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When working with young parents, you liaise frequently with midwife clinics and become connected with clients through these channels. You might not begin your advocacy until very late in the pregnancy depending on how and/or through whom a young person has been referred to your service. For example, Child Protection (or representatives from hospitals or other services) might refer you a client 8 and a half months pregnant, which restricts the kind and volume of advocacy you can do.
Where advocacy is concerned, the earlier you come into contact with an expectant client the better.
You will often need to ‘sell’ your services to resistant clients. Preconceived ideas about what you’re able to offer might mean young clients are reluctant to engage a youth worker. Negotiating the discussions that follow is a delicate process as you will need to ‘softly’ highlight your service’s benefits in ways that doesn’t overwhelm the client or put them off. In addition, depending on the client, you might need to advocate for the involvement of other services such as mental health services or drug and alcohol counselling etc.
The importance of planning
Clients entering hospital to give birth may already be apprehensive due to feeling self-conscious or judged by hospital staff. Approaching hospital with a plan is important; for example, liaise with hospital social workers so they’re informed regarding what to expect of the client and so that they can maintain contact with the client through their stay and offer support.
For those who need it, extended hospital stays can be arranged through rigorous advocacy and strong relationships with hospitals and their social work departments (which often deal exclusively within the midwife clinic and cater especially to young and/or substance using patients).
Ideally, a hospital social worker and your client will meet pre-birth as familiarity can help ease a client’s nerves and anxiety. Establishing this relationship before the birth, familiarising the client with the hospital through a hospital tour, and forming a plan for their hospital stay that focuses on preparing for a wide spectrum of emotions (extreme fatigue, isolation, being overwhelmed, withdrawal etc.) is essential to ensure your client is as prepared and informed as possible.
Planning for child protection's involvement
Many clients will enter hospital fearful of Child Protection’s potential involvement. It’s important that your aforementioned plan covers this topic in detail to ensure that clients know what to expect and unwelcome surprises are minimised.
Advocacy at birth
It’s important to begin advocacy well in advance: open a dialogue with Child Protection and discuss what they need to see from the client to avoid removal. Ideally, this channel of transparent communication will be opened as early as possible so that the young person fully understands what’s expected of them. Ideally empower your client to advocate on their own behalf and, through their pregnancy, to demonstrate progress and commitment to services.
Advocating for flexibility
A client who hasn’t accessed antenatal care throughout her pregnancy will require support to connect her with the necessary services as swiftly as possible.
It may be necessary to explore the flexibility of services to ensure the client receives relevant treatment and support as required.
It may be the case that a client will not expect or receive any visits from friends or family before or after the birth.
This can be difficult, and, if roomed with another patient who receives many visits, can exacerbate feelings of sadness and isolation.
Hold discussions with your client and the hospital social worker to prepare the client for this eventuality. Concerted support in such situations is essential to alleviate negative feelings as much as possible.
Post-birth, you will need to ensure the client and newborn are going home to a safe environment and are linked in with a variety of services (including material aid where needed). You will find most young parents are eligible for Enhanced Services through Maternal & Child Health which allows for home visits, extended appointments, a greater number of appointments, additional background work into referrals for services etc.
Sometimes you might experience other support service providers who are swift to notify after birth even when, in many cases, they are aware the young mother is linked in with services.
This may necessitate advocacy such as secondary consultation whereby you speak directly with the nurse (or whoever made the notification) to ensure they have a full and detailed picture and understanding of the client’s situation, services linked in, progress being made and plans in place. It will also assist greatly if you have over time built strong relationships with maternal and child health; for example, YSAS workers in Victoria meet regularly with maternal and child health nurses so that everyone is known to each other and all involved remain on the same page as much as possible.
Consider attending your client’s maternal and child health appointments. Key subjects such as sleeping, feeding, routines and immunisation are discussed in detail and present excellent learning opportunities for you as well as your client. Your advocacy can also help ensure your client is connected with the best possible maternal and child health stream for her particular circumstances; for example, she might be able to remain connected with the service long-term (often right through until her child starts school).
Midwives’ clinics are big on emphasising the importance of clients keeping their six-week follow-up appointments. Many clients skip this appointment, which can result in missing key educational sessions that cover important subjects such as contraception, nutrition etc. Your advocacy is needed to connect your client with alternatives in these instances.
Advocacy where in-hospital withdrawal is likely
Your support needs to account for clients who are substance using throughout their pregnancy and up until birth. Withdrawal will begin in hospital for those who, for example, smoke cannabis daily. Vigilant support is required as mothers often experience ‘third-day blues’ whereby hormones are running wild resulting in chaotic feelings mingled with negative emotions.
Paired with withdrawal, this can be an extremely difficult time for a young parent and heightened support is required.
Where possible, ensure your client is fully informed – that is, hold in-depth discussions and construct a safety plan – around what to expect and how to deal with withdrawal in hospital. It’s important that the hospital is made aware that the client is likely to experience substance withdrawal and that all involved are prepared and the client receives additional support where needed. Perhaps you’ll need to advocate for a GP’s involvement to secure medication that minimises the effects of withdrawal without harm to the baby.
Advocacy in cases of removal and voluntary undertaking
In situations where removal shortly after birth occurs, young parents are often expected to present at court within the next few days. Not only is post-birth a highly stressful and emotional time but the extremely narrow timeframe makes it near impossible for a young person to prepare themselves for court, which means most will turn up unrepresented. It’s important to connect young parents with legal representatives whose legal advice you trust and to advocate for them through this particularly demanding challenge.
Pre-birth meetings to form a post-birth plan should cover subjects such as who can look after the child if Child Protection proposes voluntary undertaking or removal. Establish a list of police-checked and trusted individuals that serves as the client’s list of preferences. If removal occurs, Child Protection might consider the client’s list rather than explore foster parent options. A list can help to avoid confusion, minimise distress and help the young parent feel that even in the crisis case of removal they still have a voice and a potential say in what happens with their children.