Health visiting supports "Transition to Parenthood" by working with NSPCC; Baby Steps programme sets the foundations for healthy development by Camilla Sanger


Dr Camilla Sanger blogs about the NSPCC’s relationship-based perinatal education programme, Baby Steps.

Pregnancy is the ideal time to offer support and help parents lay the foundations for their baby’s future. But preparing for parenthood is about more than just the physical side of labour and birth. Strong, secure and healthy relationships are fundamental to the successful transition to parenthood, and sadly absent from the current antenatal education provision.

What are the key themes in Baby Steps?

Dr Angela Underdown from Warwick University worked with us to develop a 9-session perinatal programme for parents with additional needs, called Baby Steps. Following a home visit, parents attend group sessions in the 6 weeks leading up to the birth, and a further 3 sessions after the baby is born. The programme is delivered by a health and a children’s services practitioner - bringing a crucial combination of skills to address the emotional, social and physical needs of expectant parents.

Baby Steps has a number of key themes at its core:

Parent–infant relationships - Baby Steps seeks to strengthen the parent-infant relationship by encouraging the development of a sensitive, reflective interactions. We know that the evidence shows that a mum’s level of bonding with her baby in the womb is related to the health choices she makes such as giving up smoking and alcohol, as well as how well she bonds with her baby once he or she is born – so we wanted to strengthen this relationship as much as possible.

Co-parenting relationships - Baby Steps aims to strengthen the couple relationship by encouraging listening, developing conflict resolution skills, and helping parents to manage relationship changes. This is seen as an important aim as the transition to parenthood can be a difficult and disruptive time, which can have a negative effect on a parent’s relationship with his or her partner.

Parental wellbeing - Baby Steps aims to improve parental emotional wellbeing and self-confidence by supporting mothers and fathers to negotiate the emotional and physical transition to parenthood and helping them to keep healthy and relaxed.  We know that maternal stress, anxiety and depression in pregnancy are associated with poor outcomes for mum and baby and can interfere with attachment and bonding.

Reaching disadvantaged groups - Our Baby Steps programme was designed with the needs of disadvantaged parents in mind. As these parents are less likely to attend appointments, Baby Steps facilitators visit parents at home before the programme in order to engage parents who might not otherwise attend. The programme has been designed to be participatory rather than didactic, and content is delivered through a range of interactive approaches, to make it accessible for parents with additional needs and to engage those who are disaffected from education.

Does it work?

We launched a large scale evaluation using validated questionnaire measures before and after parents completed the Baby Steps programme across 9 of our sites where we deliver the service. We have just finished collecting the data and analysing the results - and the findings are incredibly positive. The evaluation of questionnaire responses showed that parents who had attended Baby Steps:

  • showed an improvement in the quality of their relationship with their babies;
  • showed a decrease in symptoms of anxiety and depression;
  • showed increased levels of self-esteem;
  • had a lower caesarean rate, higher birth weight and fewer premature babies compared to the general population; and
  • did not show the reduced relationship satisfaction with their partners that is seen in the general population.

These findings all suggest that parents will be better equipped to provide sensitive, responsive care to their babies, which may ultimately result in these children having better long-term outcomes.

For more information about Baby Steps or to find out about working together in the future please email


Dr Camilla Sanger is a Development Manager & Clinical Psychologist with NSPCC

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