The 5 Pillars to Emotional Health and Wellbeing

Our Approach

 

Antenatal Training UK and BirthWorld CIC sister companies have been developed from 10 years of collaborative research examining the impact that antenatal education can have on parental birth, emotional health and wellbeing. Our mission is to positively impact parents’ journey and experience. There are approximately 800,000 births per year in the UK. Our aim within the next five years is to reach 25% of these parents through  classes provided by BirthWorld CIC ran by specially trained Antenatal Training UK childbirth educators.

We have now developed a unique class system based on five pillars which enhance parent’s mental and emotional resilience during pregnancy and postnatally. This not only forms the foundation of the BirthWorld CIC antenatal classes, but also the core of the Extended and Advanced Antenatal Training and Hypnobirthing Diplomas. 

Why are The Five Pillars vitally important to you as a practitioner?

 

Without getting political – although that’s almost impossible , the maternity sector is in utter, life destroying,  crisis. And that’s putting it mildly. 

57% of midwives are due to the leave the NHS within the next year. Every month that goes by the Government are slowly privatising the NHS, my personal thought is that Covid has possibly speed up this situation by around 5 years.

Im so sorry if my thoughts have upset you, for me it makes me truly, truly angry, but just stay with a me a little longer, because it may be a blessing in disguise – a life affirming, positive wonderful blessing. Im actually torn between “watching” with held breath and anger. 

Im not sure if you have noticed a rise in media coverage of babies born without midwives present?

Perhaps you’ve heard stories of just how scared parents are to birth in hospitals with Covid, and without their partner? 

What perhaps you haven’t noticed is a rise in free birthing? A conscious choice by parents to take back control of their experiences?

I won’t get into the debate about safety of free birthing here, every birth choice has its place, whether that is a C-sec or freebirth on a mountainside. But it does signify a revolution is happening – how this will actually pan out is anyone’s guess, but it does mean one thing.

 

High Quality Antenatal Classes are in High Demand

 

Over the transition between the NHS and private services , parents will be needing and wanting that extra support, that stand out class that offers more than just pain relief options. They will want a facilitator that can genuinely help and support them through what will be increasingly a tough time on their mental and emotional health. 

Covid isn’t going anywhere fast – think of all the parents that urgently needed this type of class structure, and it wasn’t there?  (Carry on reading and I will show you exactly what damage this has done, and what we can do together to address this problem). 

This is in fact exactly why is started Antenatal Training UK and Birth World CIC just 13 months ago – because parents were traveling from Oxford, London and Cambridge to attend my classes in Leicester! I cant keep up and I need to reach more parents through passionate wonderful educators – exactly like you. 

 

The Five Pillars

 

Our Five Pillar approach has been developed over 10 years, so it’s out of scope to detail it all here. However, to give you an idea, some of the more important focal points are Hypnobirthing and Partners. 

Hypnobirthing is a very old technique that has grown in popularity to the point that Antenatal Training UK, now hold training contracts with NHS trusts to enable their midwives to  effectively support parents using this technique. 

Hypnobirthing has been shown to reduce the amounts of pain relief used during birth, babies are generally easier to feed and to settle. It is suitable for every type of birth and every situation. Hypnobirthing also demonstrates lower incidence of mental health problems and higher incidence of birth experience satisfaction, which is precisely why we treat it as vital part of childbirth classes, and why all BirthWorld CIC teachers use it during classes. 

However, many classes still treat this as a stand alone option, with some like the NCT not integrating this training, relying instead on just breathing and relaxation techniques.  

Another of our core principles is that of the Partner. This may sound unusual but we actually place the partner at the centre of our classes,  not the birthing parent.  This is multi-facetted, but generally it is because the research shows that partners are often censored and unconsidered by healthcare practitioners. This then greatly impacts an informed decision making and their ability to be actively involved during birth. Around 50% of partners experience postnatal mental health issues due to overwhelm, lack of preparation and involvement.

Other elements of our five pillars are

  •  research problem solving, self-determination, knowing the rights and responsibilities including when and where to get support and how to communicate effectively with their care professionals.
  • Future-focus is preparing parents to be ready for new changes and challenges that they have not been able to plan for such as an emergency Caesarean Section or sleepless nights. Being able to build adaptability and resilience is key to a smoother experience.
  • Self-care enables parents to function effectively whilst meeting the challenges with confidence.
 

 

Why is this vitally important for Parents emotional health and wellbeing?

Currently, only a very few NHS trusts are running free Antenatal classes. However, the course runs for approximately 2 hours only and focuses just on medical side of birth. There is no mental health included. These classes are usually oversubscribed too, meaning the parents cannot always access them. Different Trusts have varying rules, but generally the mother must be 37+ weeks pregnant to attend, whereby the parents feel this is often too late. They are similarly policy focused, rather than focusing on an individual which has been proven to impact mental health negatively.

In contrast the Antenatal classes offered by BirthWorld CIC are individual focused that attract the expectant parents at around 20+ weeks into pregnancy. By working with parents as early as 20 weeks, we can reduce the cortisol exposure a fetus is exposed to and impact more on the parents’ journey.

Suicide is the leading cause of the death in new parents for the last 15 years. According to the latest research, 30,000 women in the UK experience birth trauma every year, and around 50% of men experience postnatal mental health issues following the birth.

BMC Public Health UK has published evidence showing that perinatal mental health has further deteriorated since the Covid-19 outbreak. Impacting factors were:

  • Government ‘Stay at home message’ contributed to decline in parents seeking professional help.
  • Restriction to services including women having to attend appointments alone.
  • Partners only allowed to be present at later stage of birth, not during early labour.
  • Restrictions on group activities, family and friends leading women to be isolated and coping alone, which heightened anxiety and abandonment issues.
  • Parents have not had full informed choice leading to policy-based care.
  • 75% of parents report that Covid-19 had a negative impact on their mental health with 40% of those reporting a significant level of impact.
 

Instead of being happy and joyful, the experience of giving birth has been frightening and left women traumatized. And, as with any traumatic experience, a traumatic birth can lead to the symptoms of PTSD for both, the mother who experienced the event and for the father who witnessed it. As for the baby, the parents experiencing mental difficulties due to traumatic birth or pregnancy, are more likely to struggle with the care for their newborn. Similarly, mothers experiencing mental health problems antenatally are more likely to experience stillbirth, premature birth, and low birth weight babies.

This means, they are more at risk of heart disease and diabetes and have poorer neurodevelopment such as ADHD and poor cognitive development amongst many other physical problems that may occur.

The research shows that a child’s risk of developing emotional, behavioural, or physical problems is double that of the baby not born to a mother that is stressed, anxious or depressed. This is due to higher levels of cortisol the fetus is exposed to during the early stages of pregnancy.

Perinatal mental illness affects up to one in five of new and expectant mothers. If left untreated, it can have long-lasting negative effects on the woman, her children, wider family and consequently the society.

There is also a significant issue in perinatal mental health problems amongst minority and vulnerable communities due to barriers to access to services.

According to National Institute for Health Research UK the women from Black African, Asian, and White Other backgrounds have poorer access to services in the community than White British women.

These barriers consist of:

  • Language problems
  • A lack of understanding of the services available
  • A different cultural explanatory models of mental illness and expectations about appropriate help
  • Racism 

UK has a very diverse population and the national survey found that the population of women who give birth, the proportion of women from ethnic minorities is higher than from general population.

Vulnerable Communities, LGBTQ+, and BAME is a  core module within the Extended and Advanced Diplomas.