Happier beginnings

When baby Samuel was born 12 weeks early in December 2010, his parents’ lives were turned upside down. Zoe Barker and Darren Scotford nearly lost their son to a severe chest infection and were unable to see him every day after he was transferred to a hospital in Sheffield miles away from their home in Nottinghamshire. When they finally brought him home in March last year, they soon realised they needed help.

Samuel was born less than three months after mum Zoe found out she was pregnant, giving the couple little time to get used to the fact that they were finally expecting a child after 16 years of trying to conceive.

For the 36-year-old, who has diabetes and cerebral palsy and relies on her husband as her main carer, the stress of those first weeks was overwhelming. “After he was born, I went downhill very quickly,” she recalls. “We’d only known I was pregnant for 11 weeks. Mentally, I wasn’t prepared at all.”

It wasn’t just Zoe who was overwhelmed. Her carer and husband Darren suddenly found he was looking after two people instead of one. “My responsibility was shifted,” 38-year-old Darren remembers. “I was seeing my friends much less and it was a big shock to the system. In that first month, I said: ‘I don’t want him.’ I couldn’t sleep and my emotions were everywhere.”

Luckily, Zoe’s midwife had predicted the couple would need extra support. After Samuel was born, she referred Zoe to the perinatal support project run by Family Action, which runs two children’s centres in West Mansfield, Nottinghamshire. The couple were allocated a volunteer “befriender” called Caroline, who started visiting the couple several weeks after they brought their son home, to help with the practicalities of bathing, changing and dressing a baby whose mother was unable to lift him herself.

Caroline has since gone on to pursue a social work degree and was replaced in September by a second befriender called Sam, who has been getting Zoe out of the house and introducing her to baby and toddler groups. Zoe describes the help as a “godsend”.

She now has some independence from her husband, who previously had to accompany her everywhere, and he is now able to see his friends again. Zoe says it has also done great things for her son’s development, enabling him to socialise with other children.

A year into their new life, the couple are testimony to the power of volunteers. The pair glow with pride for their lively 15-month-old as they gather for lunch with other parents and befrienders at Pleasley Hill Children’s Centre, which has become something of a second home to all of them.

Zoe is one of 11 new mothers and mothers-to-be supported by befrienders as part of the perinatal project in the children’s centre, one of four such projects run by Family Action across the country. Co-ordinator Julie Smith describes these women as a “real mix”, from teenagers to women in their early 40s, from every section of society. The common denominator is that they have all been identified as either suffering from depression in pregnancy or at risk of developing it. Most referrals come from midwives, health visitors or children’s centre staff.

Smith says there are many different triggers for mental distress during pregnancy or following childbirth, which the mental health charity Mind has estimated affects one in six women. She says some women do not receive a diagnosis of depression until they are with the project, as they have previously been too frightened to access medical help. “People think that if they’re saying they’re struggling, social services could come and take their child away,” she says.

Smith has so far compiled 10 case studies of women who have completed the project in West Mansfield. All show improvements in their mental wellbeing or the level of attachment to their children or both.

Isolated in pregnancy
One mother who has just completed the programme is 32-year-old Lisa Burton, a single mother to 13-month-old Jacob. Lisa was left isolated early in her pregnancy when her partner left. She was diagnosed with postnatal depression in August last year, when her health visitor put her in touch with Family Action. 

Lisa says her week runs from Friday to Friday, the day when her befriender Louise visits her. “Sometimes, I’m too busy to get out of the house, so it stops me feeling lonely and isolated,” she says. “She’s an unbiased person who I can offload to. She’s had similar experiences to me and it helps knowing that I’m talking to someone who knows what I’m on about.”

Lisa says Louise has built her confidence to pursue a childcare course.

“She has stopped me feeling useless, because I thought I had to do everything on my own, being a single mother,” Lisa explains. And she says the support has strengthened her relationship with her son and instilled her with new confidence about the future. “My bond with Jacob has grown stronger and my love has got deeper,” she says.

For mother-of-two Katy Dodds, having a befriender has given her a lifeline by connecting her to the community. The 21-year-old, who is mother to 18-month-old Frankie and three-month-old Bobby, was already in contact with the project due to anxiety suffered during her first pregnancy. “When I got pregnant, a lot of things changed,” she recalls. “It felt like when he was born, he stopped me from doing a lot and cut me off from my friends. With Bobby coming along, I thought I would struggle.”

Katy was allocated her befriender Cathy Jones when she was six months pregnant with her second son. Cathy has introduced Katy to play facilities, helping her build a stronger relationship with her sons. And she has helped her build a network of friends, many of whom have had similar experiences. “I’m quite unsociable when it comes to meeting new people and she’s brought my confidence up,” Katy says.

Thirty-eight-year-old Cathy says it is not just the parents who benefit. She says she has first-hand experience of the isolation suffered by Katy, and believes her befriending experience transformed her confidence and helped her discover her vocation. She will be embarking on a social work degree in September and has already started to play an active role in the children’s centre by teaming up with another befriender to set up a monthly social group for mothers.

Claire Meek, programme manager for the two West Mansfield children’s centres, says the integration of the perinatal project into both centres has enabled the health visitors and midwives to identify women in need of help early on in their pregnancy. “The project has strengthened our relationship with the midwifery service,” Meek says. “A bridge has been built between us. That has been needed, because vulnerable mums get discharged from hospital and it’s pot luck whether somebody picks up when there’s anxiety or any mental distress.”

Gap in provision
Rhian Beynon, Family Action’s head of policy, says the charity’s four projects fill a sizeable gap in provision for women with “mild to moderate difficulties”. “It’s not that health professionals are not aware [of perinatal depression], it’s just that there is not anywhere to refer people to unless you’re meeting quite a high threshold for mental health services,” Beynon says.

Sheila Shribman, national clinical director for children, young people and maternity at the Department of Health, says Family Action’s projects fit in well with the government’s Healthy Child Programme – a framework for professionals that stresses the importance of support for women during pregnancy. But she adds that the forthcoming evaluation of the project will be crucial in determining its expansion prospects.

Shribman’s cautious optimism is echoed by Dr Cheryll Adams, an independent adviser for health visiting services. “For professionals to have access to a support service like this across the country would be very useful and could serve to support a lot of mothers who may not need much more than some social support,” she says. “The challenges and risks come where the situation is more complex and where the volunteers aren’t equipped to deal with it. It could complement but never replace the work of health professionals.”

The interim evaluation of the project, due for publication this summer, will show how projects like this can save money, by preventing expenditure on health and social services intervention later on.

This is a subject on which dad Darren Scotford is disarmingly frank. “Without Julie and without Sam, Samuel could have ended up in care, because I could not cope without them,” he says. “We’re confident and more optimistic now and looking forward. It’s probably saved our marriage.

“Samuel has lit up so many lives and helped bring our family members together. There was always something missing before. It has woken us up to our potential.”

Family Action’s Perinatal support project

Who does it target? Pregnant women or new mothers suffering from depression or believed to be at risk of it.
What does it offer? Regular visits from a volunteer befriender until the child’s first birthday. The support can include practical help in preparing for and looking after a baby, help to network with other mothers and connect to other local support services, and a listening ear. A support group is also offered to help women understand and cope with perinatal depression.
Who are the befrienders? The West Mansfield project asks for women who can commit to the programme for at least three hours a week for a year and have knowledge or experience of either the pressures of becoming a parent or of mental health issues. They are matched to their befriendees by the project co-ordinator.
How are they trained? Those in West Mansfield get a six-week introductory course, covering issues including child protection, data protection, confidentiality and health and safety, then three three-hour workshops covering perinatal mental illness, including a session on basic counselling. The befrienders in the other projects receive similar training.
Locations: West Mansfield, Blackbird Leys estate in Oxford, Swaffham in Norfolk and Hackney, east London
Funding: Nearly £700,000 for the four projects over three years from July 2010 from the Monument Trust, Henry Smith Charity and Big Lottery.
Evaluation: An interim evaluation by Warwick Medical School published this summer will examine the change in emotional wellbeing and maternal attachment among the participating mothers after their involvement. The results will build on those from a perinatal support project piloted by the charity in Southwark, south London from 2007. An evaluation published in February 2009 found 88 per cent of women showing a reduced score for anxiety and 59 per cent showing a reduced score for depression on the Hospital Anxiety and Depression scale after their involvement in the project.