Tag: pow

Food and baby bank donations from Asda – thank you!

 

PLEASE NOTE: This blog post is from 2013 and we no longer run a baby bank at Gateway. If you have items to donate, you could try Birmingham Baby Bank Central.

 

asda1We were delighted to receive donations for our food and baby bank from two generous Asda stores this week.

Knowing that many of our POW (Pregnancy Outreach Worker) clients are in need of basic essentials, and to coincide with this year’s International Women’s Day, staff at Asda Cape Hill generously offered to organise an in-store food bank drive for Gateway.

Judah Griffith, who is a Community Life Champion for Asda, explained, “At the Cape Hill store, we wanted to celebrate International Women’s Day, which was on 8th March. Rather than just a day, however, we organised a whole week of activities.

“I was already aware of Gateway – they’ve helped me with my voluntary work in the past – so I got in touch and asked how we might best be able to help their POWS clients. Gateway responded with a list of items they’re most in need of and we got to work.”

Pregnancy Outreach Worker Caroline (second from right) with Asda's Community Life Champion Judah (right) and other Asda staff
Pregnancy Outreach Worker Caroline (second from right) with Asda’s Community Life Champion Judah (right) and other Asda staff

Staff at the Cape Hill store distributed leaflets with information about the POW service and asked customers to buy an extra item from a POW shopping list, which they could then drop in to a donations trolley on the way out.

The staff themselves then clubbed together to top up customers’ donations with their own, and asked their colleagues at the Small Heath store to do the same.

Thanks to the generosity of customers and staff, we now have some much needed parcels to give to our most disadvantaged families.

Where do donations go?

The donations have been made up into parcels which our POWs have already started taking out to their clients.

These food and toiletry parcels help us to help new mums and their families through particularly tough times.

There are lots of reasons that our POW clients find themselves in need of help to tide them over. Many women are eligible for benefits but experience delays in payment, especially during the move from Income Support to Maternity Allowance. Some women are between homes – fleeing domestic abuse, for example, or evicted from the family home. Some have fled their home country to seek asylum and have no recourse to public funds. All are trying to give their babies the best possible start despite their own vulnerability and needs, so a little help goes a long way.

We’d like to say a big “thank you!” to everyone who donated to the Asda drive.

If you’d like to donate…

We’re always very grateful for donations of food and baby essentials for our new mums and mums-to-be. If you think you might be able to help, please give us a call on 0121 456 7820.

"Thank you. The things you gave for the baby are going to come in handy as my claim for maternity grant was returned, so there will be a delay." - POW client Nikita
“Thank you. The things you gave for the baby are going to come in handy as my claim for maternity grant was returned, so there will be a delay.” – POW client Nikita

The things we find really useful for our food and toiletry bank are:

Rice/lentils
Pasta
Tinned Food
Nappies
Cereal
Toiletries (baby/women)
Long life Milk
Cordial
Coffee/Tea
Oil
Dried spices

The toiletries that are especially appreciated include nappies and maternal sanitary pads, both of which are essential for new mums, but expensive to stock up on.

We also work closely with Narthex, who often provide food parcels to our clients. If you’re in the Sparkhill/Sparkbrook area and you want to give food to those in need, please consider taking donations to Narthex. We know they would be glad of them.

In fact there are many food banks operating in and around Birmingham.  If you’re interested in finding out more, The Trussell Trust have compiled a foodbank map showing what’s available.

Budget Consultation: is it asking the right questions?

Here is an extract from the Budget Consultation for Adult Social Care. This is the proposal relating to Gateway’s Pregnancy Outreach Worker Service (POWS):

Proposal 15: Public Health – decommissioning pregnancy outreach

This proposal is to stop funding initiatives around pregnancy support. These services have been running as a pilot for some time and are awaiting evaluation. These services could be supported through the Health Visitor expansion, a responsibility of NHS England. Pregnancy outreach is not a traditional responsibility of the local authority. The cessation of these services will affect the most disadvantaged communities.

Question: Unless the evaluation shows good outcomes, should we decommission these services?

There are two important points I’d like to make about this consultation.

The first is that it refers to POWS as a pilot. The Pregnancy Outreach Worker Service is a contracted service that is performance-managed against a clear set out outcomes. It has been running for seven years and has consistently achieved its contract outcomes.

The second point – my main concern – is about the question you are asked to answer:

Unless the evaluation shows good outcomes, should we decommission these services?

It’s natural to read this and think, “of course a service should be decommissioned if it’s not shown to achieve good outcomes”. I certainly would. But is the public getting the full picture?

The outcomes in our contract cover things like safeguarding, housing, domestic violence, substance misuse, alcohol use and debt management. And we prove, every month, that we deliver on these.

In fact, we place so much importance on measuring our outcomes and impact that we devised a management information system for POWs, based on multiple national outcome frameworks for pregnancy and birth. This includes an Impact Assessment App that gathers direct feedback from the women we help.

But what is “the evaluation” the consultation refers to?

The evaluation that the question refers to – the evaluation upon which the future of POWS will depend – is a Randomised Control Trial (RCT) that took place in 2010-11, the results of which are not yet available.

An RCT, by its very nature, is a clinical trial. Generally, RCTs are set up to assess the effectiveness of medical interventions: drugs, or medical procedures. This one tested the impact of POWS on clinical, more than social, outcomes; things like postnatal depression, whether a mother had suffered an episiotomy tear during the birth, method of delivery (C-section or forceps) and length of stay in hospital.

But POWS is not a clinical service. The RCT couldn’t, and didn’t, cover social interventions … so it doesn’t measure the vast majority of the outcomes the POWs are contracted to achieve.

Why is Birmingham Public Health using an RCT to evaluate the Pregnancy Outreach Workers? Well, it’s the only type of trial they have – it’s the only evaluation method that has the required “academic rigour”.

I understand that RCTs are the gold standard for clinical research, and that the results will have academic rigour. My concern is that other evaluation methods, particularly those that assess social outcomes that are known to increase the risk of infant mortality, should be taken into account. At the moment this is not being considered.

It’s also worth mentioning that we had to change the service to fit the requirements of the trial; it was restricted to first time mothers and we could only work with women already booked with a midwife. After the trial we were able to work with women who had had other children (many in care) and referrals from other agencies, such as hostels, refugee and asylum support services – but we were unable to do this during the evaluation period.

We’re still fulfilling our original aims

The Pregnancy Outreach Service was originally set up as part of Birmingham’s efforts to reduce infant mortality. Of course, no-one can directly reduce infant mortality; all you can do is to try and reduce the risks associated with a poor pregnancy. Some of the risk factors are things that we can’t do anything about, like the age of the mother – but some, like nutrition, or smoking, are factors we can address, so we concentrate on those.

We soon realised that there are social barriers many of our clients need to overcome before we can address their health issues – domestic violence, debt, or homelessness, for example – so we tackle those first and achieve our original outcomes via a slightly longer route.

risks Over the years the service has been running, we have worked collaboratively with commissioners to take these social issues into account and design our outcomes. The screenshot on the left shows just some of the current risks that our POWS are working with.

Reducing these risk factors is what helps to reduce infant mortality. And so, of course, we believe these are the outcomes we should be tested on when the future of the service is being decided.

All services commissioned by the council should be constantly evaluated and we are constantly evaluating ourselves. But it’s frustrating that the future of the service is dependent on one evaluation, which assesses us on a very small area of our work.

We WANT to be evaluated. We want to prove our worth. We deliver on our outcomes every month and we’re proud to show that. I’m not dismissing the RCT – it is important as part of a fair evaluation of the worth of the service. But we are so much more than this.

If you would like to give your views on POWS being decommissioned, you can take part in the Budget Consultation for Adult Social Care by filling in the online consultation questionnaire.

The Proposal relating to POWS is Proposal 15, on page 21 of the Budget Consultation 2014 pdf.

Birmingham Budget Cuts – we need your views

Public consultation on the budget cuts for Birmingham include cutting the Pregnancy Outreach Worker (POW) service in 2015. If you have a view on this, please contribute:

THE DEADLINE IS 10th JANUARY

You can fill in the online survey here

Or use the public computers at one of the libraries

– Submit comments by text at SMS by texting ‘Budget’ followed by a space and your message to 07786 200 403
– Write to Budget Views, Room 221, Council House, Victoria Square, Birmingham B1 1BB

Baby banks – not just for Christmas

 

PLEASE NOTE: This blog post is from 2013 and we no longer run a baby bank at Gateway. If you have items to donate, you could try Birmingham Baby Bank Central.

 

Food banks have been in the news more than ever this year and recently the papers have picked up on the idea of “baby banks”, like ours, which collect and distribute baby products to families in need.

baby-parcelOur Pregnancy Outreach Workers have been busy this week making up Christmas hampers for their clients… but they don’t just give out parcels at Christmas. There’s an increasing need for donated toiletries, nappies and baby food all year round. Many families are on a low income that has stayed low as prices have gone up. Many are eligible for benefits but experience delays in payment. Some are between homes – fleeing domestic abuse, or seeking asylum. All are trying to give their babies the best possible start despite their own vulnerability and needs.

Here are some comments from clients who have been helped by parcels from our POW service over the last few months, whether that’s from our own bank of donations, or with a lift to one of Birmingham’s other foodbanks, like those at Narthex’s Sparkhill Food Bank or the Trussell Trust’s Birmingham Central Foodbank.

Making a difference – in our clients’ own words

In August, Daniele* said:

You accompany me to charity to get food parcel and baby things and which was very helpful thank you so much.

Diane* said:

today you came to my new flat that i moved into on saturday an brought me lots of baby things an a food parcel thankyou for everything you have done im realy greatful.

and Nishat* said:

You gave me book on pregnancy and leaflets on healthy diet. You have also informed me that you have been able to obtain a moses basket and will drop it of later. I feel so much better knowing that my child will have the necessary items. I was worried because i have left work and made a claim for benefits just recently. My claim is still being assesed and at the moment i have no money. You have been kind enough to supply me with a food parcel aswell. I feel so much better knowing that you are their to support me.

In September, Fozia* said:

Mariam came and brought me food parcel which is good as i have had no benefit for 2 weeks.she also brought me a moses basket changing mat, bath bouncer and clothes for baby thank you very much for everything

and Husna* said:

You gave me a food parcel. This has helped me so much as i live by myself these food parcels will last about a week. I cant thank you enough, now i can use the little amount of money i have to pay a instalment on the water, gas and electric bill.

in October Tamsin* said:

You went with me to Narthex for clothes and items for baby such as blankets, coat, moses basket, bath, baby gym, toiletries for my hospital stay, steriliser, nappies and changing mat. You also went with me to a charity shiop to buy a car seat and bouncer from gateway hardship fund. Thank you so much Miriam I do not know what I would have done without you’re support.

in November, Laila* said:

My benefit claim is still in process. I did not have much money, my pow has bought me two bags of food aswell as baby items such as clothes. God bless you all. In hard times you were there

and, just two weeks ago, teenager Gemma* said:

Im really worried about my baby being taken off me by social services. Im worried about everything and now I got to go behind my partners back and leave him. I’m scared but know its the right thing as my baby comes first. I haven’t got much money and today my POW gave me baby clothes, toiletries, blankets and food and I really appreciate it and making me excited for my baby to arrive.

hampers2Our baby bank is in demand all year round – but, at Christmas, we try and give some of our clients a bit extra with a Christmas hamper. The hampers contain not just food and baby essentials, but some gifts for mum and any other children in the family.

The bank holidays and delayed post mean that it can be more difficult to get help over the Christmas and New Year period; many of our clients find themselves in need over the holidays. So, even if a family doesn’t celebrate Christmas, the hampers are welcome.

In the video below, Catherine is putting together a hamper for her client Maya*. Whilst recovering from a C Section, Maya’s benefits were stopped due to a mix-up at the Jobcentre. “She signed something she didn’t understand, because her English is very limited and there was no interpreter,” Catherine says, “and it stopped her benefits. When she realised what had happened, she made lots of attempts to appeal and, finally, I wrote a long letter in her support.

“But, even once it had been agreed that her benefits should be reinstated, it took another two weeks for her to receive them. It was a real mess, because of course she’d got a new baby and she was still recovering from the birth, and suddenly found herself with no money. We had to give her and her family some food, from our own donations and from Narthex, during those weeks. She’s had a really tough time, so this is just a little gesture from us.”

Thank you to everyone who donated – and continues to donate – to the Gateway food and baby banks. We wouldn’t be able to give out our Christmas hampers without the donations we receive from Healthy Minds, Birmingham Registry, Vineyard Network Church and The Samaritans Purse, who’ve provided us with lots of hand knitted baby clothes and blankets.

*names have been changed

Opening up about domestic violence

We know that around 10% of the women our Pregnancy Outreach Workers Service works with are, or have recently been, experiencing domestic violence (DV).

For many women, becoming pregnant means that they are experiencing support from a range of professionals for the first time in their lives. So for many, it’s the first time they have the opportunity to talk about the things that are going on at home.

But having a lot of questions asked about their body and their home life can be quite daunting, so – unsurprisingly – many women find it difficult to open up. It takes time to build up the sort of relationship that allows these sorts of conversations to happen.

Often, women won’t disclose domestic violence to their midwife or health visitor but, given the longer period of support offered by a Pregnancy Outreach Worker, will eventually disclose to their POW.

One such client, Hasna*, was referred to us by her midwife. Catherine, the POW who was assigned to her case, says, “Hasna hadn’t mentioned her current situation to anyone, but her referral said she’d experienced ‘previous domestic violence’, so I knew it was something we might have to talk about at some stage.”

Catherine, Hasna's Pregnancy Outreach Worker
Catherine, Hasna’s Pregnancy Outreach Worker
Like most women we work with, it took a while for Hasna to talk about the relationship she has with her husband in any detail.

“When I first meet a new client, even if I know DV might be an issue, I don’t go into it unless she wants to talk about it herself,” says Catherine. “When I first met Hasna, she would talk a lot, and talk fast, but never about DV. It took a few visits, and a few instances of me talking around the subject, for her to calm down and start opening up”.

The POWs are very careful not to push women to talk about abuse until they’re ready. Obviously if there is evidence of violence, or if we feel mum and/or baby are at risk, we are obliged to act and refer to police or social services, but otherwise, we must ultimately respect the woman’s choice.

Another POW, Lynette, remembers a client who hadn’t disclosed domestic violence to anyone, but she felt there were signs in the way she talked and behaved: “I was waiting,” Lynette says. “I knew something would come out. I gave her lots of opportunities to talk if she wanted to, but didn’t push it. Eventually – after the birth, she opened up and we were able to have that conversation and take some steps”.

Catherine agrees. “It’s vital you don’t break your client’s trust. Everything goes in cycles and you know the time will come at some point. You just need to wait until she has the confidence to talk.”

So once a client feels able to talk about domestic violence, how does the POW support her?

“It’s easy for people to think ‘she should just leave him’, but that’s not the right approach,” says Catherine. “The idea of leaving is just huge; not just emotionally, but because there are so many other things to consider. If a woman is being controlled by her husband, for example, she might not have the money or the other practical things in place. The idea of going out into the world alone is frightening”.

Catherine says things are changing at home for Hasna, but Hasna knows she has to be ready with a ‘plan B’. “Now her husband knows that she speaks to other people, and that other people might be aware of what goes on at home, he’s more wary,” Catherine says. “And she feels able to challenge him more, which is good. But, together with a DV worker, we’ve been putting everything in place so that she can leave quickly at any time, should she decide she wants to.”

As well as making sure Hasna has access to money and passports, part of this work means signposting Hasna to other organisations. As well as her DV worker, Hasna is in regular contact with the Freedom Project and her local children’s centre. She knows that she can go to the police at any time and she’s building up a good support network in her local community.

In this video Hasna talks about her relationship with Catherine, what she’s learned and how she feels more able to talk to other professionals because of her.

*some names have been changed

Tackling the teenage pregnancy myths

The media image of teenage pregnancy – that rates are soaring; that teens are getting pregnant to try and play the system; that they then make bad parents – is far from the truth.

For example: according to a recent MORI poll, the British public think teenage pregnancies are far more common than they actually are. The Independent reports that:

Teen pregnancy is thought to be 25 times higher than the official estimates: 15 per cent of of girls under 16 are thought to become pregnant every year, when official figures say the amount is closer to 0.6 per cent.

But these myths just makes things even more difficult for those who find themselves in this situation and have to deal with it.

At Gateway, Pregnancy Outreach Worker Caroline works exclusively with teenagers. She says the mums-to-be that she works with battle against these kinds of misconceptions every day.

“People think that teenagers get pregnant on purpose, so that they can get a house or extra benefits. But that’s just not true. For the girls I work with, pregnancy is usually an accident and it can be a big shock for the whole family.”

Fifteen year old Megan is a good example of a teenager who challenges these perceptions. Like many teenagers who become pregnant, she lives at home with her family and intends to stay there. So in terms of benefits she’ll get Healthy Start vouchers, which concentrate on enabling her to feed her baby, but any state support goes to her parents – and that’s only if they’re entitled to it. If they’re working, they’re entitled to very little.

Caroline says that the biggest myth her clients face is that, simply because they’re young, they’re going to be a bad mum. But there’s no reason that that should be the case. Megan’s got the makings of a responsible parent. At 15 she’s already knowledgeable and interested in what will be good for her baby.

“As well as all the worries that every pregnant woman has, teenagers are also up against the constant assumption that they’re going to be a bad mum,” says Caroline. “But Megan’s really keen to do what’s best. So a big part of my work with her, and the other teens I see, is helping to build her confidence. Armed with the right information, she can go on to make good decisions for her and her baby.”

In this video, Megan talks about how she’s preparing for labour and life with baby.

What Megan does acknowledge is that she needs support, reassurance and access to information – and Gateway, along with a couple of other services across the city – are providing that. As for the cost, Caroline’s support to date works out to be well under £100; if it plays a part in ensuring that Megan can give her baby a good start, then it demonstrates good value for money.

In many ways, Caroline’s support is very similar to the work that all our POWs do, but she often finds she has to approach things slightly differently.

“I think I have to offer quite intense support,” she says. “These girls are still at school, where they’re used to being taught, but that means they’re taking in a lot of information at once. I have to work out the best way to make sure it all sinks in. I do a lot of role playing, a lot of visual stuff, and I repeat the same things in different ways. I have to try and keep it interesting without being overwhelming.”

Caroline’s support doesn’t just cover preparation for the birth. She is there with a non-judgmental ear when teens need to talk, and she also gives a lot of practical help and support with the life skills that most young people won’t yet have had much experience with, like budgeting.

Family dynamics are important, too. “Sometimes they tell me things that it would be difficult to talk to their parents about,” says Caroline. “It can be a stressful time, so it’s often better for them to speak to me impartially than to risk conflict, however well-meaning, at home.” Caroline works with the whole family – the parents, too, have her number to talk things through if they want to.

The support Caroline gives is complemented by that from other agencies. “The FNP (Family Nurse Partnership) is great,” says Caroline. “It’s a structured educational programme for 16-19 year olds, with support from a Family Nurse until the child is two. Then Megan has a specialist Teen Midwife. We work really closely; they cover the clinical side of things and we focus on the social issues. That way we’ve got it all covered.”

Working together means that, once Caroline steps out, the client is fully integrated into services that will support her going forward.

To find out more about the benefits available to teenage mums, have a look at this benefits calculator from Gingerbread.

Gateway POWs: breastfeeding figures are up again

Our figures for last year show that women supported by a Pregnancy Outreach Worker are more likely to breastfeed than the regional and national averages. Have a look:

Average number of new mothers who initiated breastfeeding:

Gateway clients 79%
Within the wards we cover 65%
Birmingham 69%
West Midlands 78%
Nationally 81%

 

Of those who initiated, those who continued to breastfeed at a week after birth:

Gateway clients 89%
Nationally 69%

 

Of those who initiated, those who continued breastfeeding after 6-8 weeks:

Gateway clients 69%
Birmingham 44%
West Midlands 31% – 54%
Nationally 55%

– Out of the 578 women we were supporting last year 197 had given birth by the end of March.  This is the data set used.

– Ward figures are taken from the Birmingham Health Inequalities Action Plan 2012, Birmingham.

– “Birmingham” is an average of the rates achieved in Birmingham’s three former PCT areas.

West Midlands figures are taken from Initiation, Uptake and Sustainability of Breastfeeding,  West Midlands Public Health Legacy Series, 2012,  Dept of Health.

– National figures are taken from the Infant Feeding Survey, 2010.

Why does POW support make a difference?

We think there are a number of reasons that support from a Pregnancy Outreach Worker results in an increased likelihood of a woman breastfeeding.

  1. Practical advice and training before the birth

    Unlike other services, POWs support most of their clients for the best part of a year. It means that they have plenty of time pre-natally to talk about breastfeeding and, where necessary, persuade mum to give it a try.

    All our POWs are UNICEF Baby Friendly Initiative trained, so they can put on impromptu one-to-one or group training as required.  As they build relationships with their clients, they try and make sure that everything’s in place for the mother to be comfortable with the practicalities of breastfeeding well before she gives birth.

  2. The POW can be there immediately after the birth, even in the hospital

    Pregnancy Outreach Worker Sylvia says, “if they don’t try and breastfeed in the hospital, straight away, it’s much more difficult to start”. Caroline, who works with teenage mums, agrees: “We try and do as much preparatory stuff as we can before the birth – because it all gets so much harder afterwards.”

    The POWs know when their clients’ babies are due, so they check in regularly with them around the time. They aim to speak to them as soon as possible after the baby arrives, so they are there to answer questions. Many go to visit while mum is still in hospital and frequently, whilst there, they will give practical breastfeeding support.

    Once mum and baby are home, POWs can continue to give practical, hands on advice. They’ve already built up a relationship with the mother, which makes it much easier to offer this kind of help. They can also also provide lots of advice over the phone and often do this out of hours.

  3. Introducing clients to more support networks

    The ideal circumstances for a mother to breastfeed include the feeling that she has plenty of support from likeminded people. So POWs always  try and introduce their clients to the various networks and groups that are available to new parents – often taking them along to clinics themselves.

    Sharon, a POW, recently took a client to the Women’s Hospital breastfeeding workshop. Sharon says “It’s a good network to be part of – very informative and very pro-breastfeeding. At the drop-in clinic they can meet the breastfeeding co-ordinators and other mums for practical advice, and talk about their fears as well as the pros and cons of breastfeeding. They get the contact numbers of counsellors to phone for support. It gives them some structure as well as social support.”

 

Coping with post-natal depression

Veronica talks about coping with post-natal depression.

Pregnancy Outreach Workers help with practical things but also offer emotional support too. Veronica suffered from severe post-natal depression. It can be hard work to deal with a new baby, but post-natal depression can make life seem impossible. Because Veronica felt unable to deal with anything at all, things piled up. Bills weren’t paid and important letters were ignored. She also had two other children that needed looking after.

I helped Veronica sort out her finances, fill in forms and make the phone calls she felt she couldn’t manage; I also helped her find a child-minder which made a big difference – and I tried to keep her outlook as positive as possible. Sometimes I even made her laugh!

All together I supported Veronica for seven months, and eventually she was able to manage much better by herself, and her baby girl did well too.