antenatal peep online: Highland

planning

In August 2020, we (Gillian Forbes, Highland Council Peep Co-ordinator, and Mairianne Nairn, CALA Family Services Project lead) - with the support of Highland Council's Midwifery Development Officer and her team - piloted Peep Antenatal Programme sessions online, to help support pregnant mums/families within the area during the Covid 19 pandemic. As two experienced, Peep Antenatal-trained practitioners, we adapted elements of the programme so that we could deliver it flexibly online with families with wide‑ranging needs.

recruiting and engaging parents

We received positive feedback from the parents and professionals involved in the pilot sessions, and it was agreed to continue offering sessions, particularly to families with additional support needs.

Once referrals were received from the midwifery teams, we made contact with each parent to introduce ourselves, establish expectations for the sessions and answer any questions. Parents-to-be start the course around 26+ weeks of pregnancy.  Initially we offered 1-1 sessions, but moved on to small online groups. This enabled parents to get to know other parents-to-be, support each other, and integrate more into their community. Isolation was a particular issue for families during the pandemic, with little opportunity to meet other families.

From our first involvement with the families we actively encouraged the pregnant mums to invite husbands/partners or family members to join the sessions as a source of support.  During the 1-1 sessions and small groups we had several dads joining and engaging.  We were conscious that the sessions had to offer lots of opportunity for discussion and for the parents to feel comfortable asking questions and share personal information. 

course content

The Programme supports parents perinatally [i.e. before and after the birth] to reflect on their developing baby, tune in to their baby's feelings and behaviour and respond sensitively (known as reflective functioning). This helps parent-baby bonding and attachment, and reduces the risk to the early parent–baby relationship, helping to prevent isolation, anxiety and low-level depression.

All sessions are a mix of discussion, video clips, sharing of relevant research and advice, songs/rhymes and story sharing, all underpinned by the focus on reflective functioning.  After the initial phone conversation with the parent/s, we offer five online group sessions of about an hour each:

  1. Getting to know each other
  2. Supportive networks
  3. Transition to parenthood
  4. Developing brain & Emotional support
  5. Baby states

Following these five sessions, we offer a reunion session once the babies are born.  Throughout the course we also signpost parents to other groups or provisions within their local community.

outcomes and feedback

All families that attended our sessions kept in touch and let us know when baby was delivered.  Several of the families have continued to stay in touch with each other, creating WhatsApp groups and meeting for socially distanced walks together.  Having that social network in their own local community is vital for community engagement and maintaining positive mental health.

parents’ feedback

'I think it was very interesting and informative to learn about how to talk to our baby and what to do to communicate.  I didn’t think to read to them since I didn’t think they would understand but I definitely will be reading to them as early as possible.'

'It has been great to meet other mums-to-be as Covid made it feel very isolating and alone, but knowing there are other mums experiencing the same things as me is very comforting.'

'I really enjoyed the course and will miss our weekly chats, however I’m delighted to have met some new people who will hopefully become lifelong friends, and Bump’s new friend group to grow up with.'

'All sessions were very positive and upbeat with some great ideas, we have been able to adapt to our own pregnancy and planning for the baby’s arrival.  I definitely felt the sessions boosted my confidence.'

'The sessions felt relaxed and were supportive.'

'The discussion around bonding and communicating with your baby helped prepare me for my baby being in SCBU [Special Care Baby Unit]. By singing and talking to her, she was able to recognise my voice.'

referrers’/ midwives’ feedback

'My client was struggling with anxiety and social isolation due to the pandemic, she has been complimentary on the emotional support she has received from the Peep Co-ordinators.'

'I think every parent would benefit from this service as we cannot put a price on the wellbeing of the next generation.'

'The weekly update received following each session [with parents’ permission] is great, and I add this to their maternity notes.'

'My client thoroughly enjoyed the sessions - she stated she felt she was doing something practical to improve her parenting knowledge and skills, and that this was at a comfortable pace.'

feedback from the Midwifery Development Officer

'The Antenatal Peep sessions have been universally welcomed and supported by all the Community Midwife Teams across the whole of Highland. It fits well within the GIRFEC framework [Getting it right for every child], and with families recommended for additional support at the HPI [Health Plan Indicator] wellbeing assessment around 16 weeks of pregnancy. 

The flexibility of the programme being delivered online or face to face (within Covid restrictions) and either in a 1:1 or group  format has been most welcomed. The Antenatal Peep Programme helps maternity services reach parents who have been historically difficult to engage in more traditional parentcraft groups, such as young parents, parents in more remote areas, and parents who are isolated or have anxiety as well as those using substances.

The sessions fill an important gap in welcoming fathers to take an early and active role in developing loving and secure attachment through deeper understanding of how to connect with their unborn babies, and to consider some of the social and emotional aspects of transitioning to parenthood.

The potential to connect with other parents albeit virtually has been particularly vital during the Covid 19 pandemic and has allowed both prospective parents to connect with other families through this challenging time. The classes are an important intervention in assisting with developing positive parent and infant mental health, and will complement the work that will be undertaken in Perinatal and Infant Mental Health teams.

Feedback from service users has been very positive. The topics covered were found to be fun and informative, often expanding on the basic knowledge they already had, at a pace and time that was suitable. The coping skills developed during the course proved to be very useful once the baby was born, and parents felt that they were able to understand their baby’s feelings more easily and figure how best to respond.

Thanks to Gillian Forbes (Highland Council Peep Co-ordinator) and Mairianne Nairn (CALA Family Services Project lead) for sharing this case study.