Q Exchange

Helping each other through a healthy pregnancy – peer support groups for pregnant women with risk factors

Setting up peer support groups in the hospital antenatal clinic setting. Kills two birds - makes good use of hospital waiting time, as well as provides women with risk factors in their pregnancy with a network of peers with similar challenges and experiences. e.g. Older mums, pregnancy after loss, women with BMI >30, multiple pregnancy.

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Idea
2018

Meet the team: Imperial Flow Coaching Academy Antenatal #FCAImperialAntenatal

There is good evidence in the literature of the benefits of peer support in the maternity setting, with benefits for mum and infant health (e.g. breastfeeding promotion, living with HIV, supporting women with postnatal depression). However, hospital-based antenatal clinics rarely integrate an organised peer support programme with routine care. Women come for 1:1 hospital-based appointments with healthcare professionals throughout their pregnancy, and do not have access to structured support outside these sessions to influence their own health. We want to test the idea of enhancing hospital appointment waiting experiences by turning the clinic waiting room into a peer support and networking area. Through facilitated discussion, provision of high quality information, signposting to relevant resources, and ongoing peer support through formation of online groups, women can be empowered to look after themselves and their babies. We would like to focus initially on groups of women such as women with BMI>30, women with mental health problems, women with twin pregnancy, older mums, women conceiving after fertility treatment, etc

How you can contribute

Has anybody tried setting up peer support in the antenatal (hospital) setting, specifically running alongside clinics? What was your experience and what did you need to set it up?
How do you get women (service users) in the room, and how do you encourage them to open up?

Comments

CIARAN CROWE 21 Jul 2018

we set up a peer support service for Diabetes in pregnancy. It starts with a group education session. This led to using WebEx for appointments and also set up other peer support groups for teenage pregnancy. This all came about from Whose Shoes coproduction. Women know lots of the solutions. The system needs to listen! Our work has been highly successful (reduced waiting lists, improved satisfaction, no cost, no capital needed and no adverse outcomes.
Tim Benson 29 May 2018

Maternity care, especially of at risk groups, has many potential benefits for statistical process control (SPC), based on the perceptions of mothers. One issue is collecting the right data, which peer support may faciltate. Do we understand how health confidence, personal wellbeing, patient experience and service integration during pregnancy impact outcomes?
Simon Knowles 22 May 2018

Great idea. I suspect women will be less bothered but the wait if they are engaged in useful conversation. This could be a terrific opportunity to identify those whose mental health is at risk.
Deborah Shaffer 20 May 2018

This sounds like a really important initiative. You may be interested to learn about our peer-support network of women across Wales with chronic health conditions (often gynaecological conditions). We haven't done this with clinical settings but online and then in the community, very successfully. I would suggest you co-produce the answers to your questions with patients you already have, this way they will be more engaged and you will design a service they want and require.
1. Sabrina O'Dwyer 23 May 2018
  
  What online forums do you use? Facebook groups? Or have you created a forum/chat room? Do your groups meet face to face as well?
Helen Smith 20 May 2018

Hi

Great idea! I wondered if you had had much contact with psychiatric perinatal services. These services are often very good at engaging people with lived experience. can I recommend you contact Dr Jo Black who is one of the national leads for perinatal psychiatry. She is based at Devon partnership NHS Trust.

Kind regards

helen
Matthew Mezey 17 May 2018

I wonder if there's any way that the NCT can help support this, if it is complementary but different to what they do?
Maybe their ante-natal course info could point to this specialised help?
1. Hadjer Nacer-laidi 17 May 2018
  
  Thanks Matthew, Yes.. we have thought of working with NCT, an idea definitely worth exploring for us.
Suzanne Wood 14 May 2018

Hi Hadjer & Sabrina

This sounds like a really interesting idea. If you haven't already seen it, there might be some relevant learning from the M(ums)-power project the HF funded a few years ago - it introduced group appointments in maternity clinics and facilitated online peer support, among other things. As suggested by Karen and Sarah, co-production was a core part of the project - https://www.health.org.uk/programmes/closing-gap-through-changing-relationships/projects/mums-power-putting-women-centre

Best wishes

Suzanne
1. Hadjer Nacer-laidi 17 May 2018
  
  Thanks Suzanne, really helpful! Yes. The idea came mostly from women, we have been engaging with them the last few weeks as part of the flow coaching academy. While we are working to reduce the waiting times (This was what they wanted most), they did emphasise the value of having sthg to do while waiting and hence we thought of peer support sessions, especially for groups that will benefit from it most
Jane salazar 13 May 2018

Great to see your vision of developing peer support where you can see a need in your clinic. As you have said the benefits of peer support have been well documented.

If you haven't already seen, reports to name a few such as:

Mental health peer support: piecing-together the jigsawhttps://www.mind.org.uk/media/5910954/piecing-together-the-jigsaw-full-version.pdf;

A helping hand:http://www.together-uk.org/wp-content/uploads/downloads/2011/11/helpinghand.pdf

include not only benefits of peer support but also importance of service-users in the process of setting up. As Karen and Sarah have mentioned, and having set up peer support myself, asking the women first is a good place to start. Hope that helps towards answering some of your questions.
Karen Machin 10 May 2018

I agree with Sarah that asking some women to join your group might help you work out what they would like - it may be that shorter waiting times might be preferred but be a barrier to oppportunities for peer support. There are various perinatal peer support groups - I wonder if your waiting room is more of an opportunity to promote them? I remember (a couple of decades ago so things may well have changed) that I was always impressed that Walton Neuro hospital had a very welcoming stall run by carers. Perhaps local peer support groups could make use of your waiting room?
1. Sabrina O'Dwyer 18 May 2018
  
  Absolutely, we would get in touch with existing advocacy groups (e.g. NCT, TAMBA for multiple births, SANDS, Mind, etc) and see if they want to partner up with us. However we want to see if we can go a step beyond just promoting other groups, and integrating the support activities and meetings that occur outside the hospital, with the hospital appointment, to give women and families more value for their time.
Sarah Neill 8 May 2018

Hello Sabrina and Hadjer

Love your idea of making better use of the waiting room and waiting time. I wondered if you had considered asking service users to join your project group? They are best placed to help you to further design your project as they know what the experience of waiting is like. Some of the things that spring to mind for me are that you would need to change the booking process so that pregnant women with these specific problems you are planning to focus on are attending on the same day (unless you do this already). Women with young children may bring their children with them. How had you planned to enable these mothers to focus on your planned activities?

Before going any further I think your main need is to establish whether or not this is something that pregnant women would welcome. I suspect that rather than plan in time for peer support and information sharing, they would prefer not have to wait!

Good luck

Sarah
1. Sabrina O'Dwyer 18 May 2018
  
  Thanks for the feedback Sarah. Overwhelmingly, feedback from women has been that waiting times are too long in the clinic. We are working to improve the underlying processes that lead to long waits, but at the same time we recognise that one of the causes for waiting is that individual women will take longer to see than the allocated time. We want to see if we can re-organise women so that the clinic visit can provide more value for women. We would love to have a user in our team, but until somebody steps forward to take this formal role, we have engaged women via the Maternity Voice Partnership and inviting them to our Antenatal Big Room.
2. Hadjer Nacer-laidi 17 May 2018
  
  Thanks Sarah, we started the project few weeks ago working on the flow of antenatal pathway. We are engaging with women at the moment, we had a maternity voices meeting yesterday, and we have been speaking to women in the clinic and inviting them to our weekly 'Big Room' so they are part of the project and will make it clearer where we should focus our improvement efforts so it has the greatest benefit on the woman's experience