Re: : RE: : Fw: Post Natal Guideline Scope Consultation

[Guest guest]

Dear Sheelah, Ann and all veterans of the NHS in Cambridge,

I spent a happy hour in the British Library yesterday, waiting for a

train from Kings Cross, looking for research on vulnerable parents etc.

The most interesting thing I found is not directly related to mothers

sent home with sick babies, but may be of more general interest to

Senate:

Cochrane library, issue 2: Barlow, J & Coren E (2001). Parent-training

programmes for improving maternal psychosocial help.

23 studies of groupwork with parents, including some with professional

facilitators and some voluntary sector groups, were included in this

review. Several outcomes showed consistent improvements = depression,

anxiety/stress, self-esteem and relationship with spouse/marital

adjustment. The outcome of social support showed no change with

parent-training. Some other potential outcomes, like changes in anger

and aggression, were reported but not widely researched.

Best wishes,

Woody.

On Wed, 17 Dec 2003 09:56:23 -0000 Sheelah Seeley <sheelah@...>

wrote:

> Hi Ann

> I it interesting to see life repeating itself!

> That was a proposal at the Rosie in about 1995, in conjunction with the

> University Counselling Service - needless to say it fell by the wayside!

> So, best of luck this time - it is certainly needed, given that Joanna's

> Brazelton interventions with parents of sick babies has proved so helpful

> Sheelah

> Re: : Fw: Post Natal Guideline Scope Consultation

>

>

> Hi Woody,

>

> I was very interested in your point 3. I have just written to Jag

> Ahluwalia

> at the Rosie with a proposal concocted between myself, Joanna hawthorne

> and

> the community neonatal nurse there to have a health visiotr on NICU who

> can

> work with mothers using counselling skills etc and the Brazelton

> assessment

> to improve outcomes for parents and babies in particular the infant &

> parent

> mental health bit. Any refs you have I'd be grateful for although, of

> course, knowing cambridge there will be no interest!!

>

> Ann

> Re: : Fw: Post Natal Guideline Scope Consultation

>

>

> > Dear Cheryll,

> >

> > Three areas of postnatal care (other than postnatal mental disorders,

> > about which Senate has several national experts among its members)

> > spring immediately to mind.

> >

> > 1) Caan W, Messent P. Maybe midwives were too busy. BMJ 2002; 324: 486.

> > This contains a snapshot of a larger study of women's experiences by

> > Messent: in poorly organised and staffed services, women

> > post-Caesarian section frequently have bad experiences, and rates of

> > Caesarians have risen even higher than when Dr. Messent collected our

> > data in 1999.

> > 2) Caan W, de Belleroche J. Drink, Drugs and Dependence. London:

> > Routledge, 2002 esp. pages 161, 182, 191.

> > Increasing numbers of mothers with drink and/or drug problems

> > (including crack cocaine) are presenting. Deaths including suicide

> > after birth are increasing among these substance users, and while there

> > is an effort in some antenatal care services to improve the engagement

> > of these vulnerable mothers and their (sometimes) sick babies,

> > postnatal follow up is erratic and of no known effectiveness. Fear of

> > " social services " drives some mothers underground and so

> > non-stigmatising health visitor services might potentially be more

> > effective and supportive - especially as we found that trying to keep

> > one's family together was a major motivation for young adult addicts to

> > engage with treatment for the first time.

> > 3) I have just taken on a new PhD student from a background in

> > neonatology, who is very concerned on the basis of her clinical

> > observations, about the future relationships, between babies who passed

> > through her special care unit and their mothers. We know prematurity,

> > low birth weight, maternal substance use, chronic maternal infections

> > all lead to poorer prospects in childhood - but too what extent can

> > these early adversities be overcome through more intensive parent

> > support (as in Olds' US research on intensive home visiting)? I suspect

> > that some Senate members may already have some Grey Literature like

> > reports or dissertations up their sleeves on postnatal interventions

> > after small or sick babies (what were all those weighing scales for,

> > after all?) - do let Cheryll have your good news!

> >

> > Woody.

> >

> > On Sun, 14 Dec 2003 22:43:27 -0000 CHERYLLAMICUS

> > <adamsc.cphva@...> wrote:

> >

> > ----------------------

> > Woody Caan

> > a.w.caan@...

> >

> >

> >

> >