 months
•• proactive health choices such as giving up > 7–12 months
smoking and healthy eating > 1–5 years
BACK NEXT
The parents
Why information It’s all in the timing
sometimes doesn’t get It’s important that advice is given at the right
stage of pregnancy. Pregnant women can feel
through bombarded if information is given ‘all in one go’
•• Physical, mental and emotional state – many or at illogical moments – for example if the pros
women are too tired or too unwell to take in and cons of breastfeeding are discussed at the
Home
or remember important information, first appointment. At other times, women can
particularly if it is delivered only verbally. feel that they don’t have enough information.
The research behind
•• Low confidence and fear of being judged – this publication
some women, especially first-time mothers, It’s a good idea to break down information into
are worried about being seen to be a good manageable chunks but also to provide a Pregnancy: an emotional
parent and therefore afraid to ask questions. roadmap for pregnancy telling expectant parents rollercoaster
This is particularly the case with younger what information will be given at what stage
women. and what they need to think about when. The right information,
•• Understanding – women whose first language
at the right time and in
isn’t English may not be able to take in large Different ways of learning the right way
quantities of information, especially in People differ in how they want or need to
medical and specialist language. They may receive information. It’s important to give
Pregnancy:
also rely on other people to translate and expectant parents opportunities to learn in > 0–12 weeks
interpret, and information may be lost or different ways that suit them, including reading, > 13–28 weeks
distorted. Also, women with low literacy may listening/watching, sharing stories, one-to-one > 29–40 weeks
find printed information difficult to face-to-face meetings, antenatal classes and > Labour and birth
understand, but not want to admit it. hospital tours.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
It’s also important to understand the role of non-
NHS information, including websites, magazines
and books, and word of mouth.
Printed information
Some women are comfortable with printed
information and like the reassurance of having a
printed source to refer to when they find it
difficult to take in and remember what they’re
told verbally; others find printed information
intimidating. Some don’t receive relevant printed
information because it is out of stock or isn’t
offered and some feel they have to prompt to be
given certain information.
For many, the first piece of information they
receive from the health service is their Bounty
pack, which steers them towards commercial
websites. Many feel this is inappropriate and
would prefer to be signposted to an NHS source.
Online information
Men in particular prefer online sources.
However, when pregnant women and their
partners search online for information, the first
sites they find are often commercial, and
become their preferred source.
The NHS Choices Pregnancy Care Planner is
popular with those who have used it; other
women described their need for something of
this type – a reliable, searchable and interactive
online resource. It is important to underline that
because the Planner is still relatively new, some
Home
of the parents who took part in the research
would not have seen it during pregnancy.
The research behind
Partners would also appreciate a section that’s
specifically for them on the Planner.
this publication
Face-to-face contact
Pregnancy: an emotional
Face-to-face appointments with healthcare rollercoaster
professionals are valued by both parties.
However, it’s important to allow plenty of time The right information,
for questions and information sharing, as well as at the right time and in
clinical checks. Some women feel their the right way
appointments are rushed and describe leaving
appointments frustrated, and with unanswered Pregnancy:
questions. Midwives also express frustration that > 0–12 weeks
short appointment times and the pressure to > 13–28 weeks
complete routine checks mean they can’t make > 29–40 weeks
enough time for answering questions. > Labour and birth
It is important to reinforce information delivered The growing child:
face to face with printed versions or other resources
that people can refer back to and review. > 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Group classes •• professional roles (midwife, obstetrician,
Women welcome practical demonstrations and anaesthetist)
antenatal classes, which ‘bring to life’ printed •• procedures (epidural, episiotomy).
information they have already received and
Whether healthcare professionals are using
give them the chance to make valuable social
printed materials or talking face to face, it’s
connections. However, some feel these classes
always important to communicate clearly and in Home
come too late in pregnancy, while others
language that parents understand and welcome.
can’t attend the classes because of work or The research behind
Printed material provided by the NHS is usually
other commitments. Evening or weekend classes
are offered in some areas and these can make a
written as clearly and simply as possible, but it this publication
may be necessary to explain technical wording,
huge difference.
especially for people whose first language isn’t Pregnancy: an emotional
Some people (for example older and younger English. rollercoaster
women, single mothers-to-be, partners, women
from ethnic minority groups) need to be The right information,
reassured that they will ‘fit in’ and that there will A roadmap for pregnancy at the right time and in
be other people like them there. Give expectant parents a helpful pregnancy the right way
schedule at the first meeting so they can see
Using the right language what lies ahead and what is involved at each Pregnancy:
appointment. This can help them plan for both > 0–12 weeks
Sometimes, it’s the language itself that proves practical issues (such as arranging time off > 13–28 weeks
to be a barrier. There are many elements of work) and emotional decisions (such as which > 29–40 weeks
pregnancy that involve technical and sometimes screening tests to have). > Labour and birth
confusing language, including:
•• medical conditions (pre-eclampsia, mastitis, The growing child:
spina bifida)
> 0–1 months
•• drugs and supplements (pethidine, folic acid) > 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Summary •• Antenatal/educational classes should be
offered flexibly and earlier in pregnancy
•• When giving information to parents, it is (for example in weeks 26 to 34). Evening
important to: and weekend classes are very valuable for
– use language that people understand and working parents.
welcome: expectant parents can be as •• Many parents welcome classes that are Home
alienated by language that is too specifically for particular groups – for example
patronising as by language that is too single mothers-to-be, younger and older The research behind
difficult women, women from ethnic minority groups this publication
– provide information in different formats, and partners/fathers.
such as magazines, DVDs, stories and real- Pregnancy: an emotional
life examples. Some of these should be rollercoaster
out-of-hours resources such as websites
and local community groups The right information,
– repeat essential information more than at the right time and in
once in different ways the right way
– take time to discuss the information
expectant parents have been given to Pregnancy:
ensure understanding. > 0–12 weeks
•• The NHS Choices Pregnancy Care Planner is > 13–28 weeks
a resource popular with those who have used > 29–40 weeks
it, so it should be promoted to parents. GPs > Labour and birth
and midwives should be encouraged to
signpost expectant parents to it. The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Pregnancy: 0–12 weeks

Home
How women may feel What expectant
•• Emotionally overwhelmed, even if the parents need from the The research behind
pregnancy is planned this publication
health service
•• Upset, confused, sometimes unsure whether
to continue the pregnancy
First contact Pregnancy: an emotional
It’s rare for women to consult a healthcare rollercoaster
•• As though the pregnancy ‘isn’t real’ professional before they get pregnant, unless
•• Worried about miscarriages they have underlying health conditions and/or The right information,
•• Disinclined to plan too far ahead – for concerns about fertility. Once they know they at the right time and in
example which hospital to choose, birth are pregnant (usually through taking a
pregnancy test at home), most women
the right way
plans, breastfeeding
automatically go to their GP for confirmation of
•• Disappointed by lack of acknowledgement by Pregnancy:
the pregnancy, support and information.
health services > 0–12 weeks
•• Anxious to ‘get things right from the start’ – Women often choose their GP simply because > 13–28 weeks
for example eating well, giving up they already know them or because they are not > 29–40 weeks
smoking/drinking aware that they have the option of seeing a > Labour and birth
•• Eager for information midwife for their first contact. However, many
are subsequently disappointed and feel their GP The growing child:
•• Unclear what to expect – what’s the
‘next step’? ‘lets them down’ by not being excited enough, > 0–1 months
not volunteering information on next steps or > 2–6 months
not doing a confirmation test. > 7–12 months
> 1–5 years
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The parents
By making the midwife the first contact, health
services could ensure that the first health
professional pregnant women talk to is baby-
focused, experienced in dealing with new
pregnancies and ready to understand how it
feels. However, because some women would still
prefer to see their GP as the first contact, GPs
also need to be aware of some simple ways in
which they can improve that first contact, by
being more empathetic and giving women/
partners the information they need.
For example the healthcare professional may
need to:
•• discuss whether the woman wants to keep
the baby, if appropriate
•• establish whether translators or interpreters
may be needed
•• give a clear sense of the journey and
next steps
•• give guidance on scans – what types
are available
•• signpost to information on non-health issues
such as housing, benefits and training
•• help women connect with other local or
online social support networks as they are
often not ready to tell friends and family
•• give more direction to young fathers – many
aren’t in a position to take on the traditional
‘provider’ role and may feel uncertain as to
how to define their role.
Most importantly, expectant parents want their
feelings to be recognised at the first
Home
appointment – perhaps being congratulated, or
The research behind
simply asked how they feel. They don’t want it
to focus on routine paperwork. this publication
The 12-week scan Pregnancy: an emotional
This is an important milestone for expectant rollercoaster
parents. It has a crucial clinical purpose, but while
health professionals focus on clinical procedures, The right information,
measurements and dates, the expectant parents at the right time and in
want reassurance that the baby is there, the the right way
chance to see it for the first time and start
bonding with it, and a picture to take away. Pregnancy:
> 0–12 weeks
Failing to acknowledge that both these sets of
> 13–28 weeks
needs are valid can lead to frustration for both
> 29–40 weeks
parties. Even a positive scan can become a
> Labour and birth
negative experience if parents don’t feel their
emotional experience has been acknowledged.
The growing child:
Parents’ expectations need to be managed, but
professionals also need to be sensitive to the > 0–1 months
huge emotional significance. > 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents

First pregnancy?
The maternity journey is very different for
the first pregnancy. Women are making the
life-changing transition into motherhood
and because they haven’t experienced
pregnancy before, they can be anxious,
lacking in confidence and fearful.
They may have little knowledge of what to
expect in the future. They have a much
greater need for emotional support,
reassurance and preparation. On the other
hand, they can be quickly overwhelmed and
overloaded with information. In particular,
they are often focused on pregnancy, labour
and birth and may feel unable to ‘deal with’
planning for parenthood itself.
Summary
•• The first contact is a vital time for expectant
parents and it is important that health
professionals make it a positive experience.
Promote midwives as an option for the first
point of contact, and work with GPs to ensure
Home
that where first contact is with them, it is a
positive experience.
The research behind
•• Parents can be overwhelmed if they get too
this publication
much information at once. Hold back on
Pregnancy: an emotional
things they don’t need to decide about yet,
such as breastfeeding and where to have the
rollercoaster
baby (but offer them signposting for where to
find the relevant information, should they
The right information,
at the right time and in
want it).
•• Women want support between the first
the right way
contact and the 12-week scan, as they can
feel isolated and anxious during this time.
Pregnancy:
> 0–12 weeks
•• Fathers say they would like more NHS
> 13–28 weeks
information online.
> 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 Key milestones

Home
First contact Booking-in 12-week
appointment scan
The research behind
Highs +

this publication
Excitement/
Shock/Upset
Chance to ask Pregnancy: an emotional
questions
rollercoaster
Finding out 12 weeks
The right information,
Disappointed not to get
more from first contact
at the right time and in
Long gap: feeling isolated
and unsupported by the right way
health services
Lows –

Deciding whether or not

to continue pregnancy
Pregnancy:
> 0–12 weeks
Feeling isolated: can’t talk about it with wider support network
> 13–28 weeks
Anxiety stage: constant fear of miscarriage > 29–40 weeks
Tired and sick
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Pregnancy: 13–28 weeks

Home
How women may feel parents to ask questions and discuss options.
Women may want to ask about:
•• Relieved the baby is there The research behind
• how to manage their working life
•• That the pregnancy has become ‘real’ this publication
•• the 16-week blood tests – what the results
•• Ready to tell people may mean, and what choices they might Pregnancy: an emotional
•• Worried about what their employer will say need to make rollercoaster
•• Anxious about the 16-week blood tests and •• the 20-week scan
the anomaly scan •• their choices about where to give birth. The right information,
•• Disappointed that the outside world doesn’t Partners may also want to be asked about how at the right time and in
understand how different they feel they are coping and given time and space to ask the right way
•• Eager to prepare for the baby’s arrival. their own questions.
Pregnancy:
A negative booking experience can include the > 0–12 weeks
What expectant following problems: > 13–28 weeks
parents need from the •• feeling rushed in and out quickly > 29–40 weeks
> Labour and birth
health service •• being unsure who they will see next and what
the journey ahead looks like
Booking-in appointment The growing child:
The first midwife appointment is the chance to •• leaving still with unanswered questions
> 0–1 months
establish a relationship of trust and openness. •• feeling judged.
> 2–6 months
There needs to be plenty of time for expectant > 7–12 months
> 1–5 years
BACK NEXT
The parents
Blood tests and screening
The 16-week blood tests are complex and come Choosing where to
relatively early in the pregnancy journey, so
expectant parents may need a lot of guidance
give birth
and support. They may not feel well-informed Most women choose where to give birth based
(even if they have been given relevant printed on the reputation for quality of care and the
Home
information in advance) and may not be ready location. Some women are not aware of having
to make decisions with difficult medical or been given a choice at all and believe they were
The research behind
religious implications. Instead, they may look to simply referred to their local hospital.
health professionals for help and guidance on
this publication
how to make a decision. Word of mouth, rather than informed knowledge,
plays a key role in how women choose between Pregnancy: an emotional
Questions expectant parents could ask local hospitals, or a home birth, and their rollercoaster
themselves: understanding of what services (for example,
different kinds of pain relief) are available in The right information,
•• Do I want to have the initial blood test?
various locations. at the right time and in
– Do I want to know my risk? Why?
How might I use this information? Do I
the right way
Women and their partners may also make the
understand the future implications of this? decision at a moment when they are unprepared, Pregnancy:
•• Would I have the diagnostic blood test? and without even realising they have made it.
> 0–12 weeks
– Do I understand what my risk factor It’s important to help women make the best
> 13–28 weeks
means? Do I understand the risks decision for them by giving them locally tailored
> 29–40 weeks
associated with the diagnostic test? information at a time when they are able to be
> Labour and birth
How do I feel about this? receptive, and discussing the implications of the
decision with them. Women may want to take
– How do I want to continue? The growing child:
some time to think about this decision, and it is
important to acknowledge that they can change > 0–1 months
their mind at a later stage if necessary. > 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 Key milestones

Home
Booking-in 16-week 20-week
appointment blood tests scan
The research behind
Highs +

this publication
Excitement/
Shock/Upset
Chance to ask Pregnancy: an emotional
questions
rollercoaster
Finding out 20 weeks
The right information,
Disappointed not to get
more from first contact
at the right time and in
Long gap: feeling isolated
and unsupported by the right way
health services
Lows –

Deciding whether or not

to continue pregnancy
Pregnancy:
> 0–12 weeks
Feeling isolated: can’t talk about it with wider support network
> 13–28 weeks
Anxiety stage: constant fear of miscarriage > 29–40 weeks
Tired and sick
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Summary
•• Women who need additional advice should
be signposted to appropriate services about
training and careers. For example, teenage
mothers should be signposted to the
Connexions service.
Home
•• Expectant parents need the opportunity to The research behind
talk through issues surrounding blood tests
and scans.
this publication
•• Parents need to be given all the information Pregnancy: an emotional
they need to decide where to give birth and rollercoaster
need the chance to discuss it and make a
considered decision. The right information,
at the right time and in
the right way
Pregnancy:
> 0–12 weeks
> 13–28 weeks
> 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Pregnancy: 29–40 weeks

Home
How women may feel To help overcome anxieties about giving birth,
planned hospital visits can be valuable to give
•• Able to think about the baby as a person expectant parents, especially fathers/partners,
The research behind
•• Unsure what to buy and what not to buy practical information about such matters as car this publication
•• Worried about the birth parking and cafés.
Pregnancy: an emotional
•• Confused about different kinds of pain relief They may also now be ready to find out more rollercoaster
•• Ready to think beyond the pregnancy. about aspects of childcare, including bonding,
coping with crying, changing nappies, sleeping, The right information,
feeding, coping with sleep deprivation and at the right time and in
What expectant postnatal depression. Many expectant parents the right way
parents need from the want reassurance about the kind of support the
health service can provide after birth. Pregnancy:
health service
Expectant parents need increasingly specific Group antenatal classes are popular. However: > 0–12 weeks
information on all aspects of birth, including > 13–28 weeks
••regnant women feel that antenatal classes in
different options for giving birth that are > 29–40 weeks
the last weeks of pregnancy are too late
available locally. They are generally ready to start > Labour and birth
•• many would welcome sessions for ‘people like
thinking about the details of the birth, such as
the option to cut the cord, skin-to-skin contact
them’, for example young mothers, older The growing child:
mothers, single mothers, some ethnic groups, > 0–1 months
and who will be present at the birth. However, it
sessions for partners, sessions just for women > 2–6 months
is important that expectant parents understand
that their birth plan is a wish list and not a blueprint. > 7–12 months
> 1–5 years
BACK NEXT
The parents
•• they need to be more accessible – evening
and weekend classes are welcomed,
particularly as partners are more able
to attend
•• organisers could tailor some sessions to the
needs and roles of partners. Home
The research behind
Summary this publication
•• Parents welcome antenatal classes – ideally
earlier in pregnancy, with evening and Pregnancy: an emotional
weekend classes available. rollercoaster
•• At this stage, parents may want information
about their choices at birth and to develop a The right information,
birth plan. Make sure that expectant parents at the right time and in
understand that their birth plan is a wish list the right way
and not a blueprint.
•• Planned hospital visits are an important way Pregnancy:
to help parents, especially fathers/partners, > 0–12 weeks
plan for the birth. > 13–28 weeks
•• Some parents need reassurance that health > 29–40 weeks
service support will continue through and > Labour and birth
beyond the birth.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 Key milestones

Home
Starting to Antenatal Hospital
prepare for classes tour
The research behind
Highs +

baby
this publication
Excitement/
Shock/Upset
Chance to ask Pregnancy: an emotional
questions
rollercoaster
Finding out 40 weeks
The right information,
Disappointed not to get
more from first contact
at the right time and in
Long gap: feeling isolated
and unsupported by the right way
health services
Lows –

Deciding whether or not

to continue pregnancy
Pregnancy:
> 0–12 weeks
Feeling isolated: can’t talk about it with wider support network
> 13–28 weeks
Anxiety stage: constant fear of miscarriage > 29–40 weeks
Tired and sick
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Labour and birth

Labour and birth can be many things to women •• Sensitive to criticism or brusqueness Home
– fulfilling, frightening, exciting, painful, •• Worried about how to look after the baby
satisfying or overwhelming. Aside from the
The research behind
•• Anxious that their needs will go unanswered this publication
physical experience, this is the moment when
as the midwife’s focus transfers to the baby.
expectant parents become parents and meet
their child for the first time. Pregnancy: an emotional
The importance of the rollercoaster
Inevitably, the day of birth comes with many
expectations. It is important for both the parents
birth experience The right information,
and the healthcare professionals to be satisfied A good birth experience may make a at the right time and in
with the birth even if it does not go according to mother feel:
the right way
the original birth plan. If there are changes of •• safe in the professionals’ hands
plan, information should be explained clearly •• that her body is respected Pregnancy:
and simply. It is important to make sure that
•• that her partner is involved > 0–12 weeks
partners/fathers are involved and consulted in
•• able to ask questions > 13–28 weeks
any decisions.
> 29–40 weeks
•• that she is listened to
> Labour and birth
How women may feel •• that she is given clear information that is not
•• Frightened too technical The growing child:
•• Stressed •• that changes to the birth plan are explained > 0–1 months
well in advance. > 2–6 months
•• Anxious, especially if things don’t go as planned
> 7–12 months
•• Vulnerable > 1–5 years
BACK NEXT
The parents
A bad birth experience may make a mother feel:
Contact points
•• abandoned/left alone
At the hospital
•• that she doesn’t understand what is Some new parents perceive hospital guidance to
happening to her be inadequate. They feel that there isn’t enough
••hat her questions aren’t answered practical help given on how to care for a baby –
for example, bathing, feeding, changing nappies.
Home
•• that she doesn’t understand the technical
language used The research behind
If new parents lose confidence in either
••hat she is confused by changes in the birth plan themselves or the health services at this this publication
•• that staff seem over-stretched or unconcerned stage, it can be hard to get things back
•• that her partner is being excluded or helpless. on track. Pregnancy: an emotional
rollercoaster
What parents need from Summary The right information,
the health service •• Parents will typically have a lot of
at the right time and in
expectations and emotions about the birth.
After the birth, new parents say they would like:
It is vital that healthcare professionals are
the right way
•• time and space to bond as a family aware of these, particularly if there are
changes to a birth plan. Any such changes
Pregnancy:
•• a starter course in parentcraft to build
confidence should be explained clearly and simply, and > 0–12 weeks
partners/fathers should be involved. > 13–28 weeks
•• to feel cared for
> 29–40 weeks
•• New parents generally need and welcome
•• reassurance that the baby is okay > Labour and birth
support from the health service after the birth
••nformation about aftercare, tearing or – especially focusing on feeding.
episiotomy, caesarean sections, postnatal The growing child:
•• However, they also need time and space to
depression and contraception. > 0–1 months
bond as a family.
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
The growing child:
0–1 months
Home
How parents may feel What parents need from
•• Worried about feeding issues – and guilty the health service The research behind
that they find breastfeeding difficult or
Home visits from the health visitor are crucial, to
this publication
unrewarding
make sure that women feel supported. Being
•• Fearful about cot death Pregnancy: an emotional
alone at home with a new baby can feel
•• Preoccupied with the baby’s weight gain, isolating and frightening. Where feeding is rollercoaster
or lack of it difficult, visits from a midwife or health visitor
are essential.
The right information,
•• Anxious that their own needs will go
at the right time and in
unanswered as the midwife’s focus transfers
to the baby
New mothers may need intensive support in the right way
learning to breastfeed. The lack of practical help
•• Guilty about thinking of their own needs can be particularly upsetting for women who Pregnancy:
••solated and lonely. feel they have been ‘sold’ the idea of > 0–12 weeks
breastfeeding by healthcare professionals > 13–28 weeks
earlier in pregnancy. > 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 Contact points
Breast or bottle – The postnatal visit from the health visitor
why it’s important not or midwife
to judge Parents value this visit, especially first-time
parents and parents who don’t have informal
Women who choose to breastfeed usually
support networks such as family close at hand.
Home
need plenty of support, as it can be difficult
Where mothers are struggling with feeding, they
at first. However, they also want their
want to be visited on the second day, before the
The research behind
decision to stop to be accepted. Women
baby loses too much weight. this publication
who choose to bottle-feed want to feel that
their decision is respected and that they will The two-week development check Pregnancy: an emotional
also be supported and looked after. This is also important to parents. Mothers can be rollercoaster
very worried about their own bodies, especially
If women feel judged for their feeding The right information,
if they have had a difficult birth involving
decisions, it can damage the trust that they
intervention or post-birth physical problems. It is at the right time and in
have established with their healthcare
reassuring for them to be checked at this stage, the right way
professional. The new mother may feel
as well as their baby.
alienated by the healthcare service and will
retreat from it, taking her child with her.
Pregnancy:
Fathers may miss this appointment if their
This shuts women off from future paternity leave has finished. Many fathers would > 0–12 weeks
interaction and health messaging, and therefore prefer this review to be earlier or ‘out > 13–28 weeks
undermines the ability to get new families of hours’. They may need guidance on how > 29–40 weeks
off to a good start. to interact with a newborn. Once engaged in > Labour and birth
their role as father and used to interacting
with health professionals, they are more likely to
The growing child:
stay engaged. > 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Getting out into the community •• Mothers also want information about a range
Women find community initiatives extremely of other subjects, including their own health
supportive, especially if they can meet other as well as the baby’s. The two-week
mothers with babies the same age as theirs. development check can therefore be an
Sometimes women can find it difficult to find important opportunity to reassure the mother
out about what’s available, or believe that about her health too.
Home
services ‘aren’t for them’, so promoting these
opportunities strongly is important. The research behind
this publication
Key milestones
•• Baby smiling, eyes focusing Pregnancy: an emotional
•• Religious rituals rollercoaster
•• Postnatal health visitor visit The right information,
•• Two-week development check. at the right time and in
the right way
Summary
Pregnancy:
•• New parents have many anxieties and
concerns about their child and welcome > 0–12 weeks
support from the health service. > 13–28 weeks
> 29–40 weeks
•• In particular, the postnatal visit from a
> Labour and birth
midwife or health visitor is vital – especially
for those mothers who are having difficulty The growing child:
breastfeeding. In these cases, mothers want a
visit within a couple of days of giving birth. > 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
The growing child:
2–6 months
Home
How parents may feel health visitor keeps parents updated. However,
the end of these visits can leave parents doubtful
•• Anxious that support from the healthcare who to contact and sometimes feeling
The research behind
services seems to be ‘dropping off’ unsupported: should they contact the health this publication
•• Confused about immunisations, particularly visitor or the GP to discuss minor illnesses?
the three-month immunisations, and would Pregnancy: an emotional
like them to be undertaken by a health visitor Clinics and children’s centres become more rollercoaster
at home relevant to fill the gap, but they need to be
promoted more consistently. The right information,
•• Worried about the baby’s weaning and
weight gain, feeding, winding, minor illness at the right time and in
Immunisation appointments
(or lack of) the right way
The eight-week and three-month immunisation
•• More in control – with the baby becoming appointments provide contact with health
much more alert, recognising parents’ voices
Pregnancy:
services. Some parents felt that they didn’t have
and beginning to express themself. enough information about the immunisations > 0–12 weeks
and few realised that these appointments were > 13–28 weeks
also an opportunity to ask questions that were > 29–40 weeks
Contact points not related to the immunisation itself. > Labour and birth
Home visits from the health visitor
Most health visitor visits stopped at four months. The growing child:
The Personal Child Health Record (red book) > 0–1 months
provides a schedule of appointments and the > 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Key milestones
•• Baby sleeping through the night
•• Weaning the baby
•• Baby developing a personality and being
more expressive, with smiles, cooing
and movements
•• Parents would benefit from a clearer
understanding of how the health service for
parents of young children operates – and in
particular understanding that it is not a series
of prescribed interactions but a service, which
parents can access proactively whenever
Home
they need it.

•• Baby gaining weight The research behind

•• Baby becoming more active: rolling this publication
over, grasping things, even sitting and
crawling early.
Pregnancy: an emotional
rollercoaster
Summary The right information,
•• Parents welcome the support they get from at the right time and in
health visitors in particular, but can feel the right way
unsupported when the visits stop. They need
more information for continuing sources of Pregnancy:
help and support after the baby is four > 0–12 weeks
months old. > 13–28 weeks
•• Immunisations should be explained clearly > 29–40 weeks
and fully, and appointments should be > Labour and birth
promoted as an opportunity to discuss other
health issues. The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
The growing child:
7–12 months
Home
How parents may feel What parents need from
•• Worried about safety in the home the health service The research behind
•• Preoccupied over whether their baby is Parents who use drop-in clinics and children’s
this publication
meeting ‘normal’ developmental milestones centres (such as Sure Start) are most likely to feel
such as walking and talking Pregnancy: an emotional
supported and satisfied with their parenting.
•• Confused about who to go to for health Mothers who don’t know of or don’t use these rollercoaster
advice and support resources are likely to be anxious and use other
services (such as their GP) ineffectively –
The right information,
•• Anxious about the baby showing signs of
especially more affluent mothers with limited at the right time and in
disobedience or clinginess
informal support. the right way
•• Concern over the measles, mumps and
rubella (MMR) jab Pregnancy:
•• Worried about whether and how the baby
Contact points
> 0–12 weeks
will learn English (for parents in ethnic The one-year review
> 13–28 weeks
minority groups). Parents consider this to be well-timed.
> 29–40 weeks
They need reassurance that developmental
> Labour and birth
milestones, such as walking and talking, are
being achieved.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Key milestones
•• Baby becoming more mobile and learning to
crawl and walk
•• Baby developing language
•• Mother may return to work Home
•• Baby becoming more interactive and social
•• Baby starting in childcare if parents
The research behind
are working this publication
•• One-year developmental review. Pregnancy: an emotional
rollercoaster
Summary
•• Parents like the one-year review and The right information,
particularly want reassurance that their baby at the right time and in
is developing ‘normally’. the right way
•• They are often confused about where to go
for healthcare information and support – Pregnancy:
particularly if they do not attend drop-in > 0–12 weeks
clinics or children’s centres. > 13–28 weeks
> 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
The growing child:
1–5 years
Home
How parents may feel Contact points
•• Worried about their child’s progress in The two-year review The research behind
developing language The two–two and a half years review is this publication
•• Concerned about what their child is eating welcomed, but some families get it at 2.5 years
and feel they are offered it ‘too late’. The review Pregnancy: an emotional
•• Anxious about poor behaviour
could/should: rollercoaster
•• Worried about choosing nurseries, pre-
•• include advice for ethnic minority families
schools and schools, especially if parents have The right information,
about teaching English in preparation
a child with a disability
for school at the right time and in
•• Anxious about their child learning English, if the right way
•• give guidance about diet (particularly
they are from an ethnic minority group
appreciated by fathers)
•• Anxious about safety as their child
•• offer advice to manage toddler behaviour
Pregnancy:
investigates their environment. > 0–12 weeks
•• be promoted as a family discussion about
> 13–28 weeks
progress rather than a quick physical check
> 29–40 weeks
•• be held at an accessible time to ensure that > Labour and birth
fathers can attend.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Key milestones
•• MMR jab
•• Two-year review
•• Starting pre-school or nursery
•• Starting school Home
•• Child developing their personality, exercising
choice (for example about clothes, TV
The research behind
programmes, etc) and becoming more this publication
independent (for example brushing their
own teeth).
Pregnancy: an emotional
rollercoaster
Summary The right information,
•• Parents welcome the two-year review but can at the right time and in
be concerned if it doesn’t take place as soon
the right way
as their child turns two.
Pregnancy:
> 0–12 weeks
> 13–28 weeks
> 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
The parents

•• Stressed and in need of support Home

Partners and fathers •• Anxious to be able to contribute in a practical The research behind
A woman’s partner and the father of her way (for example, by decorating the nursery)
this publication
baby can play an incredibly important role •• Not in control
in pregnancy and early parenthood – and •• Unable to relate to the pregnancy because Pregnancy: an emotional
they may not be the same person. It’s they aren’t experiencing the physical changes rollercoaster
important for healthcare professionals to
•• Worried about changes to the relationship
acknowledge the needs and contributions of The right information,
partners and fathers. For young mothers, •• Fearful of showing their worries in front of
their own mother may also be a prime their partner at the right time and in
source of support and these grandmothers- •• Unable to contribute fully because their
the right way
to-be should be acknowledged by partner is supported by her own family
healthcare professionals.
Pregnancy:
•• Embarrassed about what their friends think
> 0–12 weeks
•• Unable to bond fully with the baby. > 13–28 weeks
How partners and fathers Barriers to partner
> 29–40 weeks
> Labour and birth
may feel about parenthood involvement
•• Worried about finances The growing child:
Partners and fathers aren’t always engaged in
•• Unsure whether they want the baby > 0–1 months
the pregnancy and parenthood journeys,
> 2–6 months
•• Confused about their role, especially if they especially in the initial stages. The barriers to
> 7–12 months
are not the financial provider involvement can include:
> 1–5 years
BACK NEXT
The parents
•• detachment (the pregnancy ‘doesn’t feel real’ them. Partners of newly pregnant women
at first) may need time and space on their own to
•• conflicting beliefs about gender roles and express anxieties and ask questions. It’s
family structures important to give partners support outlets
outside their relationship – these could be the
•• belief that antenatal classes and appointments
health service itself, parents, other family
are for women, anxiety about taking time off Home
members, friends, online forums or sources of
work for them or being told they can’t attend
information such as magazines.
•• feeling that there is no role for them if they
The research behind
•• Frequently check that partners are managing this publication
are not the financial provider.
throughout the pregnancy journey.
Possible ways to help and When the baby is born, partners and fathers can
Pregnancy: an emotional
include partners and fathers benefit from:
rollercoaster
To help partners and fathers get more involved •• being able to stay as a family in their own The right information,
in the pregnancy journey, it can be valuable to room the night after the birth to help them at the right time and in
do the following: bond together
the right way
•• Produce pregnancy information specifically •• being shown how to care for the baby, bond
for men, including a clear idea of how to and interact with it from day one – especially Pregnancy:
support their partner and a roadmap of if the mother has had a Caesarean section or
what’s ahead. > 0–12 weeks
a traumatic birth
> 13–28 weeks
•• Encourage them to come to partner-friendly •• being actively involved in home visits after > 29–40 weeks
antenatal appointments and classes. the birth > Labour and birth
•• Include partners in labour and birth and give •• being offered information on creating a safe
them choices, for example whether to cut the home environment – they may have more The growing child:
umbilical cord, whether to give the baby its time and resources to make the changes and > 0–1 months
first bath. may welcome having a specific role. > 2–6 months
•• Actively acknowledge partners’ worries and > 7–12 months
give them opportunities to discuss and solve > 1–5 years
BACK NEXT
The parents
 How single mothers may feel
Single mothers •• Embarrassed and/or defensive
Women who don’t have the support of a
•• Anxious about parental disapproval
partner may need more support from the
health service. They often fear being judged •• Judged by or distant from the health service
because of their situation, so continuity of •• That antenatal classes and other community Home
care is particularly important so they don’t resources ‘aren’t for people like me’
have to deal with lots of different people. •• Unhappy that the father isn’t involved
The research behind
They also need to be able to trust the this publication
•• Worried about the future
professional caring for them. In some cases,
this relationship may be their only source •• Concerned about money and benefits Pregnancy: an emotional
of support. •• Uncertain about their future training and rollercoaster
employment needs.
Single pregnant women often have The right information,
alternative support networks and the at the right time and in
importance of their parents, siblings and
friends may increase. Women may want
the right way
their supporter to be present at the key
Pregnancy:
milestones. If a woman’s mother or
grandmother is her main supporter, then > 0–12 weeks
they may need help updating their > 13–28 weeks
knowledge of pregnancy and birth, if > 29–40 weeks
recommended practice has, as is likely, > Labour and birth
changed since they became a mother.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Possible ways to help
•• Be aware that single mothers may need extra
support and be ready to provide it
•• Provide practical, supportive and non-
judgemental advice Home
•• Signpost single mothers, where appropriate,
to services that can advise them on training The research behind
and employment, benefits, housing and other this publication
non-health issues
•• Ensure continuity of care throughout their Pregnancy: an emotional
pregnancy rollercoaster
•• Make sure that other supporters (such as
siblings or parents) are invited to key The right information,
milestone appointments, if that is the at the right time and in
woman’s wish the right way
•• Provide contacts with others in similar
situations Pregnancy:
•• Consider the needs of a single mother at > 0–12 weeks
birth – for example, who will take her and > 13–28 weeks
the baby home from hospital? > 29–40 weeks
> Labour and birth

The growing child:

> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
 How younger mothers
Younger mothers
Teenage and young mothers can often fear
may feel
that they will be judged and ‘looked down •• Unsure whether to continue with the
on’ by healthcare professionals. They may pregnancy, especially if it was unplanned
feel ignored in hospital and patronised by •• Fearful of being judged Home
health visitors. •• Distant from the health service
The research behind
•• Worried about finances and benefits
Some may feel angry or misunderstood and this publication
there is a danger that they will distance •• Confused by employment rights and
themselves from the health service. It’s vital educational options. Pregnancy: an emotional
that these women feel supported by rollercoaster
professionals and that they are given Possible ways to help
information at the right time. It’s vital that
•• Offer them advice and support on whether to
The right information,
young mothers are engaged successfully by at the right time and in
continue with the pregnancy.
health services – if they ‘turn off’ from
them, they shut themselves and their •• Signpost them to sources of advice on money, the right way
growing children off from this vital source benefits, education and employment.
Pregnancy:
of support. •• Organise antenatal education with other
young mothers. > 0–12 weeks
> 13–28 weeks
They may need a lot more formal support, from > 29–40 weeks
the very start of the pregnancy. They are likely > Labour and birth
to have less knowledge of and confidence about
pregnancy and parenthood and they may also The growing child:
have unsupportive families.
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
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The parents
 Women who do not speak
Parents in minority
English as a first language
ethnic groups These women may be very dependent on an
Women in minority ethnic groups may need English-speaker such as their partner or another
more support and guidance either because family member to translate and interpret for Home
their expectations of how they will them. This can be an effective way of engaging
experience pregnancy and parenthood are the father in discussions with the health The research behind
different, or because they may not speak professional – however, it can also inhibit open
English as a first language. this publication
discussion with health professionals and make it
hard for women to discuss sensitive topics such Pregnancy: an emotional
In some cultures, women are not expected
as sex and postnatal depression.
to engage with health services until far later rollercoaster
in the pregnancy journey. For many women
in these circumstances, strong family Possible ways to help The right information,
support networks may act as a barrier to •• Consider providing independent interpreters at the right time and in
engaging with formal health services. to avoid the necessity of using a family the right way
member.
Cultural influences may also be significant
•• Ensure that pregnant women who don’t Pregnancy:
in shaping fathers’ attitudes to pregnancy,
speak much English have an interpreter in > 0–12 weeks
preparing for the birth and engaging with
hospital, rather than simply relying on the > 13–28 weeks
health services.
partner/father to translate. > 29–40 weeks
•• Arrange for parents and toddler drop-in > Labour and birth
The following text is based on individual
comments from a small number of centres to have interpreters and offer
respondents. It should not be seen or English classes. The growing child:
treated as statistical evidence. However, > 0–1 months
it may provide some useful insights for > 2–6 months
planning maternity services to meet the > 7–12 months
needs of women in ethnic minority groups. > 1–5 years
BACK NEXT
The parents
Somali parents
Somali pregnant women may have been
circumcised and this may affect the birth of their
baby. They should therefore be offered advice
from a female genital mutilation expert which
may help them to have an easier birth.
Bangladeshi parents
Bangladeshi families often provide strong
informal networks of female support. When
expectant parents rely heavily on these
networks, they may not engage with the formal
health services.
Home

There may also be a lack of communication Bangladeshi fathers may be enthusiastic about The research behind
between Somali parents. During pregnancy, being involved in the pregnancy journey. this publication
some mothers move in with their families and However, fathers often work long hours and find
rely on friends rather than their partner as their it difficult to engage with the health services. Pregnancy: an emotional
main source of support. Fathers may therefore rollercoaster
not engage with the pregnancy and focus on Possible ways to help The right information,
parenting issues instead.
•• Encourage Bangladeshi pregnant women to
at the right time and in
attend all antenatal appointments.
Possible ways to help •• Ensure that appointments are scheduled when
the right way
•• Give Somali women the chance to discuss fathers can attend them if they wish.
concerns over circumcision with the health
Pregnancy:
professional in private and to get advice from > 0–12 weeks
a female genital mutilation expert. > 13–28 weeks
> 29–40 weeks
•• Encourage Somali fathers to attend antenatal
> Labour and birth
appointments.
The growing child:
> 0–1 months
> 2–6 months
> 7–12 months
> 1–5 years
BACK NEXT
The parents
Pakistani parents Possible ways to help
Pregnant women are expected to hide their •• Ensure that Black Caribbean expectant
bumps in public, especially in the presence of parents feel valued, supported and confident.
men. Fathers avoid antenatal classes to avoid •• Engage fathers with information that is
seeing other pregnant women, and mothers may specifically produced for them.
not attend classes to avoid being seen.
Home
•• Make sure that mothers-to-be consult health
professionals rather than family and friends The research behind
Possible ways to help about medical matters. this publication
•• Offer women-only antenatal classes to ensure
that Pakistani women can attend them. Gypsy and Traveller parents Pregnancy: an emotional
The Gypsy and Traveller community often rollercoaster
Black Caribbean parents conforms to strongly traditional roles in which
Black Caribbean mothers can feel under-valued by fathers provide and mothers deal with every
The right information,
the health service. It is important to make it clear other aspect of pregnancy. Most men work at the right time and in
to them that the service is there to support them. away from home and are therefore detached the right way
from the pregnancy. Mothers in the sample
Mothers and other female family members often group were mostly not in employment. They Pregnancy:
offer the most support. Pregnant women may have a strong informal female support network > 0–12 weeks
turn to older family members for advice about and there is little interest in male support. > 13–28 weeks
treating ailments rather than asking the health
> 29–40 weeks
service, which can be dangerous.
Possible ways to help > Labour and birth
Black Caribbean fathers often feel that there’s a •• Encourage mothers-to-be to attend antenatal
stigma attached to them – they are expected to The growing child:
appointments. Not only are men unlikely to
be disconnected from the pregnancy and want to be involved, the women are also very > 0–1 months
unsupportive. Fathers can therefore be very unlikely to encourage them. > 2–6 months
interested in father-specific information. > 7–12 months
> 1–5 years
BACK
The parents