July 2022

“Once on the programme, I realised that FNP was much more than a support network: it was like a helpline, a nurse, an ear, a baby holder, sexual health advisor, baby weigher and more, all rolled into one!”

I found out I was unexpectedly pregnant when I was 17. Although I would later conclude my pregnancy was a blessing in disguise, at the time I could not think of anything worse. I had worked incredibly hard the year before to get good GCSE results. Only a few months before I had been attending university fairs at college and deciding on what to study.

Pregnancy was a big shock! The morning after I took the pregnancy test, I confirmed the pregnancy at a local health centre and asked about my options. I didn’t know what to do. I considered abortion and even attended the first appointment at the clinic. My partner and I had always discussed abortion if an unexpected pregnancy ever arose, but it was only later that I realised that such a life changing decision can only be made when you’re actually in that situation.

For my first midwife appointment at 16 weeks, I didn’t know what to expect. My midwife wasn’t sure I would even turn up, considering my appointment at the abortion clinic. We talked about what my pregnancy would look like over the next 6 months, the checks that would be done and the support open to me.  It was then the Family Nurse Partnership was mentioned. I was so caught up in my emotions that I didn’t really take it in.  A month later I received my first phone call from Claire, an FNP nurse, who had been given my details by the midwife.

After Claire’s first visit, I still didn’t know whether FNP was right for me. I could see that it offered support and help to young parents but felt I would be wasting their time as, after my family’s initial shock, I had their support and that of my partner.

Talking with my partner and family afterwards, they reassured me that there was no such thing as having too much support with a baby. It really can take a village, and a village can come in many forms.  Once enrolled on the programme and with Claire as my family nurse, I realised that FNP was much more than a support network: it was like a helpline, a nurse, an ear, a baby holder, sexual health advisor, baby weigher and more, all rolled into one!

I met Claire every fortnight for most of the programme, with weekly visits when first recruited and for the initial 6 weeks after Stanlee was born. We would talk about my pregnancy, how I was feeling, and what my physical and emotional needs were. We bonded over horses, a passion we both shared.

Claire eased every worry I had during pregnancy, throughout Stanlee’s infancy, and during my subsequent pregnancy and post-partum period with my second born, Avaree. Claire was honest and helpful but sensitive to my situation and I really appreciated this; I felt I could say anything, and I wouldn’t be judged.

When I discovered I was pregnant the first time, I felt my life was over: any aspirations I had should be forgotten.  However, Claire encouraged me to talk to my college. If continuing my studies without a break was what I wanted to do, then I needed to configure an action plan that would allow me to do that. I did and ended up waddling the halls of my college nearly 30 weeks pregnant handing in my last pieces of work before taking my ‘maternity leave’ which meant continuing my course work at home and just attending college for exams and assignments. At 8 weeks post-partum, I was sat in college taking an exam, breastfeeding Stanlee in the breaks, and then returning to the exam. I don’t think I would have even been there, juggling like that without Claire’s support.

During my second and planned pregnancy, I didn’t expect my mental health to spiral downwards. Claire referred me to perinatal mental health services.  Although I didn’t meet their criteria, it did lead to talks with specialist midwives to discuss my birth plan which put my mind at ease.  However, a mixture of COVID-19 lockdown, recalling the trauma I’d felt during my first pregnancy, plus feeling disconnected from normal life, pushed my anxiety into depression.

My depression worsened after Avaree was born. There were days when I couldn’t even get myself a glass of water, but I made sure my children didn’t go without.  One day, after weeks of online video calls due to lockdown, Claire came round, and held Avaree for me so I could make myself a drink and some toast. This was a small thing, but my partner was at work pretty much full time, and I was too proud to ask for more help from family and friends. From then on, Claire and I had regular chats about mental health and the options open to me, including medication, but I was breastfeeding Avaree and was concerned how drugs would affect her.

One night I became completely overwhelmed. Both children were crying, I’d just received some bad news and my partner came in asking a question.  I walked out the house, sat in the car and called the Samaritans. After that Claire and I had a serious chat, she told me gently that it was better for both babies to have a healthy mother and that my GP would be able to advise me on the best treatment. Two days after the conversation with Claire, my GP prescribed me anti-depressants, and I was awaiting a call from Supporting Minds.

Claire had become an important part of our lives. I’d see her more than I would friends and family: twice a month over two years with messages in between if I needed anything. Looking back, we wouldn’t be where we are now without Claire. We will forever be thankful for the role she played in our lives, supporting us as a young family without judgement.

My partner is doing well in his apprenticeships with hopes of starting a career in business. I am still deciding what I want to do long term. I’m quite busy mothering and studying English Literature at university, but at some point, I’d like to become a family nurse and support other young people like Claire did with us.

After I graduated from FNP I was asked to represent the client voice within the family nurse interview process. I thoroughly enjoyed my time listening to the different applicants and being a part of the selection process, choosing new nurses to help other young families like mine. I also took part in the FNP team’s annual review meeting with commissioners, sharing my story to help those who haven’t used FNP understand how vital this program is for young families, mums, and babies.

November 2020

“I thought the relationship I was in was normal.”

Domestic abuse is a serious public health issue which disproportionately affects women and children (Office for National Statistics, 2020). It is also a prominent risk factor in Serious Case Reviews where a child has died or been seriously injured (Brandon et al 2020).  So, if we are to improve outcomes for children and families, then we must look for more effective ways of tackling domestic abuse and seek to understand what can make a difference.

The personal account below is written by Leah, a former FNP client who was enrolled onto the FNP programme when she was 16 years old. At that time, she was in an abusive relationship – now 9 years on, Leah is a qualified health professional. Here she describes the importance of having a relationship with a trusted professional who adopted a non-judgmental, trauma informed approach which enabled her to recognise and then leave an abusive relationship.

“I thought the relationship I was in was normal so didn’t realise it was abusive. I didn’t tell the truth as I didn’t know I was in an abusive relationship. Having general discussions about relationships with my family nurse allowed seeds to be sown about what a healthy relationship is.

Domestic abuse work was trickled into other sessions e.g. baby weaning, safe sleeping, coping with lack of sleep, these sessions looked at how we would support each other in difficult times, I then started to realise he wouldn’t support me and that if he was tired he may kick off, this felt wrong.

One of the FNP materials is about things you would/wouldn’t like your baby to get from you and the same from their Dad. I wrote ‘I don’t want her to be scared’ under my section. I just felt that was incredibly powerful: how the program can explore these things indirectly.

The family nurse’s approach made a difference – she was calm about it, there was no blame or judgement like I felt there was with other professionals, she spoke to me like an adult. I felt she was the only professional I saw who actually ‘saw me’ instead of the fact I was a 16-year-old single mum who was in/had been in an abusive relationship. I got the impression from others ‘that I brought it on myself’ and was told at one point, by another professional, that I shouldn’t have continued with the pregnancy if I didn’t want to end up in that situation.

During a session with the family nurse on attachment, I realised Ruby’s dad had a different attachment style to me.  This made me understand his priorities in a relationship were not good, experiences were always about him, not Ruby, and this shone a light on his behaviour. The family nurse helped me understand the impact on Ruby if I’d stayed and how this would have negatively affected our positive attachment - this gave me strength to carry on with the court process.

I knew I always had the family nurse to support me through the process of leaving him, without her I would have felt stuck and unable to leave, my parents didn’t know what was going on as I had been isolated from all my family and friends. The court process took 13 months and continued support from the family nurse allowed me to complete this without giving up. During this process I encountered self-blame which made me go two steps back and lose confidence in myself. The family nurse would review the relationship work again focusing on unhealthy relationships which allowed me to understand it was his fault, not mine, giving me renewed confidence. My family nurse encouraged me to continue by keeping my focus on Ruby.

It took me a long time to start another relationship. I was now aware of the signs to look out for and because I knew what a healthy relationship was I was able to look for this. I also knew the warning signs to prevent me staying in a relationship that would be unhealthy. I am now in a healthy, happy and equal relationship."

(Names have been changed to protect identities)