How are you going to birth? What are you bringing to the experience?
This very insightful reflection was written by the doula who helped me bring Markus into the world. I enjoyed her ideas so much that I’m reposting it here.
Marie
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Oh boy, having just returned from attending a birth I have a hundred things going through my mind! But what I want to share is that over and over again I see the same thing in birth. What you bring in is what you get. Let me explain.
Every birth is so individual, so special in its own right. We have the power as women to decide what the first day and moments of life for our new family will be like. What I am learning in my work with birth is that the experience is actually determined long before you feel those first twinges and tightenings. Time after time I have seen strong women prepare themselves both mentally and physically for the birth experience they desire and then I have the pleasure of witnessing as they achieve those goals. There seems to be at least 2 factors involved. One, these women want to own their birth experience. They are not ready to just let it happen to them, they want to see the map, check out alternate routes to the destination and even pick up some tools and skills that will make the journey easier. Secondly, they act on their desires! They ask questions, face their fears, seek out other sources of information and truly desire to do what is best for them and the child to come.
This pre- determination of your birth experience occurs whether or not you invest yourself in the process. We all carry our preconceived notions of birth, pain, and parenting, We all drag our baggage along with us. We have those terrible or joyous birth stories that we have been told by other mothers swirling through our heads. We have our own issues around self confidence and trusting that our bodies can actually do this thing it was created to do.
Regardless of how you plan, intentionally or by default, your experience will bear that out in the end. Now, I am not saying that every women can plan herself a quick, painless, effortless birth. I am also not saying that things will always go the way you have planned. What I am saying is that when you plan you can handle whatever curve balls birth might throw at you with confidence.
A huge chunk of our birth experience depends on how we mentally process the things that are happening through us and around us. Any competitive athlete will tell you, physical preparation is vitally important, but the mental stamina to complete the challenge is just as important!
The first step is finding out what you don’t know about birth that could influence how you prepare and the choices you will make for your child. Start by questioning the obvious. Challenge notions that have been accepted as truth. For example: Why do we feel ‘pain’ in birth? Sounds like a stupid question doesn’t it? But, could our experience be a reflection of our expectations? I have seen the full spectrum of responses to the work a woman’s body does during birth. They have ranged from intense pleasure to out of control writhing. The factors affecting these births all seemed to lay within the mother’s mind. Her responses to the work. Her ability to flow with and relax into the experience all aided the coping with ‘pain’. When we are prepared for the work ahead, when we realize that the work is really coming through us. Women seem to be able to tap into an amazingly deep well of strength and focus.
I am going to be posting some birth stories and reflections from women I have worked with at some point either prenatally or during their their births as a Doula. They are filled with wisdom. I hope they will help you to start asking yourself how you need to prepare. What do you really want from your birth ? What can you do? What is within your power to control and what is not?
Welcome to the journey.
Believing in Birth,
Lisa Wass
Your baby has arrived! Congratulations! Life will never quite be the same. It’s a huge transition. Especially with that first baby. But still true with second, third and subsequent children. Enjoying your baby moon is the idea that the first month or first moon after the baby is born is a special time of settling into together. Getting to know each other on the outside and getting used to one another’s personalities. It’s a really special time. Just like a honeymoon. Hence the name baby moon.
For that first month after your baby is born, give yourself permission to take it slow. Spend time at home just hanging out with this new little person. Let go for all the little stuff… the unimportant stuff… like the state of cleanliness in your house, or the errands on your to-d0 list. All of it can wait. Hopefully your freezer is already full of easy to prepare meals… and if it isn’t send out someone to buy that type of food for you. And if anyone offers to help, ask for things you really need, like help with cleaning, laundry or meals. Remember your primary job is to care for your little one. All the rest is extra. Bonding with your baby is more important than the dishes!
In important to remember that your body needs time to heal as well. The place that the placenta attached to your uterus is an open wound on the inside of you. That takes times to heal. Additionally your body may have damage to the pelvic floor to heal from. And if you had a cesarean birth (yes it’s still a birth) you have major surgery to recover from. So take it easy and allow yourself time. Everyone will tell you to nap while the baby is napping. THIS IS ABSOLUTELY A GOOD IDEA! I know it’s hard. It’s soooo tempting to get stuff done. But for the first month, just relax and let baby sleep on you. And even if you don’t actually sleep when baby is sleeping, then at least lay down and rest. Caring for a newborn is so much more than a full time job. It’s a 24-7 job and there is nothing else quite like it.
Here are some helpful hints to making that babymoon one of the best months of your life.
1. Simplify Meal Preparation : A fridge and freezer brimming with healthy food can be a blessing in those early days with a newborn. Nursing makes your hungry. Stock up of nutritious snacks that you can eat with one hand while you nurse or hold a baby. Fruit and cut-up veggies, tube yogurt, muffins, and cut-up cheese slices work great.
2 Know Where to Find Help and Support : Knowing before where to go if you run into troubles can really help. In you are in Regina here are our local resources (Ok. I’m still working on this part – please check back). If you live else where, find your local breastfeeding clinics, emergency rooms, 24-hour pharmacies and local new mother support program.
3 Build a support team. As a new mom it’s so easy to fall into the trap of thinking… “I’m an independent working woman who has managed my own life successfully for years. I’ll be able to take care of things myself.” The truth is that newborns are demanding. And you will appreciate help. Family is great. You might even consider a post-partum doula. Contact me for the name of some of these awesome women in Regina. marie.berwald@birthbliss.ca
4 Keep Visits Short. Visits are ok, IF they are short and not too many. Especially while you and baby are learning to breastfeed. Often breastfeeding at the beginning will be easier if mom is naked and baby is naked. That isn’t easy to do with company. And waiting to feed baby until the company leaves results in a fussy baby and a mom who’s breasts are so engorged that it’s hard for baby to latch.
5 Breastfeeding isn’t always easy. It takes time for you and baby to figure out a rhythm and settle into your nursing relationship. If you can any difficulties ask for help right away! Problems are easier to solve the sooner that you get help. See a lactation consultant (in Regina, Linda Cheston, 586-4930), attend a breastfeeding clinic, or call the La Leche League breastfeeding helpline: 1-800-665-4324, or in Regina call 584-5600.
6 Get as much sleep as possible. Sleep deprivation is a true challenge and the truth is that most babies are wakeful at night… many even cluster feed in the middle of the night when you are the most used to sleeping. Changing your attitude towards night feedings can really help. Think of them as a special time for you and baby with no other distractions when you can really focus on each other. Keeping baby physically close to you can also make it easier. That way you can reach baby quickly before baby or you fully wakes up.
7 Hold that baby close. In the first months of life babies crave a womb-like environment. Things that mimic the womb trigger their own built in calming reflexes. This is the reason that swaddling, shhing, and rocking all sooth baby. Please please read the happiest baby on the block to learn really effective ways to calm your baby down. Babies thrive on touch. It is their first means of communication. Baby massage is an excellent way to build loving touch into the rhythm of your day. Wearing your baby is the other excellent way to build lots of touch into your day with them. Babies love interaction; looking at you and hearing your voice. They can see your clearly for a distance of 6 to 11 inches away… that’s the exact distance they are when you hold them. Isn’t nature great. Babies even recognize your smell. You are the center of their world.
8. Let bonding happen in its own way. There is pressure to bond right away. My sincere wish is that every women would feel that deep immediate love for their baby the second they meet them. This is why I am such a huge advocate for skin-to-skin contact after birth. It’s like there is glue on the baby and glue on the mother right after birth and when they are placed physically skin-to-skin, the glue sticks and the bonding is strong and easy. When moms and babies are separated, it’s like the glue begins to dry a bit, and it can take longer to stick. But stick it will, if you simply touch. So if you didn’t feel that deep love right from the start, don’t despair… the day-to-day experience of being close to your baby (wearing your baby is great for this) will establish and deepen your bond.
9. Give Dad the baby. In the first bit it’s easy for dads to feel a bit left out of the action, and some Moms have a hard time trusting that their partners will do the job right. It’s important to remember that your partner is different than you and will do things differently. And THAT’S OK! Give them the space and time to establish their own bond with baby and to build their confidence as a caregiver. Plus it’s really important that babies learn to be soothed by both parents. If baby is only comforted by mom, pretty soon mom’s touch is the only one that baby will accept. And that’s a shame for both partners.
10. Read some wonderfully helpful books. All these tittles are available at the our local library and as well as local bookstores.
The happiest baby on the block – Harvey Karp, MD (great advice for the first 3 months – especially if baby is fussy)
Natural Health after Birth – Aviva Romm (wonderful book which concentrates on the mother and her health after birth)
Infant massage, a handbook for loving parents – Vimala Schneider McClure (a classic for baby massage, wonderful writing, research and photos)
The Baby Book, by Dr. William (MD) and Martha (RN) Sears (a wonderful all around guide for gentle parenting from birth or 2 years old. The book answers lots of questions)
The Baby Whisperer by Tracy Hogg (a good guide for create a rhythm to your day and to learn your baby’s cues)
This message comes from my Hypnobirthing collegue’s friend Merrill Wilcox. I believe she raises some very good points about the realities of the situation in Haiti and what we can do to help.
Marie
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Dear friends,
As anyone who knows me is aware, the nation of Haiti has long been the jewel of my heart. My passion for that country has led my research, study, and work for as many years as I have known it to exist.
As the devastation in Haiti has become increasingly clear– and, increasingly, it has become clear that we are only seeing the tip of the iceberg– many people have asked me for recommendations about who to donate to. The following short list includes the organizations that I believe have established organizational capacity, networks, and credibility in-country to efficiently and effectively use any donations they receive:
Partners in Health- If you have read Mountains beyond Mountains by Tracy Kidder, you know the story of this health organization and it’s founder, Paul Farmer. It is unquestionably one of THE MOST reputable and effective NGOs in the country. It’s focus on medical treatment is especially relevant to the current crisis, which has left only two functioning surgeries in the capital. http://www.standwit hhaiti.org/ haiti
Yele Haiti- this organization started by Wyclef Jean, works directly with local organizations on the ground. It has an extensive local network, mobilizes local people, and has earned and maintained respect from the Haitian people. With the state of the rule of law and infrastructure of Haiti, which barely existed before and has now completely dissolved, this network and credibility are both critical to getting resources to the people who need it. http://www.yele. org/
Batey Relief Alliance- Spanning the Dominican Republic and Haiti, this organization has long delt with relief work in Bateys (poverty stricken Haitian worker communities in the DR) and has the presence in the DR to facilitate the movement of supplies into Haiti. http://www.bateyrel ief.org/
Red Cross- For obvious reasons. http://www.redcross .org/
A few other points I hope to call your attention to, as you consider donating to ease this monumental hardship:
1) Looting and lawlessness will happen. The Haitian people are the most dignified I have ever met. I have lived in Haitian communities in contexts of extreme poverty and hardship, and regularly been struck and humbled by the patience, diligence, and civility of the culture. Having said that, this is an extremely desperate situation. Remember Katrina, where our own demons came out, then add to it 200 years of hunger and hardship. Please do not be discouraged by the reality that people will loot, fight, and scramble to survive this current crisis– do not let that stay your compassion. The Haitian national motto is “Unity makes Strength,” and I have in my own life seen the degree to which these simple words live and breath in the culture. So when ugly things happen in this ugly situation, please do not let yourself make the jump to conclude that it is an ugly people you are reaching out to.
2) The relief efforts will stumble and be disorganized. The wide-reaching response to the crisis in Haiti has been inspirational in scope. The motivation to help, to save lives, to do what can be done, burns across our nation and the globe. However, directing that fire into appropriate and effective systems of delivering aid will be challenging. The entities involved are not used to working together, have differing ideas of the correct way to approach their shared goals, and are now struggling to build effective organizational partnership under very real constraints of time and resources. Furthermore, they can not turn to any strong system of organization within Haiti to guide them. There exists in Haiti almost no infrastructure, effective government, or strong police presence, ESPECIALLY now, after what was there a week ago has been shaken to the ground. Thus, the struggle to create effective organization out of chaos and crisis will be difficult; this is appropriate and correct. It will succeed, however, given the time, attention, and support that any such process requires.
My goal in raising these points is not to discourage, but to beg patience. The frustrations of this situation can easily lead to a sense of disillusionment and fatigue, which can sap the perseverance that is absolutely necessary to save lives and rebuild livelihoods in Haiti. My warning is against that sense of disillusionment, to encourage us, as donors and witnesses, to go into this with no illusions. If your heart cries for the people of Haiti, for a man sobbing over his infant daughter, for a woman’s body stacked outside the morgue with only a piece of cardboard tied to her stating her name, for a family crowded together in the remains of their home without food or water, grateful to be alive but terrified about what they will have to do through to remain so, then hold strong. The worst is not past, but it will pass; in the meantime please continue to support the movement to ease that passage.
Thank you, and God bless,
Merrill
p.s. Please feel free to forward this message on if you feel it helps, and don’t hesitate to contact me if you have any questions, comments, or other resources to add.
–
Merrill Wilcox
19 Isle of Hope Road
Mount Pleasant, SC 29464
merrillwilcox@ gmail.com
781-697-7715 (cell)
I thought you would enjoy an excerpt of an interview with Jean Pierre Hallet (now deceased), who grew up with the Efe pygmies in equatorial Africa, and lived with them for much of his sixty plus years. I wish that our so-called advanced western society had it this right!
This account fits in really well with what my hypnobirthing families learn when we study the history of birth. Primitive or primal people the world over have seen birth as a celebration of life, a sacred expression of the divine power in nature. This is in sharp contrast to the early Catholic Church teaching that birth was a curse and a source of sorrow and suffering. If you believe as I do, that our thoughts and beliefs collectively shape our world, then it’s easy to understand why birth is so feared today.
A note to this description : typically in early labour, the laboring woman stays alone and in the dark, or as dark as she can make her hut until her waters release. No interference. The woman is free to be in any position and make any type of sounds… safe, private and unobserved. (Sarah Buckley’s hallmarks for a great birth) I also love that the ‘aunties’ (midwives) are beside her and not in front-good energetics there. No one is taking command by body placement. Notice always the size of the babies in relation to their mothers. And note the use of vocalizations/singing to help move the energy through.
If you would like to read another first hand account of “primitive or primal” birthing, then please read the post on bellydancing which includes the story of an American woman who traveled to the Sahara dessert in the 60s and witnessed a traditional birth in which the women helped the birthing mother attain a trance like state by dancing with and around her. If you know of any other primal birthing accounts please let me know. I would love to read them.
Marie
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Hallet described Pygmy labor as being very short, natural, and easy, even for a first-time mother. And this is in spite of the fact
that Pygmy babies are, proportionally, the biggest babies in the world. For example an 80-pound Pygmy mother typically gives birth to an eight-pound baby, about one-tenth of her body weight. This would compare to a 130-pound woman birthing a 13-pound baby.
When the mother’s membranes rupture, she notifies her two midwives, who then walk with her to the river, one on either side. “At the time of the pain,” Hallet said, “she will walk and sing, sing and be joyous.”
Once at the river, the pregnant woman squats on a flat rock. The midwives hold her on each side, and breath deeply with her in what Hallet referred to as “a tremendous feeling on oneness.” When they feel the time has come, the women hold their breath. “They pause together,” said Hallet, “and then you see the baby coming out.”
One of the midwives briefly holds the baby upside down, washes the upper part of the body to make sure the baby is breathing well, and then returns the child to the mother for nursing. The other midwife works her teeth down the umbilical cord until she finds the narrow part, a few inches from the infant’s abdomen. “This is the place where, if a baby were dropped from the womb of a standing mother, the weight of the child would be enough to break that cord at that point,” said Hallet. The midwife bites this narrow part very slowly, and then gently squeezes the cord with her fingers. There is usually very little bleeding.
To celebrate the birth of her child, Hallet noted, a mother will sing this song:
My heart is so joyous,
My heart flies in singing,
Under the trees of the forest,
The forest, our home, our mother.
In my net I have caught
A little bird,
A very little bird,
And my heart is caught
In the net with my little bird.
During the birth, the father stays away. Birth is considered to be women’s business. After birth, when the mother and baby have returned to their leafy, dome hut, the father comes to them and asks permission to enter. Then the father might clap his hands and thank his wife for their very wanted child.
Newborn Care
According to Hallet, there is no bonding ritual, but there is a bond — “like a fruit to its branch” — a physical attachment for the first year or so. During this year, the baby is “never separated from the mother.” In Hallet’s view, this constant contact is one reason why Pygmy infants rarely cry. Pygmy babies appear to feel good. “They are satisfied in all of their requirements, ” he stated. On the rare occasion when a baby does cry, it is only for a moment, because the baby’s need is immediately taken care of. Often this means nursing, which satisfies the baby’s necessity for close contact and attention, as well as for nourishment.
Hallet remarked that the baby is usually carried in front, although sometimes on the back. In either position, Pygmies feel it is essential to maintain skin-to-skin contact, with the child naked against the mother’s bare skin. If clothing is needed for warmth, the mother wraps a clothe around both herself and her child, not between them. This constant skin contact continues for at least the first six months. Thereafter, the mother continues to provide plenty of touching as well as baby-led nursing.
…
The father takes great interest in his baby. He plays, holds and hugs the child as much as the mother does. Men and women equally manifest love and care. In fact, fathers will sometimes hold their babies for very long periods of time. Hallet recalled, “The most beautiful time for a father is when he holds his baby for the very first time. He will hold his newborn with great . . . tenderness. And usually he will cry, because he is so touched by his baby.”
by Ushanda io Elima, a Pygmy Model For Partnership
The quest for balance as a mom isn’t something that I find very easy. Usually in an attempt to meet everyone needs, I end up ignoring my own. I forget to nurture myself. This is not a very good recipe for a happy, healthy family. I once read a t-shirt that declared… if the mama ain’t happy, ain’t nobody happy. To large extend I think that’s true. As a mom, our mood sets the emotional climate for the whole household. And what I’ve noticed is that when I spend too much time focusing on everything else, the kids, the house, work, my hubby… then I deplete my own stores and I end up feeling like I have nothing more to give.
So I decided as my new year’s resolution, that at least once a month I’m going to make at least one decision that puts me first. That lets it be all about me for a change.
The January decision : Return to Belly Dancing. I love belly dancing. It’s fun. It makes me smile. A lot. I really enjoy the company of my fellow dancers. I love my teacher. I love the costumes. I love the way I can move my body. I love how it makes me feel.
“Just look at how happy I am dancing.”
I haven’t bellydanced in far too many months. I miss it. So I decided to go back. This means that I will have to change the time of my prenatal yoga class back to Friday nights. The prenatal yoga was scheduled at the same time as dancing on Thursdays. This means I might lose a few students, but I’m hoping that everyone understands.
As for the decisions in the coming months… I will keep you post.
And I leave you with this question… this month, what did you do for you?
Ok. So I don’t normally blog about products but this one is just so great that I’m gonna! 
The Diva Cup. It’s this silicon cup made right here in Canada that takes care of all of your menstrual cycle needs in one easy to use, environmental, cost effective, tidy and comfortable way.
Some of you already know that I make an effort to reduce my environmental impact where I can. I cloth diaper, recycle, reuse, compost and all that. I thought about what to do around the whole monthly period experience. While actually I hadn’t really thought about it for a long time, seeing as I went from pregnant to nursing and back and forth for the past 6 years. But I’m finally off that wagon. Well almost. Markus is still nursing. But my menstrual cycle has returned and that got me thinking about the kind of product that I wanted to use.
I discovered the Diva Cup and I’m just soooo happy with its performance. It is neat and tidy! No messy pads! No strong smell. And it’s totally comfortable too. Plus it’s not associated with toxic shock syndrome which gives me some nice peace of mind. The form of silicone used in the product is odorless, has antibacterial properties, is latex-free, plastic-free and BPA-free. And this type of silicone is approved for use as feminine hygiene protection by the FDA and Health Canada. Sounds pretty good’eh! Think of all the pads and tampons you use in a year and then think of all the women in Canada who also use those products. It adds up to a lot in the landfill over time. It’s easy way to be “green”.
On top of it all, it’s cost effective, because you pay once and reuse again and again. Plus it would be great for traveling. Actually I’ve been so excited about this thing that I have been telling everyone including my brother (we are a pretty open family), and he surprised me by launching into this big speech about how this is the best thing since sliced bread. Apparently his backpacking travel companion Michelle used it throughout their trip, loved it and she also could not shut up about it… so hence my brother’s surprising awareness of the Dive Cup.
Essentially it’s a little cup that you fold in half, insert and your vaginal muscles keep it in place and it collects all the fluids. Two or three times a day you pull it out using the tap at the bottom of the cup and dump the contents in the toilet, wash and reinsert. Easy peasy!
If you really want to find out more, visit their website…. www.divacup.com
Cheers,
Marie
Have you even gotten sucked into the myth of the Perfect Mother whose kids meet all the benchmarks on time? It’s so easy to do.
We all want to do this job of parenting so well. And I think we look outside ourselves and our families to judge whether or not we’re “succeeding”…. we look at benchmarks. Even that word, succeeding cares such an emotional weight when applied to parenting. Benchmarks are after all external indicators of development. And I wonder sometimes if the focus of meeting the benchmarks pushes our kids too far, to their and our emotional detriment. I saw a baby t-shirt on the internet, that proudly proclaimed, “I’ll walk when I’m good and ready!”. That made me smile. Markus could use that one. At almost 15 months, he’s still not walking. He’s close so I’m too concerned, but I did feel that little yucky feeling of “Oh is he behind?” when all of the other babies his age and some younger at the birthday yesterday were walking. And there are times to be genuinely concerned. A friend of mine’s little guy needed some physiotherapy because he bum scooted for so long that his inner leg muscles were almost too flexible and he had trouble standing. Today he’s a happy 5 year old today who runs with no problems. And I know that the vast majority of bum scooters transition into walking with no extra assistance. But to me, stories like that illustrate the need for benchmarks. When development is veering off the path of normal, it’s good to have some indicators to alert us to that fact and so that we can get our children the help that they need to thrive.
However benchmarks work better when understood as window of time rather than an actually date. Babies roll between 4 to 7 months old. Kids learn to read between 4 and 7 years old. It’s a window! Just like your due date was.
Every child develops so uniquely. Benchmarks work better when they are not confused with value measurements. A benchmark can let you know when your child might need some extra help with learning her letters. But it does not in any way reflect the value of your child. A mental challenged child is not worth more than a mental “gifted” one or vice versa. But it’s easy to get caught up in the value connotations of benchmarks.
So here’s to sitting back and enjoying the ride and being content to marvel at the development of your little one without making yourself crazy.
Marie
Kelly Green, my very first yoga instructor and owner of Everyday Sacred, recently became an interfaith minster. I have attend a number of her ceremonies and they are awesome. Heart-felt and moving. This is a wonderful opportunity to celebrate the new life in your family. 
Marie
CELEBRATE LIFE… through PERSONALIZED CHILD CEREMONIES
Ceremonies include:
Baby Welcomings, Namings, Blessings, Baptism/Christenings, Adoptions, and Blended Family Unions
We all use Ceremonies and Rituals to celebrate, honor and mark the many milestones and transitions in life, the life of our families and community. Baby and Child Ceremonies acknowledge and honor the preciousness of our children and families.
A personalized child ceremony includes you and I meeting several times. By the way, we can meet over the phone or I can come to your home so we don’t disturb your child’s schedule. I ask a lot of thought provoking questions and we meet a number of times so that I may create a meaningful, one of a kind ceremony which perfectly reflects your needs, your beliefs, your values, and the uniqueness that is your child and family. The ceremony takes significant time to create so please book well ahead of time.
Please call 306. 529.9790 if you would like to have a preliminary discussion and ask any questions. If you leave a message, give me some days/times to get back to you. It may take us a few days to connect as my schedule is rich and full with ceremonies, life coaching and teaching yoga.
Other ceremonies and rituals I can co-create and officiate include-
*Weddings, Commitments, Renewal of Vows
*Funerals, Memorials
*Transitions- Divorce, Retirement, Moving
*Milestones- Birthdays, Coming of Age, Graduations, Mid Life, Empty Nest
*Healing, Hope, Living through Loss, Survivor, Missing Persons
*Animal Ceremonies (memorials, adoptions)
*Others- Seasonal, House, Business, Grand Openings, Dedications
___________________________________________________
Every Day Sacred…Centre
Kelly Green
Interfaith Minister, Life Coach, Social Worker, Yoga Therapist
green.k@sasktel.net www.everydaysacred.ca
cell (306) 529-9790/studio (306) 569-8088
A while back, the Regina Qu’appelle Health District invited Dianne Younker, Adminstrator of Women’s and Infants’ programs at Toronto’s Mount Sinai Hospital, to come to Regina and speak about Family Centred Care. Part of Dianne’s stay in Regina included a public forum on maternity services with our health district.
I attended this forum and invited my past clients to attend at well. Many responded that they were interested but were unable to attend and asked that I share what was discussed at the meeting. So I decided that this would be a good place to report on the details for the forum.
The majority of the evening focused on what is Family Centred Care and what does it look like and feel like for patients and their family. The basic premise of family centred care is that when a patient is supported by their family while receiving treatment, then the patient’s emotional and mental health is much better. This makes a lot of sense. When you take care of the emotional health of a patient, their physical health will improve. It goes hand in hand.
So as our hospital moves in this direction, some changes are being made in regards to moms and babies. For one, dads can now stay at the hospital with mom for the duration of her stay. If mom is having a c-section, then usually during the procedure she will allow to have her partner plus a second support person can stay with her the whole time. Babies can stay with mom in the event of the C-section. The medical staff comes to the baby rather than taking the baby away. This one the hospital is still working on. Currently the babies are taking away for the postnatal checks, but hopefully by early 2010 the babies will be staying the room with mom. And another change is that they are more strongly encouraging babies to stay with mom at all times while mom is in the mother baby unit. With the new renovations that are being done, there will be more rooms for moms to stay at the hospital if their baby is in the NICU, and they themselves have been discharged. There will be recliners beside the incubators so that moms and dads can comfortably stay close to their baby. It’s also a change in the way that the nursing staff approach their patients. Rather than coming into the room of a new mom and her baby and stating that now they are going to do this and that. They can come in and say, “Listen we have some time today to focus on what you need help with. There are also some things that I need to do with baby but I want to hear from you as well about what you would like help with.” Even just reading that statement, doesn’t that feel good? It’s a much more collaborative approach.
Another part of this philosophy that I really love, is the idea that neither the doctor (nurse) or the patient has all the answers and that the best care arises from a clear communication between all the participants – doctor or nurse and patient. It comes from the belief that just because two people have the same illness, doesn’t necessary mean that they need exactly the same care. Birth isn’t an illness, but this philosophy is so appropriate in the area of birth. Just because two women are giving birth doesn’t mean that they need the same care. In fact quite likely they will have different ideas about what is a good birth experience and what kind of care and support they need. And I’m so glad that this is being acknowledged.
Congrats to the Regina Qu’appelle Health Region for moving towards this type of care for families! We’ll all benefit.
Marie
Below is some additional information from the Institute for Family Centered Health Care.
http://www.familycenteredcare.org/index.html
What is patient- and family-centered health care?
Patient- and family-centered care is an innovative approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care patients, families, and providers. Patient- and family-centered care applies to patients of all ages, and it may be practiced in any health care setting.
What are the core concepts of patient- and family-centered care?
- Dignity and Respect. Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into the planning and delivery of care.
- Information Sharing. Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.
- Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.
- Collaboration. Patients and families are also included on an institution-wide basis. Health care leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in health care facility design; and in professional education, as well as in the delivery of care.
Patient- and Family-Centered Care Core Concepts
What is meant by the word “family”?
The word “family” refers to two or more persons who are related in any way—biologically, legally, or emotionally. Patients and families define their families.
In the patient- and family-centered approach, the definition of family, as well as the degree of the family’s involvement in health care, is determined by the patient, provided that he or she is developmentally mature and competent to do so. The term “family-centered” is in no way intended to remove control from patients who are competent to make decisions concerning their own health care. In pediatrics, particularly with infants and young children, family members are defined by the patient’s parents or guardians.
Is the term family-centered, patient-centered, or patient- and family-centered care?
In the early 1990s, the Institute’s work focused primarily on family-centered approaches to pediatric care. Within this framework, it was always recommended however, that as patients matured, they should be encouraged to become more involved as decision-makers in their health care. As the Institute has become more involved in adult and geriatric care in the last 8-10 years, we have felt that it was important to make the acknowledgement of the patient’s role more explicit. Thus we now more commonly use the term patient- and family-centered care.
We believe that the term, “patient-centered care,” is not sufficient to adequately describe this approach to care for several reasons. The original definition of patient-centered care as discussed in the literature in the late 1980s and early 1990s did not include the concept of patients and families as advisors and essential partners in improving care practices and systems of care.
A second reason is that the majority of patients have some connection to family or support networks and it is important for the health system to encourage the continuing link to these natural supports. Due to the profound influence of families on patients’ health and well-being, families and other supportive persons should be viewed as allies in efforts to enhance safety and quality in health care.
A third reason to be explicit in the use of the term, “patient- and family-centered care,” is that social isolation is a risk factor in today’s society. Individuals, who are most dependent on hospital care and the broader health care system, are also often most dependent on families and other support networks:
- The very young;
- The very old; and
- Those with chronic conditions.
Hospitals, clinics and other health care agencies that make an explicit commitment to patient- and family-centered care develop policies, programs, and practices collaboratively with patients and families that support and encourage family presence and participation.
Is there a difference between family-centered care and family-focused care?
While both approaches acknowledge involvement with the family as a fundamental element of care, there are key differences. In family-focused care, professionals often provide care from the position of an “expert -” assessing the patient and family, recommending a treatment or intervention and creating a plan for the family to follow. They do things to and for the patient and family, regarding the family as the “unit of intervention.” Family-centered care, by contrast, is characterized by a collaborative approach to caregiving and decision-making. Each party respects the knowledge, skills, and experience that the other brings to health care encounters. The family and health care team collaboratively assess the needs and development of the treatment plan.
Does patient- and family-centered care take more time?
Implementing a patient- and family-centered approach does require an up-front investment in relationship building. Staff must have opportunities to explore how they currently interact with patients and families, to discuss and reflect on the value of collaborative approaches, and to build new knowledge and skills. For family-centered care to be effectively implemented in any healthcare setting, the staff must honestly assess how they are currently treating their patients and how this can change. Just undertaking this honest assessment is very valuable for the institution.
Patients and families, who are more accustomed to being passive recipients of care, will require time and training to learn new skills and strategies to become active participants in care and decision-making. Patients and family members who will play key roles on hospital committees or task forces will need training and mentoring .
The time it takes to build these partnerships and acquire appropriate knowledge and skills will eventually be repaid several fold. When administrators, clinicians, patients and families have a shared understanding of, and respect for, what each brings to the health care experience, the stage is set for mutually beneficial relationships. With shared priorities and goals, time will most likely not be wasted on repetitive, ineffective, or counterproductive activities. The possibility of misunderstanding, dissatisfaction, and even medical error is greatly diminished.
Does patient- and family-centered care cost more?
Many aspects of patient- and family-centered care do not cost more money; they simply require a change in attitude and approach. Patient- and family-centered care improves the quality and effectiveness of communication. It is proactive, rather than reactive. As a result, many problems are prevented, and others are handled before they grow out of control.
Introducing patient- and family-centered care does entail some initial and ongoing education costs. But the costs of failed communication and trust—often quantified in terms of poor patient outcomes, wasted resources, and malpractice litigation—are much higher.
Environments that support the presence and participation of families and ensure a healing environment with privacy for patients and families may be more expensive to build. These initial design costs are quickly recouped, often in quantifiable terms, as demonstrated by lower infection rates, higher patient and staff satisfaction ratings, and improved market share. A healing environment that offers appropriate space for families is more supportive of staff and thus enhances staff satisfaction and retention.
What are strategies to overcome staff resistance?
Administrative and clinical leaders should begin by setting a positive example, modeling collaboration with patients and families. Other steps include ensuring that staff have the appropriate resources to practice patient- and family-centered care and rewarding exemplary practice.
For example, it is helpful to create forums at which staff can voice their concerns and then provide educational programs to address these concerns. Providing staff with the resources and support they need to effectively partner with patients and families usually leads to change in practice and attitudes. Programs that feature patients and families as faculty—where they recount their own experiences within the health care system—helps broaden staff perspectives and understanding. As part of these efforts, inviting staff to think about their own health care experiences and how these experiences influence their own practice assists staff in learning about patient- and family-centered care on both intellectual and emotional levels.
Another effective technique is to develop patient- and family-centered champions across the hospital or agency. This can be done by asking managers, clinicians, and support staff who are already interested in or knowledgeable about patient- and family-centered care to serve on committees and task forces with patients and families. When possible, choose staff who are already viewed as opinion leaders by their peers for these roles.
Involving staff in the process of measuring changes and improvements as well as structuring plans for dissemination and the spread of innovation, helps overcome resistance. Providing staff opportunities to share their positive experiences and engage in problem-solving discussions in areas of concern are also helpful strategies.
How do we identify patients and families to serve in advisory roles?
Ask staff and physicians to recommend patients and families whom they believe may be effective advisors. Contact peer support groups in the community or groups that are affiliated with the clinical programs at the hospital or agency. Review satisfaction surveys for individuals who have constructive ideas to share for improving care experiences.
Once a pool of potential candidates has been identified, some organizations invite patients and families to come to an exploratory meeting about serving as advisors. Others convene an informal workgroup of patients and families as a way of building mutual understanding and trust for this collaborative process.
What qualities should we look for in selecting patients and family members as committee members and advisors?
Individuals serving as patient or family advisors should reflect a range of experiences within the unit, hospital, or agency and should be representative of the community served.
In reviewing possible candidates for advisory positions, look for individuals who:
- Share insights and information about their experiences in ways that others can learn from them.
- Show concern for more than one issue or agenda.
- Listen well.
- Respect the perspectives of others.
- Speak comfortably and candidly in a group.
- Interact well with many different kinds of people.
- Work in partnerships with others.
- See beyond their own personal experience.
The environment. These days it seems like everywhere we turn we are
bombarded with reports and studies about the myriad of ways that we have
harmed our environment. The headlines are hard for any mum to ignore:
global warming, pesticides and factory farming, toxic chemicals in the
ocean, the list goes on.
For many of us, becoming parents means a considerable shift in the way
we view the world and the future. Suddenly the hazy idea that future
generations might be forced to bear the burden for our environmental
failures has a flesh and blood reality. And that reality is currently
wearing fuzzy pajamas and sleeping in the next room.
So we try to consider how we can minimize our environmental footprint.
Maybe that means carpooling with our mums, maybe that means buying
organic fruit, using natural cleaners or trying cloth diapers.
At its heart, I believe that sustainable living is not just about the
environment, but the interconnection of all life on this planet. In
taking care of where we live with strong environmental, economic and
cultural policies we can create the sort of communities that foster our
physical and emotional health and the health of our planet.
In Regina this week, we have the chance to do just that. The City of
Regina is holding open houses to discuss the waste plan for Regina. It
is a chance to talk about what we want in terms of garbage, recycling,
curbside composting, etc.
There are 3 upcoming, drop-in open houses and I strongly urge to attend
one of them:
Thursday, Nov. 26
Glencairn Neighbourhood Recreation Centre
2626 Dewdney Ave.
5:30 -8 pm
Wednesday, Dec. 2
Cathedral Neighourhood Centre
2900 13th Avenue
5:30 -8:00 pm
Wednesday, Dec. 9
North West Leisure Centre
1127 Arnason Street
5:30 -8:00 pm
For more information you can visit www.regina.ca
And if you can’t make the public talks, take the time to make your voice heard by filling out the questionnaire at
http://regina.ca/Page4331.aspx
Here’s to a healthy, joyous planet. Now there is a Christmas gift worth
celebrating!
Hugs,
Marie
