I couldn’t have got through being pregnant without my family; the Northern One, my mum and dad, my brother and the couple of friends that I’m not biologically related to but who I consider to be part of my family. I read a quote somewhere that went along the lines of ‘Friends are the family that you chose’ which is maybe at bit cheesy but is also true.
At work I see all kinds of different families; big and small, nuclear, single parent, same sex parents, young parents, old parents, bereaved parents.
All different types of families, functional and dysfunctional.
Sometimes the families work well together; the parents love and lean on each other and their relatives gather around them to offer any support they can. They look after existing siblings, buy presents and cards for the new baby and are delighted to receieve photographs and news of any progress, no matter how small.
With these families there’s always an endless stream of people waiting outside the unit for it to be their turn to accompany mum and dad to the incubator to spend a few precious minutes with the little person at the heart of this family.
Mum, dad and baby are surrounded by love.
Other families are fractured and broken or weren’t even whole to start with; the parents having split up before the baby is even born. In these cases dad either isn’t involved at all and has no interest in the baby or he and mum are thrown back together because they are both the parents of a sick baby.
If the parents are in contact, most of the time they are civil or even friendly towards each other, sharing news and updating each other although we always make sure to give any information to each of them separately. Some parents however, can’t stand the sight of each other and will only visit the unit if they can guarantee that the other won’t be there. Usually this doesn’t cause us any problems, apart from constantly take phone calls from each parent asking if the other one has left yet.
If the parents are not together mum usually registers the baby’s name and birth without informing dad. This meaning that he no longer has any parental rights if he’s not named on the birth certificate and he and mum aren’t married. Mum also sometimes decides that dad isn’t allowed to the visit the unit or be given any information about the baby and we have to support her because legally she is the baby’s sole guardian.
In almost all cases mum has taken this step because dad is either completely uninterested in the baby or because they have ended the relationship with him for their own safety. I can only think of one occasion where mum took these steps simply to be vindictive towards her ex partner. Usually we have no problems as dad doesn’t make any effort to visit or contact the unit but there have been cases where we’ve had to refuse to give out information or let dad onto the unit and they’ve become abusive, threatening and violent even though the decision is nothing to do with us.
Even if the parents are together some still fight and are as unpleasant towards each other couples that split months ago. Sometimes they do go on to separate, their relationship either rocky to begin with or just unable to cope with the strain of having a sick child. Usually they continue to behave appropriately and just focus on the baby but in other cases the relationship turns volatile. The parents fight with each other on the unit, not caring who sees or hears. They tell anyone who will listen what the other one has done to them and their relative are rarely any better. Sometimes we’re surprised when we’re told that parents are no longer together, other times we just wait to hear the inevitable.
On some occasions the parents are deemed unfit to be able to look after a baby; sick or well. This can be for any number of reasons and while social services try to keep babies with their parents in some cases it’s just not a viable option. Usually the best place for a baby is with their parents and we work with social services to do everything we can to make that happen. These are the families plagued by abuse and violence, uncontrolled drug and alcohol abuse and unstable mental health issues.
It’s a common misconception that babies who are born to parents who have a history of drug or alcohol abuse are automatically taken into care but this isn’t the case. If the parents engage with social services, the specialist midwives and stick to a controlled drug programme, for example methadone we do everything that we can to help this family stay together.
I’ve looked after a few children where mum has discovered she’s pregnant and this has given her the focus to give up the drugs and turn her life around. Sometimes they slip up; they pull of their previous addiction being so strong but they admit to it straight away and don’t try to hide it. They attend every appointment with every support service they’ve been registered with, they attend all their drug tests and they take the methadone as prescribed. They prepare for the baby, making sure that they’ve got everything they need even though they’re usually on a limited budget.
The baby arrives and they are in love; devoting themselves to their baby’s care and wellbeing, continuing to engage with everyone even after the baby arrives.
I have so much admiration for these women, regardless of how many times they fall off the wagon because they get up and get straight back on.
In many cases though, there isn’t a happy ending.
With these families there are sometimes older siblings who have been abused or neglected and the parents are aware that they won’t be taking this baby home, the decision having been made almost as soon as mum announced she was pregnant. In other cases we come to the conclusions that they’re simply unable to care for a baby no matter how much support is given and we’re left with the task of telling the parents that they’re not going to be able to look after their child.
There are some parents who just don’t understand why they aren’t capable and are heart broken. They think that because they’ve bought clothes and nappies it doesn’t matter that several nights a week they drink themselves into unconsciousness or that their current partner has just been released from prison for violence against them.
I’ve looked after babies where the parents attempt to come onto the unit drunk or under the influence of drugs. Sometimes they respond calmly to being asked to leave and sway and stagger off the unit. Other times they become abusive and aggressive and we have to call security but in both instances they don’t understand why it’s an issue.
I’ve worked with families where dad is know to be violent and there is a long term history of domestic abuse but mum refuses to accept that her relationship is potentially a danger to the child. With these families there’s always the thought at the back of your mind that if you tell them something they don’t want to hear it may be you that ends up with a black eye.
It wouldn’t be the first time.
Sometimes dad is in prison.
Sometimes mum is in prison.
These women are bought to the hospital to deliver the baby and sometimes is allowed to visit if there’s no danger to the rest of the unit. These women arrive, handcuffed to armed prison officers, unable to feed or hold the baby in case they try to run, with or without baby. If it’s dad who’s in prison they aren’t bought to visit unless it looks as though the baby won’t survive.
I’ve looked after some babies who are mum’s third or fourth or fifth child but she’s been unable to keep any them. She desperately wants to keep this baby but hasn’t engaged with social services or any of the support they’ve provided; unable to make the connection between complying with the child protection plan and taking the baby home.
I looked after one little girl who was mum’s ninth child and who, like all of her siblings would be taken into care and placed with a foster family. Mum would enter into relationships with men known to be violent, end up pregnant and then be unable to understand why she couldn’t keep the baby. She would sit there with bruises on her face from her latest partner and the social worker would try to explain to her why they couldn’t let the baby go home with her but the message never seemed to sink in.
A few months later she would be pregnant again, by the same partner or a different one and would be convinced that social services would let her keep this baby. Her sister was in exactly the same situation, having had eighteen children between them that were all placed in foster families and were eventually put up for adoption.
On some rare occasions a baby arrives because they don’t have any family; mum having decided that she doesn’t want to keep them or that she just can’t. On one awful occasion the mum had died during the delivery and we were unable to trace any relatives.
These babies are not always sick but some to us because we have the capacity to care for them while the adoption process is carried out.
We have 24 hour visiting access for parents and visiting hours during the day for other relatives but the only people who come to see these children are their social worker. When I look after these children I have to keep telling myself that soon they will have a loving, forever family who are desperate to love and care for them and that they won’t remember this time of abandonment at all.
Keeping this in mind I fill in a photo diary and make a memory box, filled with all the little items that other parents like to keep; baby’s first hat, their name bands, their cot card and all sorts of other bits and pieces. The baby’s forever mummy might not be here now but that doesn’t mean that she won’t want keepsakes from when baby was first born. My box of Squidge’s first is precious to me and there’s no reason why the baby’s adoptive mum would be any different.
Family can make you or break you and working on a neonatal unit I see both sides. My heart breaks looking after some babies, knowing what life is likely to have in store for them.