Category: Pregnancy

POWS: so much more than pregnancy outreach

When you hear “Pregnancy Outreach Work”, what do you think of? Breastfeeding education, perhaps? Blood pressure checks, or birth plans?

The truth is, the women we work with need much, much more than this. The risks our Pregnancy Outreach Workers Service (POWS) clients have include:

  • substance misuse
  • domestic abuse
  • safeguarding
  • mental ill health
  • housing and homelessness
  • issues linked to being a recent arrival to the UK
  • other issues linked to financial hardship

The Pregnancy Outreach Workers Service (POWS) provides crucial extra, early interventions needed to support women with these issues – often because no-one else can.

POWs are able to work with woman from a very early stage of pregnancy; often from as early as 10 weeks. Take away POWS, and the standard maternity pathway means no extra support until the Health Visitor gets involved at 26-28 weeks.

We can do this because of our close relationship with midwives, who alert us to women who would benefit from an early intervention. It means that we can start to tackle – and often resolve – issues as soon as possible, reducing risks that might otherwise have affected the unborn child.

As well as filling this gap, POWs work alongside many other services, including Housing Officers, Midwives, FNPs, Social Workers and the emergency services, to create a “wraparound” support service for families. And we do so in an efficient, cost-effective way.


More than two thirds of our clients have a housing risk. Around 47% are in temporary accommodation (eg living on a friend’s sofa, or in a B&B or hostel) and another 21% are in accommodation that, although more stable, is completely unsuitable for bringing up a baby (access issues, no power, problems with damp or rodents, etc).

POWS help women to access the support they need, including helping them to understand systems and processes, to access and fill in forms, to make homelessness and housing benefit applications, to bid on properties, and to furnish social letting properties (which are usually let without curtains, carpets or any furniture or white goods).

Importantly, POWS support also enables other services and agencies to do their jobs more efficiently. Having a POW on hand to offer social, emotional and practical support means that a Housing Officer, for example, can concentrate solely on their remit: finding a tenant suitable accommodation. POWS also save time for Housing Officers further down the line, because those who receive our support are more likely to understand how to sustain their tenancy. Together, we create a more efficient and less costly system.

Mental health

Nearly two-thirds (65%) of the women supported by POWS have a mental health need, but many would not have any support if it wasn’t for POWS.

All sorts of mental health problems, including “low level” depression and anxiety, can begin or escalate when a woman is pregnant or in her child’s first year. But with the right social support, many mental health risks can be reduced.

For women with a diagnosed mental health condition they’re struggling to control (medically “high risk”), POWS offer practical support, including help to manage medication and attend appointments. However, many of the women we see are medically “low risk”, with low reported wellbeing, or high levels of anxiety. Because they don’t meet the criteria of a clinically diagnosed mental health condition, they don’t qualify for extra support from other services. For these women, the one-to-one support a POW gives is vital, and has been proven to help.

We use the nationally-recognised DASS (Depression Anxiety and Stress Scales) to measure our impact and 50% of the women we worked with in the last year have seen an improvement in their DASS score as a result of support.

What’s more, a clinical study by researchers at the University of Birmingham, published last year, showed that the intervention of a POW was “beneficial in preventing postnatal depression in women with two or more social risk factors”.


Most of the safeguarding advice for new mothers is based around the child. Of course, the safety of the child is paramount, but children aren’t the only people who need protection and support.

Collecting food and toiletries for our “baby bank”

So while social services and midwives are focusing on the child, our focus is on mum.

Just over a quarter of the women POWS support officially meet the threshold of “vulnerable adult”. Around a third of our clients have a child protection plan in place for the unborn baby. Often, we’re looking at a “double whammy”: a vulnerable adult with a protection plan in place for her unborn child.

If mum leads a chaotic lifestyle, with intermittent or no support from family or friends, then working on her own to build up the sorts of routines and networks that she will need as a parent – and that social workers and family courts will approve of – can be virtually impossible.

With a POW, however, there’s hope.

Not only will the POW work one-to-one with mum to come up with an action plan, helping her to tackle issues in a methodical way and providing her with important contacts, but she will also liaise with social workers and other services to ensure that they are aware of the changes being made.

In this way, mum is supported to be the best possible parent she can be, and mum and baby have a better chance of staying together.

This isn’t just a better outcome for mum and baby – it’s cost-efficient, too. The approximate cost of removing a child and caring for them in the foster system runs into tens of thousands of pounds.

Put simply: POWS solve issues and save money.

Chloe’s story

Chloe (not her real name) is a great example of the ways in which POWS can step in to break the cycle and stop someone slipping through the cracks. When we met Chloe, her two children had been taken into care and she had just found out she was pregnant again. She was deeply unhappy with her situation and desperate for things to change, but didn’t know where to start. Chloe has been brave enough to talk about what happened next.


If you are affected by the issues in this story, please click here to see a list of links and phone numbers that might be able to help.

Gateway POWS: unique support for mum

When social services become involved to protect an unborn child, who is there for mum?

Gateway Pregnancy Outreach Workers Service (POWS) is a unique service in this respect. Because, while social services and midwives – quite rightly – are focusing on the child, our focus is on mum. As far as we know, we’re the only organisation that can provide this intensive level of support to women during and after pregnancy.

The women POWS work with are referred to the service for many reasons. Many have issues with unsuitable accommodation, financial difficulties, problems with substance misuse, or risky relationships. All are vulnerable. Some have had children removed from them in the past, which means that their current pregnancy will be under increased scrutiny, bringing added pressures to an already difficult situation.

While this scrutiny and focus on the unborn child is necessary, it can often leave mum feeling bereft and unsupported, with her original needs unmet. And if she leads a chaotic lifestyle, with intermittent or no support from family or friends, then working on her own to build up the sorts of routines and networks that a parent needs (and that social workers and family courts will approve of) can be virtually impossible.

This is where POWS support is invaluable. Not only does a POW work one-to-one with mum to come up with an action plan, helping her to tackle issues in a methodical way, but she will also liaise with social workers and other services to ensure that they are aware of the changes being made.

Gateway POW, Shazia, who supported Chloe*.
In the video below, you can hear from Chloe*, who tells us about the support her POW Shazia gave to her, and how it changed the outcome of her social services intervention.

Shazia says, “Chloe was proactive – she knew the dangers and wanted to change – but she needed emotional and practical support to actually get stuff done. I was able to be there for her throughout the pregnancy, not just at the end of the phone, but with practical advice – signposting her to other services, going with her to appointments, writing letters on her behalf and making sure social services knew she was making progress.”

Just having someone available to talk to is really important, so POWS work together to make sure all their clients get constant access to support. Shazia works part time, so she introduced Chloe to another POW she could contact, and made sure she had the number for the office too. If anything happened and Shazia wasn’t around, someone else would be.

Shazia continues, “There were times when Chloe doubted herself and times when she struggled to understand what she needed to do, but as time went on she started to believe in herself and that’s when she really started to make changes. She was keen to prove herself – even requesting things like additional drug tests – and just generally needing me to do things for her less and less. A nice example is when I rang her to remind her she needed to register the baby’s birth – and she’d already done it!”

As you’ll see from the video, Chloe is still making progress. She’s a lot happier now, and a lot more confident in herself. In fact, we found out this week that she has been given unsupervised access to her other two children on a regular basis.

Even when a mum doesn’t get the outcome she wishes for, and a child is removed, POWS are able to continue supporting her for up to eight weeks. However, it frustrates us that we can only work with her for such a short time. A mother is extremely vulnerable – and likely to fall into old patterns – during this period, so continued practical and emotional support and guidance is absolutely vital at this time.

Finally: the sort of support offered by POWS isn’t just something that would be “nice to have” for hundreds of families – it also saves a surprising amount of money. The approximate cost of taking a child into care for nine months runs into tens of thousands of pounds, but the approximate cost of the combined preventative services accessed by a vulnerable mum over nine months is less than a quarter of that.

*Name has been changed

24 hours in POWS

It’s now 18 months since we changed the intake criteria for our Pregnancy Outreach Workers Service (POWS). We thought it would be interesting to show you how the POWS service looks now, on an average day.

What changed 18 months ago?

Some of our POWs, past and present, pictured in 2014
Some of our POWs, past and present, pictured in 2014

In Spring 2015, the way POWS was funded changed, which meant we had to make some changes to the service and the way we work.

One big, positive change was that we could start accepting referrals from across the city, rather than being restricted by postcode.

But at the same time, our intake criteria changed. Rather than working with everyone who was referred, we began to focus on the most complex, vulnerable clients. Each referral is now assessed prior to being assigned a POW, and those with fewer risks are instead signposted to other agencies, including our own Befrienders.

The principles are still the same, however. While other services are there for baby, POWs are there primarily for mum. The support is client-led – we decide with them what they need, then help them to prioritise and tackle the issues they’re facing in a methodical way. We offer a listening ear as well as practical support, and we help them to access every bit of assistance that is available to them.

24 hours in POWS

On any given day, up to 10 of our POWs are out and about. The number of visits they make varies, as some need to be longer than others and the distance can vary. In some situations a chat on the phone, or a text can be as useful as a face-to-face meeting. POWs then also need to fit in time to complete paperwork, make chase-up phonecalls and discuss issues with colleagues.

On 27th July this year – a very normal Wednesday – 15 visits took place. We’ve picked out a few of them to give you an idea of an average day.

Kelly visited Sadia

Kelly works across Castle Vale, Erdington and Perry Common. Today she’s visiting a new client, Sadia, a vulnerable adult who was referred with the following risks: domestic abuse, financial hardship, social isolation, short term mental health and unsuitable accommodation.

Kelly’s notes from the visit say:

“This is Sadia’s second violent relationship. Her ex turns up uninvited, plays mind games and tries to scare her. He wants to be registered on the birth certificate. We talked about organisations who could help and did the usual first appointment check to see if she’s applied for maternity grants.”

Sadia’s statement on the Impact Assessment App says:

“We spoke about how I’m feeling at the moment due to having problems with my ex.”

Sarah visited Sophie

Sarah works across central and west Birmingham. She’s been supporting Sophie, a teenager, for five months now. Sophie was referred with the following risks: domestic abuse, diagnosed mental health condition, safeguarded (unborn) child.

Sarah’s notes from the visit say:

“A difficult visit. Following some things that Sophie told me last time I was worried I had to make a referral to social services. Today was about explaining why. Sophie was upset and angry at the start but then seemed to understand why this had to happen and that it was about getting her the support she needs. She is often confused and she’s also been self harming.”

Sophie’s statement on the Impact Assessment App says:

“We just talked and talked!”

Suad visited Munira

Suad works primarily with women from Arabic speaking communities. Today she’s making her 12th visit to Munira, who is a vulnerable adult due to a learning disability. She was referred with the following risks: vulnerable adult, vulnerable child, social isolation, mental health – low reported wellbeing, financial hardship.

Suad’s notes from the visit say:

“Took the supporting letter for Sure Start grant. Munira lost the first application so she’s doing it again. Social services are unhappy about how little support Munira is getting from her partner, they need to see he will share parenting otherwise it could be too much for her on her own. They’re also unhappy about her living accommodation as it’s unsanitary and unsuitable for a baby. I talked with her again about the actions she needs to take, and I took her some items from the Gateway baby bank.”

Munira’s statement on the Impact Assessment App says:

“Suad gave me a supporting letter for the grant application as I need to do another one. We went to a charity shop to buy a mattress and talked about the next child protection meeting.”

Miriam visited Annette

Miriam was previously seconded to the council as a Temporary Accommodation support worker, so she often takes on clients who need housing help. On this day, she made her fifth visit to Annette, who is living in south Birmingham and was referred to the service with the following risks: she meets the vulnerable adult criteria and safeguarded (unborn) child, temporary accommodation, social isolation and smoking. On the way to see Annette, Miriam dropped off a food parcel for a family she’s supporting with no recourse to public funds.

Miriam’s notes from the visit say:

“Annette is now in a hostel, but some problems as there have been complaints about noise and unpaid rent. I’m working hard to help her see that she needs to keep to the rules so she can stay. Baby will be arriving soon.”

Annette’s statement on the Impact Assessment App says:

“You went with me to my appointment to discuss my accommodation and you’ve said you will help me move rooms. You also spoke to my support worker about the service charges at the hostel.”

A happy coincidence

Although it’s wonderful to hear from past clients, most people choose not to get in touch once their support has ended… Which is why this story comes to you as a result of a happy coincidence.

Pregnancy Outreach Workers Service (POWS) Manager Justine went to the hairdressers the other day, and found a familiar face working in the salon: Anita, a POWS client she’d met and interviewed on video more than four years ago! Anita remembered Justine and her POW Nasreen fondly, and agreed to do a catchup video which you can see below.

Nasreen 2007
Anita’s POW Nasreen
We don’t often get to find out what happens to the women our POWs support. We just have to hope that the information, connections and moral support we offer gives them enough confidence and resilience to get on in the world independently. So we’re really pleased to hear how Anita’s getting on.

Anita’s story

Anita came to POWS in late 2011, some months after she’d arrived in the UK from Eritrea. She had recently become pregnant and, although she was working, the accommodation she was living in wasn’t suitable to bring up a baby. Not only that, but she wasn’t accessing any of the housing or maternity benefits she was entitled to, because she didn’t know her rights, or understand the system.

Anita’s POW, Nasreen, helped Anita to find out exactly what her rights were, and to start building a social network. Together they applied for better accommodation and the benefits she was entitled to, and Anita started visiting the group parenting sessions that POWS used to run at local community centres.

Anita gave birth to a beautiful baby girl, and eventually her POWS support ended. But what happened next? Watch the video below to find out!

Gaps in service leave women in danger

If you are affected by the issues in this story, please click here to see a list of links and phone numbers that might be able to help.


Mind the gapAt Gateway we often find ourselves “filling in the gaps” – in funding and in service. And on Thursday last week we were faced with a very stark reminder of this.

Julie (not her real name) was referred to the Gateway Pregnancy Outreach Workers Service (POWS) by her midwife, and assigned to Denise. They met for the first time on Thursday, at the house Julie shares with her partner.

Within minutes of meeting, Julie told Denise that she felt unsafe in the house, especially now that she was pregnant. She explained that her partner was extremely controlling and regularly violent. Although the police had been involved already, she’d denied the abuse when questioned in front of him because she was frightened. She told Denise, “right now, he’s asleep upstairs. If I leave him, I need to do it now.”

In a situation like this, the plan is always the same, and POWS know it by heart: get the woman to a place of safety, give her an opportunity to talk, and find her somewhere to stay.

Denise immediately called a colleague to pick them both up and let her manager know what was happening. While they were making their way to the Gateway offices so that they could talk openly, her manager was calling the relevant agencies to find Julie some accommodation.

However, it soon became clear that all was not going to go to plan.

Not pregnant enough

Denise and her manager Michelle made nearly 30 phonecalls on Thursday and not a single agency was able to accommodate her. Julie fell outside the criteria for every organisation.

None of the places of refuge, charities and other organisations – and yes, we tried them all – could take her because she is an overstayer (she had originally come to the UK on a short term visa, and hadn’t returned at the due time).

Apparently the fact that she is here illegally – despite having lived in the UK for many years and having a National Insurance number and NHS number – overrides the potential danger to her life.

Birmingham MASH (Multi Agency Safeguarding Hub) can help pregnant women, even those with immigration issues… but only from 20 weeks. At 15 weeks, Julie is not yet pregnant enough.

We are absolutely not looking for blame here; we are looking for solutions. Each organisation has to have boundaries, and for good reason, but… where is someone like Julie supposed to go?

By late afternoon things were looking desperate, so Denise took Julie to the police station (although of course this met with some resistance from Julie). After waiting to be seen for an hour, Julie told them everything; how she was trafficked here in the first place, why she can’t return to her home country, and the history of violence with her partner. But, again, it came down to “this is an immigration issue”.

We asked again, where is she supposed to go?

The police suggested many of the places we had already tried and eventually persuaded the Salvation Army, who had already refused her a place, to give Julie a bed for that night. But it was for one night only, and she would have to leave by 9am on Friday. They also suggested we go to the Neighbourhood Office first thing the next day.

In the morning Denise picked Julie up from the hostel. Together with a council officer at the Neighbourhood Office, Denise, Julie and Michelle spent another frustrating day speaking to agencies – many of which they’d already tried – and coming up against the same barriers. Referrals would go so far, only to be refused due to Julie’s immigration status and the fact she has no recourse to public funds.

By the time the office closed, Julie had had enough. She was tired.

That evening, she went home to her partner.

What’s the answer?

We don’t know what else we could have done for Julie, but her situation is by no means unique. It’s so frustrating to see someone in need and not be able to help them.

We are still supporting her, of course; we’re helping her to find out if she has grounds for citizenship and helping her to put together all the paperwork and information she needs to “become legal”. In five weeks’ time she will be able to re-apply to MASH for housing because she will be 20 weeks pregnant – and we will help her through that process too. We are giving her food and toiletries and ensuring she has access to her midwife, despite what is now an even more dangerous situation at home.

But we can’t make sure she’s safe, and that is incredibly, horribly frustrating.

Sharing our knowledge with the Child Poverty Commission

Did you know that Birmingham has a Child Poverty Commission? The cross-partner Commission, which includes the Council, the University of Birmingham and The Children’s Society, was set up in March last year to look at ways of reducing child poverty and making sure children are not disadvantaged by their background.

It’s early days for this group, though, and the first stage is for them to get the fullest picture of the extent of the issue. So we’re very pleased that they’ve asked us to get involved and share our knowledge.

At its launch, the Council’s press release about the Commission said:

“As well as asking professionals to give evidence, the commission wants to listen to the everyday experiences of children and families living in poverty and understand poverty from their perspective and bring to life the stories of children and families behind the hard statistics.”

We were asked by the City Council to get involved as they recognise that our Pregnancy Outreach Workers Service (POWS) works with some of the most in-need families in the city. The Commission is keen to see case studies and information compiled via our Impact Assessment App, but they’re also really keen to hear some experiences first hand, so they’ll be visiting us in a few weeks’ time to meet some of the families we work with and hear how life is for them.

POWs’ experiences of Child Poverty

mother-babyPOWs support some of the most vulnerable women and families in the city, and they come face to face with child poverty on a daily basis. The issue is immense… and it’s growing.

Some of the women we work with don’t yet have a child so, in these cases, “child poverty” includes the strong potential for the baby to be born into poverty.

More than 75% of the women we support record “Financial Hardship” as a current issue when they are assessed. This means they have unmanaged debt, rent arrears, or a low income and, in many cases, all three. For many of the women we visit, we also record that their living accommodation is unsuitable. This could mean overcrowded, in need of repair, or unsafe, and of course we have to take into account the imminent arrival of a baby. The main barrier the women have to changing this is financial hardship.

Since the POW service changed last April to working with the most vulnerable women only, we’ve seen demand for food parcels and hardship payments double. We are also seeing a growing number of women who are underweight or suffering from dietary deficiencies. This issue becomes a real danger during pregnancy, both to mother and child.

Although we do what we can, there’s a limit. Frequently, despite the hard work of our POWs, we’re not able to make things all that much better. To be honest, we often feel a bit helpless. So we’re very pleased to be able to talk about our experiences to the Commission and, hopefully, help to make a difference.

Celina’s Story

Celina* came to the UK from the Caribbean because she had been suffering domestic abuse from her partner (she has actually suffered a miscarriage in the past as a result of the abuse). Legally she should have returned to her home country by now, but her partner has been threatening her family and she is understandably frightened to return.

Celina’s had a lot of complications and medical issues during and since the birth, but her baby is doing OK. Like most of the women POWS support, Celina has dire financial hardship, and because she is now an overstayer, she doesn’t have any access to funds at all. She cannot claim any financial support and wouldn’t be allowed to work even if she could. She has told us she is worried for her own survival.

Just before Christmas, Celina’s Pregnancy Outreach Worker Jacque took Celina a Christmas hamper which included a few essentials – food, baby items and toiletries – as well as a couple of treats for mum and baby. You can hear Celina’s reaction in the video below.

*name has been changed

“I am here today because of you” – Bushra’s story

Bushra* was referred to the Gateway Pregnancy Outreach Workers Service when her life started unravelling and she didn’t know where to turn. In just a few months she had gone from being a college student, supported by friends and family, to being homeless with two mouths to feed and very little support.

Here, her Pregnancy Outreach Worker (POW) Jahanara tells us Bushra’s story, and we’ve also included some quotes from Bushra herself, because she logged her thoughts on our Impact Assessment App after every appointment.


“I am helping Bushra to build a new life without her family”

Case Study by Jahanara Begum, Pregnancy Outreach Worker.


Bushra had been referred to POWS because of social isolation and short term mental health issues.

Bushra and her baby

When I first contacted her, she said she didn’t want me to meet her at home. So I first met Bushra at her GP surgery, where she was attending an antenatal class. She was stressed and tearful, and told me the story of her pregnancy.

Soon after arriving in the UK with a student visa, Bushra had met a man at a bus stop. They got chatting and, thinking that he came across as a very Islamic, “good” man, she gave him her number. Over the next few weeks they spoke on the phone and met once, at McDonalds. He told her he would like to marry her; that he had spoken to his family and they had agreed.

One evening he phoned and asked Bushra to go out and meet him in his car, which she did. It was only the third time they’d met, but he took her to a hotel, telling her it wouldn’t matter if they took their relationship further because they were going to get married.

Bushra believed him.

When Bushra found out she was pregnant, she phoned her boyfriend but he told her he wasn’t interested. Soon after that he changed his number and disappeared. She had never known his address, so she wasn’t able to find him.


At our first meeting Bushra told me she just didn’t know what to do. She said her family would not accept her now that she was pregnant, and so it was impossible for her to go back to Pakistan. She told me her extended family are so strict that she was afraid for her life, and that of her unborn baby, if she was to return.

She was living with a family friend but she couldn’t stay there for much longer because, once her friend found out she was pregnant, she would probably tell her family. This was why she’d arranged to meet me at the doctors.

Bushra said her student visa would soon expire, which would make her an illegal immigrant, but she felt trapped. She couldn’t go back to Pakistan and had no money or recourse to public funds in the UK.

I am very stressed all the time but now that you’re going to support me, maybe things will get better. You have given me encouragement to think positive about my life.

The first thing we needed to do was to find out what support, if any, Bushra was entitled to. We went to a legal advice centre but they said she was not entitled to any legal aid, so I referred her to Asirt (Asylum Support and Immigration Resource Team) and the British Red Cross.

We went to British Red Cross together and they were very helpful. They made an appointment for Bushra at the Home Office and gave her food vouchers, and travel expenses to attend the appointment. They could only support her until her asylum application had been completed, because their funding is very limited, but advised that she should get support from NASS (National Asylum Support Service).

My family has found out I’m pregnant and they are sending me threatening email. My sister said I will not get away with getting pregnant.

By now, Bushra had moved in with another friend – although this friend had made it clear it was a temporary arrangement. Bushra attended the Home Office in Croydon and made an asylum application; however they did not apply for support for emergency accommodation or financial support because her friend had said she was willing to let her stay for another two weeks.

You have offered to get baby items from the Gateway baby bank, and a food bag. Although my friend provides me with food, I feel like a burden on her. I hate having to always ask her for money but I have no choice.

I contacted the migration helpline and got Bushra to speak to them via an interpreter and do an application over the phone for accommodation. I also gave her food, baby items, toiletries and a moses basket from Gateway’s baby bank.


Bushra wasn’t happy staying at her friend’s property, and her friend made it very clear she wanted her to move out as soon as possible, but Bushra needed somewhere to stay while her application was processed. I spoke to the friend and she agreed to let her stay until she had the baby.

As soon as Bushra had the baby her friend asked her to move out. So I phoned the migration helpline again and explained the situation, and Bushra completed another emergency application over the phone. The Refugee Council rehoused her, on the same day, to accommodation where she will live until her application is processed. They are also providing her with some financial support and helping her with her rehousing application.

I do feel lonely here and miss my friend and her son, so please can you visit me regularly. I have lost my family forever but miss my mum so much. It’s been so long that I have not heard her voice. But what can I do, I just have to live with this reality.

I am still supporting Bushra. I occasionally give her food parcels and baby items, and recently I’ve been trying to get her to visit the local Children’s Centre to meet other mums.

I am grateful to you because you’re the one who directed me to the services that helped me, so I am here today because of you.

*not her real name


Gateway Food Bank

We are currently taking donations of tinned goods and baby items for the food and baby bank at Gateway. The bank is increasingly needed by clients of all our services, not just the Pregnancy Outreach Workers Service. You can drop donations off at the Gateway offices, or give us a ring on 0121 456 7820 – if you’re local we can even collect.

You can find out more about donating to Gateway in the blog post called Why we are starting our Christmas collection early this year.

Thank you.

“My POW was there for me” – Rumbidzai’s story

Those of you who came to our Gala a couple of weeks ago, and listened to our clients’ stories, might remember Rumbidzai.

Rumbidzai had planned to speak at the Gala about the support she received from her Pregnancy Outreach Worker, Jahanara. But at the crucial moment, baby Sylvia decided that she didn’t want mum taking the limelight from her, and demanded a feed!

So to make up for it, we videoed Rumby on the night to hear what she had planned to say. You can watch the video below, but first, here’s a bit of background.

Rumby’s story


When Rumbidzai was first referred to the Pregnancy Outreach Workers Service (POWS) she was living in a hostel that isn’t suitable for pregnant women. As soon as she found out she was pregnant, she’d had to begin the process of moving out and looking for somewhere else to live with some urgency.

With help from her key support worker at the hostel, Rumbidzai was already bidding on properties and getting help with benefit claims. However, she was keen to have some extra support with the pregnancy – which is where Jahanara came in.

Jahanara said, “Rumbidzai has a good head on her shoulders, and she’s very focused, but she was anxious to get everything right for her baby, especially given her circumstances – which is why she’d been referred to POWS.

Pregnancy Outreach Worker Jahanara
Pregnancy Outreach Worker Jahanara
“Usually a lot of our support work involves helping women to make sure they’re getting everything they’re entitled to and showing them how to access further support, but Rumby was already on top of that, which was great. She is very independent.

“But becoming a first time mother when you’re young and single is a lot for anyone to take on. Rumby was especially keen to learn more about things like breastfeeding and bathing the baby, so that’s where we began.”

As a young first time mother Rumbidzai was very positive, but Jahanara could see she was anxious. She needed reassurance and, without any family or friends around, Jahanara was concerned about the lack of a support network.

So as well as giving Rumbidzai some practical one-on-one demonstrations of things like breastfeeding and bathing, and showing her videos and websites that she could look at on her own, Jahanara helped her to chase up important information and attend appointments (Jahanara says, “she made good use of my phone!”) and also referred her to a Gateway Volunteer Befriender who could offer extra time and emotional support.

Health and Wellbeing Dept Manager Jane with baby Sylvia at the Gala
Health and Wellbeing Dept Manager Jane with baby Sylvia at the Gala
Jahanara was also able to give Rumby a moses basket and other items from Gateway’s own baby bank, and put her in touch with Narthex to get vouchers for baby food.

Once Rumbidzai had moved into a flat, Jahanara helped to co-ordinate help from Homestart, Nathex, and Birmingham City Mission to get the property ready for baby.

After the POW support ended, things didn’t quite go according to plan, as Rumby explains in the video. But, as you’ll hear, she was able to access the service a second time – and Jahanara was there to support her again.

Pregnancy Outreach Workers: busy all year round

Although the summer holidays are traditionally a quieter time for many of our services, the Pregnancy Outreach Workers Service is busy all year round. Each of our full time POWs has more than 20 cases at any one time and we’re currently working with 248 women.

Unsurprisingly, since we changed our intake to cover the whole city, working with the most complex cases, we are hearing more and more stories of hardship. Here’s the story of just one of the women we’re supporting at the moment, as told by her POW Sylvia.

I helped Rosa to make a new life away from her abusive husband

Case Study by Sylvia Robinson, Pregnancy Outreach Worker
Sylvia, a Gateway Pregnancy Outreach Worker
Sylvia, Rosa’s Pregnancy Outreach Worker

Rosa and her husband had an arranged marriage in Rosa’s home country. After the marriage, Rosa’s husband flew back to the UK without her, but her family managed to raise the money to send her to the UK. She moved in with her husband but she says he was mentally and physically abusive towards her from the day she moved in.

Last year Rosa became pregnant, but her husband didn’t want her to have the baby. He took her to a clinic, but she didn’t realise he had booked an abortion until the doctor asked “are you sure you want to do this?”. She refused the abortion, but her husband tried this approach three times, taking her to clinics and using physical violence against her to try and persuade her to terminate the pregnancy. On the third visit she was told that her pregnancy had advanced too far for them to go ahead with an abortion anyway, so she was able to keep her child.

Rosa has family in Birmingham so, at four months pregnant, she fled her husband and moved into her cousin’s tiny flat. Her midwife had referred her to the POW service and so I went along to meet her at the flat.

I would describe Rosa as a nervous wreck at that first meeting. Her husband was continuing to phone and text her, making at least 500 contacts a day, so she was very stressed, but she opened up to me and we talked through her options. Her statement on the Impact Assessment App after that first meeting said:

He told me that if I wanted to stay with him I would have to do what he says. I am scared for me and my baby, I have no money and all my clothes are in the house.

My first concern was that she should report the abuse and get some protection for herself. She didn’t know where the nearest police station was – she hadn’t even understood that the police would be able to help her – but over the next couple of visits I encouraged her to make a police statement. She was nervous about what would happen, so I talked it through with her and explained what it might involve. It took a couple of weeks but she eventually went. The police took her very seriously and they began working towards getting an injunction.

He is still phoning the house and we are not answering but I know it’s him.

As a new arrival under a spousal visa Rosa had no recourse to public funds, and most of her belongings were still at her husband’s house. Her husband has a well paid, full time job, but he wasn’t giving any money to Rosa; she literally had only the clothes she stood in. With help from Women’s Aid we got a lawyer involved so that she could sort out her immigration status and become eligible for benefits.

I feel very happy now that I know things are happening for me. Thank you, you are so good to me.

Once things were starting to become slightly easier for Rosa I wanted to help her find somewhere to live; although her cousin’s tiny attic flat had been OK for her temporarily, it wouldn’t have been appropriate once baby came along. I phoned around local hostels, and got her a place at a mother and baby unit. I helped her to register for council accommodation and she began bidding for properties.

I have moved to the hostel. It is alright I have made some friends.

Two months after our first meeting Rosa asked me to go to court to support her with the injunction against her husband. We went together and he was given a restraining order.

mother babyAfter a long time without any money, Rosa eventually started to get income support so, two weeks before the birth, she was finally able to start buying clothes and equipment for her baby.

She was still living between hostels and her cousin’s flat when she gave birth to her baby, but a few weeks later she was housed in a more suitable long term property.

POWS support finishes at eight weeks after birth, so my time with Rosa is nearly up.

Her most recent statement said:

I am feeling a bit stressed right now with a new baby and a house, it is a lot. Just need help getting some furniture. I also want help getting child benefit, you told me that I need a form so I ask you to get me one. I also would like to get my child tax credit, you said you will help me thank you.

Rosa is still being supported by the police, who are going to escort her to retrieve her things from her husband’s house. Her solicitor is helping her to apply to stay in the country indefinitely and will be helping her to apply for rights on behalf of her child, who is not technically a British Citizen.

The solicitor is also helping Rosa to gather evidence about the domestic violence that she’s been subjected to, and she will have to go back to court over the next few months. Her husband continues to contact her and is applying for custody of the baby.

Why breast is best – some tips from our breastfeeding experts!

bf-toolkitNext week is World Breastfeeding Week, so for this week’s Friday Story we thought we’d ask our Pregnancy Outreach Workers (POWs) for their expert advice on breastfeeding.

All of our POWs are trained in breastfeeding support as part of Unicef’s Baby Friendly Initiative. A POW will work with a client for around a year altogether, building up the sort of relationship where their practical advice will be welcomed and listened to.

And we know it works: women supported by a Pregnancy Outreach Worker in Birmingham are more likely to breastfeed than the city averages. In the last contract year (April 2014 – March 2015), 76% of POW clients initiated breastfeeding, compared to 75% of new mums in the city overall. More importantly, they’re much more likely to maintain their breastfeeding than other new mums in the city: 62% of our clients continued to breastfeed and were still doing so at 6-8 weeks post birth, compared to a city average of just 43%.

This is even more impressive when you consider that our service is targeted on areas of high deprivation and some of these wards have a significantly lower average in terms of breastfeeding initiation.

Why breast is best!

By Pregnancy Outreach Workers, Khadijah Irving and Tynika Butler.


The main reason breastfeeding is better than bottle feeding is the convenience. It’s just so much easier to breastfeed compared to the hassle of constantly buying and preparing bottles, equipment and formula.

When you wake up in the night, what’s easier?

  • Getting out of bed, going downstairs, boiling the kettle, sterilising a bottle, making up the feed, cooling it down by putting the bottle into two or three changes of cold water… and all the time soothing your crying baby? Or…
  • Simply picking baby up and lying back down in bed to breastfeed?

Breast milk is the best food your baby could possibly have. It is naturally tailored to baby’s needs, right from the first milk you produce (colostrum). It contains all the nutrients baby needs, when it needs them, and your baby will have a much lower risk of illness (gastrointestinal infection, urinary tract infection, constipation, etc) as a result.

The skin to skin contact you get when you breastfeed is really important too. It helps to build a strong physical and emotional bond with your baby.


No competition here. Breast milk is free! Formula milk is about £10 a tin, and then you need to factor in bottles and equipment too.

It’s not widely known, but there’s also a cost at the hospital; if you want to bottle feed, they’ll provide you with disposable sterilised bottles, but you will have to pay for them.

Many of our clients use Healthy Start vouchers, and you can use these to buy powdered formula, but you must take into consideration that you only get £3 of milk tokens. When a tin of formula costs £10, and you have to make up the rest of the money yourself, AND buy the bottles, teats, sterilising stuff, cleaning brushes… it soon adds up.


Here’s a benefit for mum: breastfeeding is good for weight loss! Your stomach will appear flatter quicker because, as you breastfeed, it contracts the womb. You’re also losing up to 500 calories every time you do a feed. You’ll be back in those jeans sooner than you think!

Watch a breastfeeding demo

Finally, here’s a video from another one of our Pregnancy Outreach Workers, Shazia, with some demonstrations of breastfeeding positions and latching-on techniques… with a little help from her knitted “breast”!