Developing Relationships through Informed Choice
Walking into a hospital or a doctor’s office isn’t usually a comfortable space for most people. We usually go when we are sick and as a result, sometimes we aren’t thinking as clearly.
Yesterday, I got the dreaded call from my daughter’s school that she got hurt playing outside. She hit her head and was bleeding. I went over to pick her up and they had some ice on to bring down the swelling. After taking her home and cleaning it up a little to get a better look at her head, I found a pebble in the wound. Once I took it out, I could see the cut was much deeper than it originally appeared. I packed up some books to keep us entertained (because you never know how long the wait will be) and off to the hospital we went.
I am comfortable walking into those places because I love to have discussions with them and know how to ask questions that get to the point (because they are busy too) but also help me get my answers so I can make the best decisions for me and my family. Here are my favourites!
What are the benefits? I want to know how this will help and what results I will expect to see.
What are the risks? Is there something that I need to be concerned about or maybe it isn’t recommended for someone with particular medical conditions? Does it increase the likelihood of needing other treatments?
What are the alternatives? I like to know about my options (medical and non-medical) because one may work better for us or just feel better with our values and plans.
What would happen if we didn’t treat it or did nothing?
How much time do we have to think about it? This is my favourite question! Most medical decisions don’t need to be made right on the spot! Even 5-10 minutes can let you get some clarity about the situation.
My partner will even attest to me asking questions as I was signing a consent form for surgery for an ectopic pregnancy that ruptured. These questions have become almost routine for me to ask now but it means that even walking into the emergency department (or urgent care like I did yesterday) that I can develop a relationship with the health care provider – one based on mutual trust and not on superiority.
Doulas are also for Dads
When we think of pregnancy and birth, mom and baby come to mind right away. We forget the people who are “behind the scenes” but who do so much – dads!
Why would a dad want a doula?
Labours can be long. I have supported women who don’t have partners and it is hard work (and this is my profession)! Having the doula can help you work together, to be involved the way you want to be. The doula can remember to grab the hospital card or make sure you have the car seat while you help mom into the car. At the hospital, if paperwork has to be filled out by dad, mom would normally be left alone. With a doula, she now has someone she knows and trusts to be with and to help provide comfort measures. Once you are admitted to the hospital (let’s pretend you have an OB as your health care provider), your nurse will pop in for a few minutes but for the most part, you are left in your room alone. Just the two of you. This can be scary for both of you if you don’t know what is happening. Moms often make low roars, get uncomfortable, and a doula can walk you through how to help and reassure you that this is normal.
Does a doula interfere with the intimacy of birth?
Actually, it is quite the opposite. Especially for a birth in a hospital setting, it is easy to get swept away with the list of procedures, moving rooms, beeping monitors, and bright fluorescent lights. A doula can help you transform that into a private and intimate space that matches who you are and let you share these moments together (instead of dad trying to do all the work and mom labouring alone). You get to spend more time connected on the important stuff and leave the details to us! Of course, she also doesn’t need to stay right in your face. Alone time can help trememdously, so she will read your cues and leave to get you something to eat or drink and you can share some special moments together.
Is there a difference in care between what a dad and a doula can provide?
Sure there is but they work together…here is what I mean. Dads know mom better than the doula because they have been together longer. He loves her and no one will ever be able to take that place. When he can bring that into the birth space, it can actually help support a healthy labour. The doula doesn’t have the same emotional investment (although we do tend to shed a tear or two when we see what you have accomplished together) which means she can be that objective perspective when you need it. She is also experience in providing the supportive care required for birth and can guide dad to the the best support ever! She is familiar with the cahllenges of providing care in a hospital setting, how media impacts both mom and dad’s views and beliefs about birth, and even the psychology of birth.
What can a dad do to help get ready for labour?
I always joke that they should hit the gym (and in some cases when mom wants her hips squeezed for every contraction, it might be helpful). Here are some more serious suggestions. Talk openly about labour, birth, and life with baby. Listen and share your own fears, hopes, expectations, and forseen challenges. Learn what you can about all of these topics. Help mom practice comfort measures for birth before you actually have to use them. It helps to decrease fear and helps make these positions more natural for the body to use in birth. For your own sanity, make a plan to support the household after baby arrives – all the practical stuff: cleaning, meals, laundry, sleep, caring for pets. If you have to enlist help, do it early and hold them to it!
Safe Sleep for Sweet Dreams
Sleep is important to everyone and is one of the most talked about subjects when you are a new parent. We are used to sleeping for hours at a time and our new babies, not so much. It can seem like a problem but I’ll explain why for them, it is helpful. As humans, we are one of the few species who birth our babies before their brains are fully developed – or else they would never come through the pelvis. We welcome our babies with immature brains and they need to stay in a light stage of sleep so they can be responsive to cues to remind them to breathe and eat.
Here are some ways to help everyone sleep safely.
1) Keep baby in your room for the first six months. When they hear you breathing through the night, it helps their little brains to keep breathing too.
2) Sleep when the baby sleeps, even during the daytime. This will help keep you safe if you need to drive, keep you alert with your newborn, and even help your milk production!
3) If your baby is sleeping in a crib, it should have a tight fitted sheet over a firm mattress. That’s it. No bumper pads, no toys, no monitors in the crib.
4) If you are bed sharing with your baby, take a look at where your bed is in the room. Make sure that the baby can’t roll off the bed and keep pillows and blankets away from baby.
5) Temperature is important too. Keep an eye on how warm baby is feeling. If you touch the back of baby’s neck and they are clamy or sweaty, they are too warm. Take off a layer to help them cool off.
6) Feeding your baby formula puts them into a deeper sleep than they are biologically meant to be in. Keep breastfeeding your baby, even if it may mean waking a little more often. You can learn to breastfeed lying down so you can rest at the same time as you are feeding.
March for Midwives
This weekend, I woke up early on a Saturday to drive out to Orangeville, Ontario. They currently have a practice of 4 midwives and are supposed to have privileges at two hospitals – one in Orangeville and one in Fergus. However, only 2 of the midwives have privileges at Headwater Hills Hospital in Orangeville. They have been waiting over a year and a half for everyone to have privileges in their practice.
What does this mean?
The midwives would never get time off because if one woman wanted to birth there, both midwives would have to be available. Without time off, it could result in burnout and exhaustion…therefore it isn’t safe for the women, families, and babies. As a result, they have stopped attending births there. Women now have the option of a birthing in the hospital in Fergus or at home.
So on Saturday morning we met in the parking lot behind the midwives office and we rallied together support from the community and with signs in hand, babies in strollers and carriers, we walked the 2.5kms to the hospital to let them know that midwives are important to us. We chanted. Cars honked. It was powerful to see the community come together to support these four women who have been there to welcome babies, to witness birth of parents. I was honoured to walk with this group and to use my voice to amplify their message.
They are simply asking for one thing: privileges for all. To grant the two remaining midwives privileges and to put in a system that will allow them to easily get privileges as the practice grows. We know it happens in other hospitals – look at any practice here in Toronto. There are upwards of 10 midwives in most of them and we have never had to wait a year and a half.
I also had my car painted while I was there. I now proudly drive a car that says “Where’s My Midwife?” I know that we have many more than 4 in Toronto and York Region but I also know that many women who want a midwife may not get one (4 out of 10 women!).
So many pumps to choose from! How do I choose?
You are planning on breastfeeding and one of the most thought of purchases then becomes a breastpump. First, I want to address a common myth – to breastfeed, you need to have a breastpump. You really don’t NEED it. In order to make enough milk, the real requirement is to keep your baby close and allow them to feed when they are hungry. However, many moms like to have the opportunity to go out for a bit without baby or some have to go back to work and are pumping while they are seperated. How do you choose which one fits your needs?
Manual pump – this is a pump where you do the work. It can only be used on one breast at a time and you squeeze the handle to remove the milk. These are the least expensive pumps and can be used for the occaisional time out. If you need to pump on a regular basis, this is not the one for you.
Single electric pump – this take the work out of the manual pump, but you are still only doing one breast at a time. Again, this is great if you only need it occaisionally. Since you usually have to pump both sides, it would double the time you are pumping. If you are just looking for the night out with friends, time at the grocery store alone or other small outing, either the manual or single electric would work well for you.
Double electric pump – this pump allows you do pump both breasts at the same time. This is an ideal pump if you are working or baby is having problems latching properly and you are using your pump to help keep up your milk supply. You can pump in about 15-20 minutes instead of 15-20 minutes per side, so for someone who may pump on a regular basis, this is what you are looking for.
Hospital grade pump – this is a special pump because of the way the milk travels. It allows multiple women to use the same pump (which means you could sell it if you wanted to). Each woman would buy the tubing kit but there is no risk of cross-contamination from other women using the same pump (breastmilk can contain infections, such as HIV if the woman is positive). This is a double electric pump too but certainly more expensive because of the design. These can also be rented from hospitals and a few other stores like Shoppers Home Health if you are looking for that option.
