Baby Steps

Last updated: 16 Jan 2019
Introduction

Helping parents cope with the pressures of a new baby

Pregnancy and the first months of a child’s life are crucial and lay the foundations for their future.

Baby Steps is a perinatal educational programme. It’s designed to help prepare people for becoming parents, not just for the birth itself.

How it works

How Baby Steps works

Baby Steps starts with a home visit in the seventh month of pregnancy and then includes six group sessions, one each week before the baby is born. After the baby is born, the family is visited again at home, and then there are three more group sessions. Groups are led by someone who works in children’s services, like a family support worker, and a health visitor or midwife.

Sessions include films, group discussions and creative activities. They’re interactive and designed to build confidence and communication skills. There’s a strong focus on building relationships between parents and their babies.

Users of Baby Steps can sign up to receive weekly texts with tips, pregnancy advice and support for their sessions. They can also opt in to a messaging service for practitioners to send session reminders to everyone in their Baby Steps group.

Themes

Baby Steps covers six themes:

  • the development of my/our unborn baby
  • changes for me and us
  • my/our health and wellbeing
  • giving birth and meeting my/our baby
  • caring for my/our baby
  • who is there for us – people and services.
Evidence base

The evidence base

Research suggests that the parent-child relationship is central to the child’s development and wellbeing (National Scientific Council on the Developing Child, 2004).

There is promising evidence that antenatal education that focuses on the transition to parenthood, the relationship between partners and the development of a positive parent-infant relationship can improve parent and child outcomes (Schrader-McMillan et al, 2009).

A woman whose partner remains involved during pregnancy is more likely to:

  • attend antenatal care
  • take better care of her health
  • deliver a healthy baby
  • recover more quickly from postnatal depression

(Fletcher, May and St George, 2014; Fatherhood Institute, 2010).

Currently, however, many vulnerable and at-risk populations do not receive any antenatal education or support on top of their standard midwife care (Royal College of Midwives, 2011). Where antenatal education does exist, it is of variable quality, usually aimed solely at mothers and mostly focused on the medical aspects of childbirth.

Who it is for

Who is Baby Steps for?

Baby Steps is for new parents who are more likely to need extra help, and less likely to access antenatal education. This includes those who:

  • have drug or alcohol problems (misuse substances)
  • are a recent migrant, asylum seeker or refugee
  • have difficulty reading, speaking or understanding English
  • have identified learning difficulties
  • have low-level mental health problems (such as depression or anxiety)
  • are a victim of domestic abuse
  • are an offender or ex-offender (committed a crime)
  • are homeless
  • are a care leaver
  • are from a traveller community
  • have no social support networks
  • are in severe financial hardships (having severe money troubles)
  • are under 20 years of age.

Making a referral

To make a referral to Baby Steps, either get in touch with one of the service centres offering this service, as listed under the Locations tab.

Delivering Baby Steps

The NSPCC is also supporting organisations to adopt, implement and deliver Baby Steps themselves.

> Find out more about delivering our services

Evaluation

Evaluation of Baby Steps

Using a variety of data, our evaluation looked at the overall experience of Baby Steps users and measured the service’s effect on parental mental health and relationships.

What we learnt

Quantitative evaluation

Quantitative evaluation found 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 (see the World Health Organisation’s report (PDF) on the importance of this measure)
  • had babies with a higher birth weight.

(Coster, Brookes and Sanger, 2015)

> Read our quantitative evaluation report

Qualitative evaluation

Qualitative evaluations of parents’ experiences of Baby Steps found:

  • parents were very satisfied with the programme and enjoyed it
  • parents felt they had acquired new knowledge, which had prepared them for pregnancy and parenthood
  • parents felt the programme had a positive effect on their relationship with their partner
  • parents felt that the programme had made them feel secure and supported
  • groups of parents who had less access to other forms of information and support, including parents in prison and those from minority ethnic groups, particularly benefited from Baby Steps.

(Brookes and Coster, 2014; Brookes and Coster, 2014; Brookes and Coster, 2015)

> See the References and resources tab for a full list of evaluation reports for this service.

How we evaluated this service

Baby Steps was evaluated during the first three years of delivery.

Process evaluation

During the first year, a process evaluation was carried out, with three components: focus groups, survey and interviews. The process evaluation demonstrated that the programme had the potential to be beneficial to parents, and that they appreciated it.

Focus groups

Held with practitioners to explore their experiences of delivering the programme.

Survey

148 parents were surveyed immediately after they had completed the service. This explored their satisfaction with the programme immediately after they had completed it, and whether they thought it was helpful.

Interviews

51 parents were asked about their experience of the programme and how they thought it had helped them. We selected parents for the interviews with a mix of characteristics such as gender, geographical area and referral criteria. Some interviews explored how the programme worked for particular groups, such as parents in prison and those from minority ethnic families.

Further evaluation

A second stage of the evaluation was conducted, measuring the programme’s envisaged outcomes using self-report psychometric measures. The measures were obtained at four time points:

  • T1: before the programme started
  • T2: at the end of the last antenatal session
  • T3: at the post-birth home visit
  • T4: at the last postnatal session.

In addition to the psychometric measures, data on birth weight, length of gestation, and delivery mode were collected from parents at the first home visit following birth as indicators of healthy birth outcomes.

Parents were also contacted six months after they had finished the course and asked to complete the psychometric measures and answer some additional questions about the longer-term impact of the course.

Evaluation tools

The evaluation used the following tools:

  • Hospital Anxiety and Depression Scale
  • Mother Object Relationship Scale
  • Prenatal Attachment Inventory and adapted Prenatal Attachment Inventory for fathers
  • Relationship Quality Index
  • Rosenberg Self-Esteem Scale.
References and resources

References and resources

Evaluation reports

Brookes, H. and Coster, D. (2014) Evaluation of the first year of Baby Steps: parents' perspectives. London: NSPCC.

Brookes, H. and Coster, D. (2014) Baby Steps in a prison context: parents' perspectives. London: NSPCC.

Brookes, H. and Coster, D. (2015) Baby Steps: perspectives of parents from a minority ethnic background. London: NSPCC.

Coster, D., Brookes, H. and Sanger, C. (2015) Evaluation of the Baby Steps programme: pre- and post-measures study. London: NSPCC.

Hogg, S., Coster, D. and Brookes, H. (2015) Baby Steps: evidence from a relationships-based perinatal education programme: summary document. London: NSPCC.

Johnson, R. and Andersson, T. (2018) Implementation evaluation of Baby Steps scale-up. London: NSPCC.

Evidence base

Fatherhood Institute (2010) Fatherhood Institute Research Summary: Fathers and Postnatal Depression. [Accessed 20/09/2018]

Fletcher, R., May, C. and St George, J. (2014) Fathers’ prenatal relationship with ‘their’ baby and ‘her’ pregnancy – implications for antenatal education. International Journal of Birth and Parent Education, 1(3): 7-11.

National Scientific Council on the Developing Child (2004) Young children develop in an environment of relationships. Working Paper No. 1 (PDF). Harvard: Center on the Developing Child.

Royal College of Midwives (2011) Low-income women 'poorly served' by midwifery services. [Accessed 20/09/2018]

Schrader-McMillan, A. et al (2009) Birth and beyond: a review of evidence about antenatal education. London: Department of Health.

World Health Organisation (WHO) (2018) WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections (PDF). Geneva: World Health Organisation (WHO).