14th March 2025
We are delighted that Louisa Clifford-Taylor, our Research Associate at iHV, has completed her PhD – congratulations! In this Voices blog, Louisa discusses her research findings which focus on the support needs of multiple birth families and her experience of undertaking the PhD.
Dr Louisa Clifford-Taylor, iHV Research Associate
The transition to parenthood is a life-altering event for all families, but for those expecting twins or higher-order multiples, it comes with distinct challenges and joys. It is understood that preterm birth can be a traumatic experience for any parent. They frequently describe feeling a loss of control, powerful, often conflicting emotions and interruptions to bonding and attachment. Separation from their infants, in addition to the division of their time between their infants while receiving differing levels of medical care after birth, can be a particularly traumatic experience for families.
Parents reported receiving insufficient and inadequate information specifically tailored to the needs of multiple birth families. And they experienced a lack of preparedness. Parents also felt that most healthcare professionals did not have enough knowledge of multiple pregnancy, birth and parenting to address their needs. Multiple birth families who experience preterm birth are faced with additional unique challenges during their time in hospital and following their transition home.
Multiple birth infants are high users of health care, accounting for a disproportionate percentage of admissions to neonatal units. This can significantly impact bonding and the mental health of parents who are also understandably concerned about their infants’ wellbeing. The MBRRACE-UK 2022 report shows that twins face a significantly higher risk of stillbirth and neonatal death compared to singletons. These families also face increased risks of developmental challenges in early childhood, are at greater risk of readmission to hospital, financial strain, sleep deprivation and social isolation, particularly in the first years of life.
Participant generated image shared with consent
The Role of Health Visitors in Supporting Multiple Birth Families
Health visitors have an essential role in supporting parents of twins and higher order multiples. They are often uniquely placed to offer not only practical advice, but emotional support during a potentially overwhelming time. From my research into the experiences of multiple birth families, parents highly value interactions with professionals who are knowledgeable, empathetic and responsive to their specific needs.
A supportive, sensitive approach is important and there are several recommendations to offer the best possible support to multiple birth families:
- Sensitivity to Higher Support Needs: Families of multiples may need extra assistance with day-to-day care. This is particularly relevant for families discharged home from the neonatal unit as these parents describe finding adjusting to life without monitors and the routine of the unit challenging.
- Providing Evidence-Based Information: Offering up-to-date, reliable guidance on issues such as prematurity, infant care and developmental milestones can help ease anxiety and promote positive outcomes for both babies and parents.
- Infant Feeding: Feeding multiple infants presents additional challenges compared with feeding a singleton infant. Premature birth further exacerbates this. The rates and duration of breastfeeding are lower for multiples than singletons. Support from skilled, trained professionals is essential in reducing these disparities. Feeding advice that is accurate and consistent with current guidelines is invaluable to parents.
- Signposting to Specialist Services: Where appropriate, health visitors may connect families with relevant services, such as neonatal support, therapy services or local support networks for multiple birth families.
- Consistency in Care: Where possible, building a rapport with families over time helps them feel supported, safe and understood. This is important when families may be dealing with the physical and emotional strain of caring for multiple infants simultaneously, especially when their infants have divergent needs.
- Promoting Parental Mental Health: Health visitors are also in a unique position to monitor and support the mental health and wellbeing of parents. Ongoing emotional support and signposting to mental health resources are critical, especially given the higher incidence of perinatal mental health challenges faced by the families of multiple infants.
My research journey
Although the PhD process has felt challenging on many occasions, I am grateful for the opportunities afforded to me in terms of my personal, professional and academic growth. The knowledge and experience I have gained through the process have enabled me to move into a Research Associate role and continue to develop my understanding of research methods and how well-formulated research can lead to meaningful change for families and practitioners. Throughout this project, I have gained valuable insights into the challenges and resilience of families navigating the complexities of preterm multiple births. My next steps involve disseminating these findings to, and continuing to engage with, the community to ensure the research has a positive impact.
I would encourage other health visitors to consider a career in research, which can be very rewarding. This article, written by my iHV colleagues, explores some of the common barriers in health visiting research – however, research offers the opportunity to contribute to meaningful advancements in our field and to make a tangible difference in the lives of children and families. Read a recent Voices blog for more information about the need for more health visitors in research – We need more health visitors to engage and lead research – watch video.
Further Resources for Health Visitors Supporting Multiple Birth Families
- The Elizabeth Bryan Multiple Births Centre: Established through a collaboration between Birmingham City University and the Multiple Births Foundation, the Centre offers resources and an established Specialist Interest Group for professionals supporting multiple birth families. An online CPD module focusing on care and support from conception to one year is also available.
- Twins Trust: This organisation offers a wealth of resources for both multiple birth families and healthcare professionals, including guidance on navigating the specific challenges of multiple birth parenthood.
- Future Learn – Loss of a Baby in Multiple Pregnancy: Supporting Grieving Parents: This online course by The Butterfly Project provides valuable guidance on providing bereavement support, a crucial area of care for families facing loss during a multiple pregnancy.
Further information about HV research opportunities:
iHV Research Network for iHV members
We have a fantastic iHV Research Network, open to all iHV members who:
- are interested in research in health visiting practice
- would like to connect with other health visitors who are active in research to share learning
- want to find out about support to become involved in research
Our next Research Networking event is on 2 April, 09:30-11:30 – book here
Find out more and access our research resources here
