Navigating the NICU
Many babies are born at term and are healthy. There are a number of other children who need support in their early days. My daughter was one of those who stayed in the NICU (Neonatal Intensive Care Unit).
The NICU can have a lot of staff walking around and your baby might be seen by many of them throughout the day. Who exactly will care for your baby?
The first person is YOU! You, the parents of this new baby are encouraged to take care of your baby as much as possible. This includes all the care you would have done at home: feeding, diapering, baths, singing songs, kangaroo care (skin-to-skin), reading books, and more. You are the most important careprovider because you are coming from a place of love for this little one and they will know it, no matter how early they may have arrived.
Your baby will have a pediatrician or neonatologist. This is the doctor that your baby will be assigned to. This is the person to discuss treatment plans with and work with them to get the care you would like to see for your baby.
Nurses are a big part of the team too. They are the ones who are interacting most with your baby (other than you). They will make sure that medications are on time, that the monitors are connected properly, and they will help you learn to care for your baby if there are additional considerations (usually machines and wires).
Respiratory Technologist (or RT for short). If your baby needs oxygen or any breathing support, they will be making sure that the treatment is working for your baby and providing instructions to the nursing staff about it. You can certainly ask them questions too about the support they are providing for your child.
Even little baby’s see dieticians sometimes. They ensure that they are getting the vitamins and calories to ensure optimal growth.
Lactation consultants are also available to help in the NICU. Baby’s who can’t suck yet can still get breastmilk. The lactation consultants can help you with questions about pumping, latching, and ensuring you establish a solid milk supply for your baby when he/she is ready.
Occupational Therapists (OTs) make sure that your baby is meeting developmental milestones. Most of these involve feeding skills but they can also answer questions about infant behaviours.
With all of the technical staff who each have an area of expertise, many NICUs have the support of a social worker or pastoral services. A lot can happen in short periods of time, which makes the intensive care unit an intense experience for some. Don’t be afraid to reach out to these people. They can listen and help you navigate your time there. Your hospital may offer a variety of resources for you and they can be your link to accessing some of the hidden gems. It is also important that at a time like this, when you face unexpected outcomes, that you surround yourself with positive support and take care of yourself so you can better care for your baby.
The neonatal intensive care unit can be a busy place but getting to know the staff who are participating with you in caring for your baby and building that relationship early, you can help your baby get a great start.
Speaking about Stretch Marks
Pregnancy pictures in many magazines don’t show stretch marks (unless it is an ad for the newest product). However, stretch marks are a reality that many women have during pregnancy.
We have been conditioned by our society to try to prevent stretch marks or try to hide them once they appear. This is usually with the latest product (cream, oil, etc). Many of the women that I work with tell me that they used product ‘x’ and it didn’t work. They focus on their bodies being destroyed by their babies. This continues into our societal thinking that our babies destroy our lives by being “demanding”, wanting to feed to often, asking to be held often. Stretch marks can then become depressing. It can signify a loss of the body that was. It begins our spiral into never really appreciating our body it’s true magnificence. Our body was able to grow a baby and give birth in its own way. If you were to take a moment and write stretch marks in a search engine, you are immediately confronted with treatment options. We are only making ourselves feel bad about the people we are and passing that guilt onto our children.
There are a few women who have decided to change their perception about stretch marks. Some say that it is their warrior marks. It brings to mind the idea that women are strong, fierce, and ready for the road ahead that is labour, birth, and parenting. It can be a celebrated look of motherhood. One that says ‘I did it!’ and maybe ‘I would do it again’. It might not be in many magazines or walking the runway, but it is a reality – and we all know that reality is not captured in the on the catwalk. If we can celebrate with each other our bodies and get to understand them the way they are, the way they change as we grow, age, and live, then maybe we can start to celebrate the real people we are. We might also start to listen more to our babies as we grow in trust with our own bodies. Our babies can tell us when they are hungry, when they have had enough, when they want to be held and when they are too warm.
Reframing is a useful tool that we can use anytime in our lives to help us change negative thoughts or concepts that don’t work for us. Stretch marks don’t have to be the way society wants us to see them. What if we called it strength marks? Or what if stretch was an analogy for being flexible in the way we want to see ourselves and our children?
We are teaching each other that stretch marks have no place in our bodies. Yet, our society is okay with putting in foreign objects like implants for cosmetic reasons, or changing our nose just because we don’t like what we were born with. Are we paying the price for not understanding or valuing our bodies just the way they are? What values do we want to pass on to our children? Do we want to make them feel bad for changing our bodies?
How do you see stretch marks? How would you reframe them?
Speak up about YOUR health care!
I received an e-mail today about a new survey trying to improve women’s health care in Ontario. As a doula, I often hear stories about how people were treated by health care professionals, not to mention my own personal experiences.
This survey is part of a project called Health Research and Knowledge Translation: Including the Voices of Ontario Women. This project is being carried out by a partnership that includes the Ontario Women’s Health Network, and is under the guidance of an Advisory Committee. The project is funded by Echo: Improving Women’s Health in Ontario, an agency of the Ministry of Health and Long-Term Care.
The province of Ontario wants to include the voices of all women and strongly encourage women who are often under represented in the mainstream to participate.
Let’s improve women’s health care today by taking this anonymous survey. Don’t forget to send it to your friends and have them participate too – together we can make a difference. We can get the health care we need and deserve!
http://www.surveymonkey.com/s/womenhealth
The survey is only up until June 27th!
Breastfeeding – a gift from the heart
We are at a point in our culture where breastfeeding is presented as a choice. Our species didn’t have that choice when it first began. If women did not breastfeed their children, none of us would be here today.
Breastfeeding is about more than food. It is a gift of health and love that you only have one chance to give to your children. So why are many women choosing to breastfeed? Why are their partners supporting this (or maybe even encouraging it)?
H – Healthy Moms – Yes, that’s right. Breastfeeding is good for mom. The longer she breastfeeds, the more she reduces her chances of breast cancer. Choosing to breastfeed also decreases her risk of ovarian cancer, helps her lose weight after baby. If a mother has to go back to work at any point in the breastfeeding relationship, she can continue breastfeeding when she is home. This can allow her time to connect with her baby that no one else can replace. It can help make that emotional transition a little easier because she still has an important role to play in her baby’s life.
E – Eye development is balanced. When a woman is breastfeeding, she uses both breasts throughout the day. The act of switching sides allows the baby’s eyes to develop equally. Some babies who are fed using a bottle or other methods including cup feeding or finger feeding have their caregiver hold them in the same position every time they eat.
A – Always available – Breastmilk is always being made. The more the baby nurses, the more milk mom will make. This is also a great benefit to any sleepy parent. It does not involve any cleaning, prep work or any other task that takes you away from your baby. This is a great time saver no matter what you were doing. I read a great story about a family who went camping and decided to go on a hike from their campsite. They got lost in the woods and had to spend the night away from their stuff. They were very thankful for deciding to breastfeed because they did not have to worry about where they would find clean water, how much artificial milk they would pack or any other details. They did return to their campsite the next day when daylight returned.
R – Required Rest – This might be one of the most challenging aspects as well for some people. I can speak for myself – prior to my daughter’s birth, I worked 3 jobs and was in school full-time. I could multi-task in my sleep. When she was born, priorities changed and the rest that I didn’t allow myself before was more important than ever, especially when it came in small increments. This rest allows the body to recover from birth and allow mom some time to be mothered herself. After birth, mom has bleeding for a few weeks, this bleeding is called lochia. The bleeding will begin as red and change to lighter colours. If mom is doing too much before her body is ready, the body responds by going back to the bright red bleeding. The body does speak back to us but we need to listen.
T – Touch – touching is an important part of breastfeeding. It encourages skin-to-skin contact, which has many benefits including regulating baby’s heart rate, blood sugar levels, respiration rate, and body temperature. It allows you to get to know your baby because it encourages bonding. We all need human touch in our lives. This is becoming more evident to researchers as we study our technological developments. Some people may go days without even hearing another person speak. Touch can be calming, powerful, centering, or just a reminder that there is someone who cares about you. Remember, your baby could feel you all the time. Imagine that loving touch being taken away and replaced with a bouncy chair or swing and a towel to hold your bottle in place. It doesn’t have the same care, love, and attention, now does it?
There are many more benefits that are not listed here. If you are pregnant and wanting to learn about breastfeeding, why not contact your local La Leche League chapter. They are an international breastfeeding organization that supports any mom who wishes to breastfeed. This includes women who want to breastfeed once a day, to women who are exclusively breastfeeding, and women who are breastfeeding adoptive babies – visit www.llli.org to find the one nearest you!
Bill 94 – Can we really deny these rights?
Quebec is about to vote on a new legislation that would deny access to Muslim women who wear the niqab (face veil) to health care, educational opportunities, public employment, and essential government services.
Forcing women to reveal their bodies is no different from forcing them to be covered up. We are still controlling women’s autonomy. In our society that is supposed to be democratic, women should have the choice. If they choose that they want to wear the niqab, then that is their choice and it should be respected. It does not change her need for some of these very basic of health care, education, employment, and other services. Currently in Ontario, it is legal for a woman to go topless. Most people do not do that here, unless it is the Pride Parade downtown. It does not make people feel comfortable. Why can I choose to wear a shirt to cover parts of my body but a Muslim woman cannot choose to cover hers with a niqab?
As a doula (in Ontario), if this were the case here and I was supporting a Muslim woman, if she was in labour and was wearing her niqab, would they tell her that if she wanted to have her baby, she would have to take it off before coming in? If her labour is progressing well, why would you go and pressure her, deny her and her baby access to health care?
Spirituality and religion is a different subject for all of us. Some people may be atheists, Buddhist, humanist, Jewish, Christian, follow Earth-based spiritualities or a multitude of others. This is not a reason what we should be discriminating. If someone believes in their faith tradition and they are empowered by it to love and care for each other, than who are we to take it away?
Many people of the Muslim faith are already being targeted by discrimination since 9-11. This would perpetuate that discrimination. People will stop taking the time to get to know a person based on more than physical appearance. Canada is a country that is known for its multiculturalism. I live in Toronto where you can find almost any culture. I live in a neighbourhood that is very diverse with people, Muslims included. Many women that I see on a daily basis cover their heads, wear the niqab, and some the hijab. I love going out with my daughter (who is almost 3) and playing in the park. She gets to see and interact with so many different people. She gets to see the most important thing – we are all people.
If this bill is passed, I don’t know if I will be able to really believe that Canada is a multicultural community. Our Charter of Rights and Freedoms allows us the freedom of religion. This would not be congruent with our deepest values as a society.
Government of Canada – you cannot control our bodies this way!
Learning about birth on TV?
Most families in Canada own a television and many own multiple TVs. As much of the programming is starting to show “reality”, we are getting more information about birthing babies without having to pick up a book or speak to anyone else.
The problem doesn’t lie in birth being on television programs, but the information that they are giving. One show that I caught by accident (I actually didn’t even know it existed), had a panel of health care providers debating if elective c-sections were ethical. They gave some inaccurate information about the safety of c-sections and said that it was up to the doctor who would be performing the surgery. What scared me most is that they didn’t speak about the mother. They weren’t concerned about her.
On another TV show, a very popular one from what I understand, an OBGYN was telling families to practice birthing laying down, purple pushing, and that epidurals are safe for the baby. Many studies have shown side effects for both mom and baby due to the epidural. That side was completely ignored.
We aren’t getting the balance of information to be able to make informed decisions. We need to know the benefits, the risks, and the alternatives. There is often more than one option so don’t be afraid to ask. You are your own advocate and an advocate for your growing baby – so don’t let someone put you on a conveyor belt of care and expect you to submit, become passive, and compliant. If it doesn’t feel right, then say so.
What I usually suggest to clients is to find a care provider who will take time to answer their questions and make them feel comfortable and welcomed. Read books and discuss the content with others. Some books, like TV shows are better than others but test out the information in the world. I am happy to discuss points that have been brought about through reading or television and to give them more to think about, whether it is options, benefits, risks, or other studies.
TV is a one way medium. The information only comes to you and you don’t have the option of having a discussion or asking the “experts” questions about the topics. Know that not all the information is wrong (I did hear a pediatrician say one that skin to skin is amazing for babies), but seek out the other side to the story. We used to learn about birth from other women – mothers, aunts, and sisters. We were supported by these women during birth. Things have changed a great deal. Many people who share their birth stories with you can often frighten the pregnant woman with traumatic birth experiences. Instead of increasing fear in birth, why not suggest a good prenatal class and offer to help her find a doula. A doula can help put things into perspective, help her wishes be heard, and help her have a positive birth experience. A doula will be there to support the family, no matter what the composition.
What have your experiences been with birth on television or other one-way mediums? Are you a first-time mom curious about what birth is like? Are you a mom of one or many – do you still watch those shows?
With Woman
What better way to describe what doulas do – we are with women.
It can be looked at from the literal context of being present with women. This happens during the last stages of their pregnancy, throughout the birth, and the early moments with their new baby. Being present means being in the moment, in tune with her as she is giving birth. Doulas help women listen to their bodies, their minds, and their hearts – and let them know that no matter what decision they make, it is their decision, they are in control. With women also means that we are with the people that they love. Partners, family, and friends that may be present and want to support her aren’t always sure what she is looking for and we can gently guide them so they are supporting her, so she feels that connection with them. Our ears are always listening. Many times our words are few but our touch or our gaze is reassuring and strengthening.
I also thought about it from a more metaphorical sense – instead of being with child, we are with women. We are ever pregnant and ever birthing. We are always conceiving ideas and ways to help women and families grow in supportive ways, filled with empowerment, trust, and love. It is through the gestation period that we work on new ideas and help them develop into solid plans to support women, to change the system, to make it accessible. Through birth, the plans and goals come to fruition.
It means that a doula is balancing supporting the individual woman and family who is birthing but also bringing about change in our society so birth becomes a celebration and a normal part of our lives instead of the medical parade. I don’t know many women who were keen on staff walking in the room without even knocking at a moment where she may feel vulnerable.
As a doula, I am with women – I am on their team. I am not hired by a midwifery clinic, a hospital, or any other agency. I am invited by women and their families. There is no one more important in that room than the mother giving birth. If she has a request, needs a cool cloth, wants a suggestion for a new position, asks for massage, then I am there. I work with doctors and midwives to ensure that her questions are answered, she feels confident in her team, and she is being respected and heard.
With women, I am an advocate. I am an advocate for anything they need or want. If a woman decides she would like to eat during her labour at a hospital, then I encourage her to do some research. I may point her in the direction of a few articles to get her started and encourage her to bring it up with her health care provider. Some women feel that it may be a battle, so prior to the appointment, we can role play the conversation to help her gain confidence. It isn’t easy to stand up to people, especially when we may have been brought up not to question their authority. Women do have the right to ask questions, get reliable information, and make their own decisions about their bodies and their babies.
I am also a women’s cheerleader. I believe in her ability to birth in a way that will bring her joy. Everyone has different expectations of what birth will be or what they may want to happen. It is my role to help her find the tools inside herself to make it happen, confidence and empowerment being the two most common.
I find that more and more I am becoming a women’s library. Libraries are a great place to get connected with the local community. You get to meet some of the other people who live in the neighbourhood, talk, understand the culture of the community. It is the same in the birth world. A doula is that connection to everything mom and baby related. We can tell you about the different breastfeeding clinics, who is or isn’t covered under OHIP, what early year’s centre is near by and the programs they are offering, what doctors support women with breech babies, where to turn with concerns in early pregnancy, which chiropractors have training in the Webster technique (to turn breech babies), who does acupuncture to help morning sickness, and the list goes on. Even though a doula is there for part of the journey, we let you find your way. We provide you with options and you make the best decision for you in that moment. Connecting you to community resources means that you can continue to access support. Of course, a doula has a lot of information she could share too but the connections are more meaningful. Like they say “if you teach a man to fish, he will eat for life”.
As a doula, I also find it helpful to be connected to the woman I am. Not all doulas are women but I think it is important to be connected to yourself, your beliefs, and your views. I know who I am, how I like to birth, where I would choose to give birth. Knowing all of this, I can set it aside to support a woman who may choose differently. I respect her decision because she isn’t me. Her family is different, her body is different, her life experiences are not identical to mine. My goal is that she feels in control of the process, which helps increase her satisfaction with the experience.
As a doula…I am with woman, in every sense imaginable.
Happy Mothers’ Day
I had the opportunity to hear a wise woman speak today about “Mother’s Day”. This is a day where we traditionally say thank you to our mothers for what they have done for us. Many children say thank you, place phone calls, send flowers, take her out to lunch or bring her breakfast in bed.
Mothers come in many different shapes and sizes. There are women who have adopted babies or who are in the process. Like birth, it has many challenges that require you to think outside the box, lots of time to be patient, and a great deal of anticipation. There are mothers who are foster parents. These women open their doors to children who may not understand what a parent usually does for their children. There are families that have two mothers and they too face challenges when confronted with society, but their homes can be filled with a great deal of love, kindness and acceptance. There are surrogate mothers who have offered their womb to others who may not have that opportunity themselves for whatever reason. There are all the women who have been told they will not be able to have children biologically and may face the options in front of them. Some women have made the decision not to have children but it doesn’t mean that they don’t “mother”. They, like any other person, can provide nurturing kindess, a place to sit, an ear to listen, and even take them to soccer practice. The statistics are quite high for the number of women who have lost children during pregnancy or shortly after birth. Like many others out there, when the test comes back positive, the planning begins on how to take care of this child that is smaller than a sesame seed. When one looses a child, there is much that goes with it – hopes, dreams, wishes and plans. Those women – they are mothers too. Their time with their children may have been brief, but nonetheless valid as they shared that time together. Those children are always a part of their families. I also had the joy of attending a conference on Thursday about parenting with a disability. Many parents expressed the challenges they were faced with from the medical communities, families, friends, society.
So if you have noticed, the title of this post is “Mothers’ Day” with the apostrophe after the ‘s’ to include all the mothers that may not come to mind for many but who should be celebrated today. There is not just one type of mother. It is this inclusion that allows us to grow and learn from each others strengths, to support each other as we go through each day, and to celebrate together the world that we are creating.
That’s who we are as mothers – creators. We create life experiences – not just life. To give birth to a child – it is a great act, but it is only one. There are many more experiences in one’s lifetime where we have the opportunity to create, to change the world we live in and that which we leave to our children (and the world’s children).
