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Inviting the cameras
Film crews - even ones as well behaved as BBC teams - can sometimes be seen as a bit of a nuisance when you're trying to get a job done. Sheila Appleby, Southern Derbyshire's head of Midwifery Services, explains her reason for inviting the cameras.
Related programme
Kerri-Anne Gifford asks how health inequalities affect the chances of survival for premature babies
The earlier the baby is born the more problems may be encountered. Breathing difficulties, infection, oxygen deprivation, gut problems, eyesight problems, heart conditions and brain abnormalities among them. Survival rates for babies without abnormalities at 23 weeks are around 17per cent, at 25 weeks there is a 50 per cent chance of survival and much better chances after 30 weeks, depending on the weight of the baby. There are miracle stories of the 23 week baby that survived without any long-term problems but increasingly researchers find that this is the exception rather than the rule. They are finding that many of these infants carry long term disability with them. Babies may need up to a three month stay - or longer - in hospital and parents have to get used to their lifestyle being hospital-centred during this time. You must expect huge amounts of stress and worry and a roller coaster ride and maybe you will be the lucky one at the end of it with a relatively healthy living baby. However, infants who go home to disadvantaged circumstances are more likely to end up back in hospital. It is again unclear in relation to the evidence and the public health agenda what significant interventions would make a difference for those infants, apart from successful breastfeeding. There are also support groups which parents who feel socially at ease with are able to access.
There are current academic trends to identify and discuss behaviours that appear to lock people into social deprivation. These need to be understood and worked with if any of the public health agenda wishes are to be achieved. For example, one behaviour discussed is something called ‘learned helplessness’. Whole new forms of behavioural education may need to be introduced in order to improve outcomes that reduce health inequalities of the social gradient. People may need to learn ways that give them desire for utilising ‘enabling knowledge’, to live healthily rather than having do-gooders trying to impose lifestyle changes upon them!
At the moment some health practitioners feel that they may be involved with an expensive public health experiment that only reflects historical activity in other parts of the world. There is neither convincing statistical nor intervention evidence that shows that the money being spent will make a difference. Yet, intuitively, practitioners know that anything that may help to eliminate poverty and its effects has to be a good thing.
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Content last updated: 17/02/2005
About our author
Kerri-Anne Gifford is chair of the Nottingham branch of Royal College of Midwives and has been a member of the Association of Radical Midwives. Presently, she works as a nurse, midwife and health visitor representative on the Nottingham City PCT Professional Executive Committee. She has also written for The Practising Midwife and Midwifery Matters.
Originally from Australia, Kerri-Anne began adult life as a teenage mother of one daughter. A health professional with 25 years experience in the public sector working in nursing, surgery and research, she qualified as a registered midwife in 1994.
