What have we found? (pt. 1)

What does it mean to come to care for a child as a first time parent? How do you figure out what ‘getting it right’ looks like, how do you make sure you stay happy and healthy as well, and how do you find and access support when needed? These questions were central to our research with first-time parents in the city of Oxford. Having finished our fieldwork, with over a dozen new parents, we wanted to share here some of our initial reflections and findings.

For all of the parents we talked to, care was never a straightforward affair. When babies were fussy, or restless, when they refused to sleep or to be left alone, there was rarely a straightforward answer as to what to do. Rather, parents often took an experimental approach, trying out new foods or schedules, activities or ways of interacting, and watching closely to see how their children would respond. And, because babies are always growing and changing, this process of figuring things out was an ongoing one, which changed from day to day. The scholar Annmarie Mol has described care as a ““persistent tinkering in a world full of complex ambivalence and shifting tensions”. This description resonated strongly with what we were seeing parents doing in caring for their babies.

Where things get even more complex, however, is when this ‘persistent tinkering’ comes into contact with the ways in which different institutions, organisations, and charities provide care. Uncertainty, exhaustion, loneliness, and mental health challenges make external support important and necessary for most new parents. However, the tight budgetary restrictions facing many care providers means that, despite their best efforts, the needs of new parents faced with this myriad of challenges are not always met.

Last month (Aug 2018), we presented a paper at the Institute of British Geographers and Royal Geographical Society Annual Conference in Cardiff, talking about the challenges parents face in moving between different care settings. Following on from this, we wanted to share some of our findings around three key themes: feeding, sleep, and social acceptance. These themes, or concerns of care, are not in or of themselves particularly remarkable and will be of no surprise to most. However, each of them has important implications for how new parents move across the city, access services, and even manage care at home, which are often overlooked.

 

Feeding

 

Increasingly in the UK, mothers are being urged to breastfeed their babies. Whilst a high percentage of mothers try breastfeeding, a relatively small amount continue up to the World Health Organization’s recommended 6-month mark. Some research around why this is the case has pointed to the fact that public spaces and attitudes still often remain hostile to breastfeeding, making mothers feel ashamed or excluded[1]. Another reason for this, however, is that breastfeeding a small child, whilst balancing other commitments, is simply very challenging, and can require complex juggling to make it work.

As we all know, babies vary widely. Some feed quickly and hungrily, while others can take over an hour on the breast to become content. Others can have difficulty latching on, or can have conditions such as tongue-tie, which can mean that they feed for long amounts of time without necessarily getting enough milk to be full or healthy. And while some babies settle into routines fairly easily, others resist any sort of regular timing, simply demanding feeding as and when they are hungry. So while some mothers find breastfeeding easy and simple, others, through no fault of their own, can find it to be tiring, time-consuming, and fraught with uncertainty. Even for those who do not breastfeed directly, but who may express breast milk, as well for as those who use formula, the challenges of feeding still include managing timings and moods, alongside tasks such as sterilising bottles and waiting for milk to cool down.

Juggling all of these considerations can lead to parents feeling isolated or under stress. The challenges of feeding can make it feel hard to get out of the house, to see friends or family, or to seek professional support. At the same time, feeding can be such a multi-dimensional challenge, it can be hard for parents to know exactly where they need support. If a baby is breastfeeding for hours, and then demanding more food just a short while later, is this a problem with how they are feeding, or simply a case where parents need to impose a stricter schedule?

And yet, especially in an age of austerity, services are changing to be more time-limited, and targeted. This means that if mothers (and fathers) want to access support, they are increasingly expected to be able to show up at the right place at the right time, and to have a clear, unambiguous idea of what they need help with. In many cases parents are expected to research the range of services available themselves, to identify the correct one, and to show up, having effectively self-diagnosed. There are fewer and fewer places where parents can simply show up and say “I need help”[2]. As such there are fewer places that accommodate the uncertainty, immobility, and constraint that parents often experience around feeding. Meanwhile, those that remain are under increasing pressure, having to help more and more people while relying on increasingly scarce funds.

In our interviews with parents, what this meant was that the challenges around feeding were keeping many parents not only from accessing services, but often from leaving their house, or at least getting beyond their neighbourhood. Things could become even more challenging when moving between locations. Often baby groups or services would be timed to follow on one from another. But going to a group or to seek help often meant putting the babies’ needs on hold for a while, and so after things ended, there was often a need to feed, change nappies, calm babies, and perhaps even to nap, before parents could become mobile again. For some parents this generated anxiety around whether they would have a space in which to do this, as one group ended, and venues were shut. Others simply dedicated huge amounts of time towards making mobility possible. For example, one mother we interviewed, always started preparing to leave the house around two hours before she actually wanted to be anywhere – despite the fact that all the places she was going were a 15-30 minute walk away.

In terms of service design, then, one key implication is that supporting and facilitating feeding can help tremendously in terms of accessibility. Having feeding and changing facilities, but perhaps also support – such as lactation consultants, health visitors, or simply even some useful advice from the group facilitator – can play a large role in making spaces more open and supportive. At present, in Oxford, however, the everyday complexities around feeding is just one of the challenges that can make it difficult to access much needed support. As we will see in the next entry, sleep can be an even bigger challenge.

[1] Kate Boyer has written insightfully on the feelings and politics which surround public breastfeeding. See: https://www.sciencedirect.com/science/article/pii/S135382921200024X and https://www.sciencedirect.com/science/article/pii/S1755458616300317

[2] Eleanor Jupp, Tracey Jensen, Sara de Benedictis and Val Gillies have all written about how parents and families are being made increasingly personally responsible for children’s wellbeing and behaviour, regardless of the level of support or income that they have access to. ‘Good parenting’ is being promoted as the root solution to a range of social ills, while parents are expected to conform to expectations of good parenting with little support or resources. See respectively: https://www.mamsie.bbk.ac.uk/articles/abstract/10.16995/sim.35/  https://onlinelibrary.wiley.com/doi/abs/10.1111/area.12263 https://www.mamsie.bbk.ac.uk/articles/abstract/10.16995/sim.40/ and https://link.springer.com/chapter/10.1057/9781137016386_6

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