Transcript Slide 1

Debbie Chalk RNC, IBCLC-RLC, CPD
Certified Postpartum Doula
603-340-7028
[email protected]
Located in Bow, New Hampshire
Family Roots
Postpartum Doula Care
&
in home
Lactation Consultant
Today we will learn:
1. about the universal need for family and
community support.
2. to identify stressors and potential adverse
short term and long term health effects if
not alleviated.
3. to assist the family in understanding the
benefits of support, sources and how to
access them.
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Studies have shown that women who
have social support during the
postpartum period tend to have less
postpartum depression, breastfeed for
a longer duration and make a better
adjustment to parenthood.
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Native Americans“Longhouse”
China“Man yue jue”
South America“La quarentina”
Burma- “Thie-dwin”
Greece- “Doula”
Holland“Kraam verz orgster”
Historically, we
recognized the
importance of a
community of
women helping
women…
However help is
provided it was
recognized that the
new mother couldn’t
manage all these
family duties herself,
at least for several
weeks. These
traditions make a lot
of sense!
Boston Lying-In Hospital
Historically, in colonial America, there was a distinct postpartum period
(6 weeks after birth). This was called a “lying in” period, a period of
“apprenticeship” when more experienced mothers taught the new mother.
Although different, they
shared 5 protective social
structures.
1.
2.
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5.
A distinct postpartum period- set apart from
normal life
Protective measures recognizing need for
physical healing from pregnancy and birth
Social seclusion- for rest, care and for the
parents to get to know their new baby
Assistance in the home- parents only
responsibility was to rest and care for their baby
Recognition and respect for their
accomplishments in the new roles as parents
First time parents:
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have no previous experience.
are recovering from pregnancy and birth.
are learning basic hands on infant care.
Experienced parents:
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may have had difficult previous
circumstances.
are recovering from pregnancy and birth.
are integrating the new sibling into family
life.
Sally Placksin, author
of Mothering the New
Mother, identifies that
“many women today
are entering into
motherhood in
unprecedented states
of isolation”.
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Lots of changes
occur instantly at the
moment of birth.
They must nourish
and love more than
one person and
divide their time into
multiple
unpredictable
circumstances.
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They have assisted
the Mom during
pregnancy, managing
labor and birth and
now must assist her
in recovery.
Fathers are
redefining their roles;
they may also be
adjusting to sleep
deprivation, financial
pressure and other
stressors, as well.
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With most couples the
partner must go back to
work in a week or two
with lots of sleep
deprivation and added
responsibilities on board.
They are expected to
function fully in their job
and pretend nothing ever
happened.
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Men can get “baby blues”
and postpartum
depression also.
Their signs and
symptoms are different
from the woman’s and
can take the form of
anger, irritability,
physical pain and
substance use.
They need a listening
ear, support and an extra
pair of hands too.
Unrelieved stress can begin a
vicious cycle of heath
problems to include negative
mental states and depression.
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“Researchers at the
University of
Helsinki have now
shown what kinds
of biological
mechanisms related
to sleep loss affect
the immune system
and trigger an
inflammatory
response.”
red Orbit New Biological Links Between Sleep
Deprivation and the Immune System
Discovered 10/24/2013
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“These results
corroborate the
idea that sleep does
not only impact
brain function, but
also interacts with
our immune system
and metabolism…
Some of these
changes appear to
be long term…”
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“A molecule linked
to inflammation
could play a role in
depressive
symptoms caused
by social stress, a
new study in mice
suggests.”
HUFFPOST Healthy Living
Inflammation Molecule Linked With
Depression From Social Stress
11/13/2013
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“This may represent
a legitimate
biomarker for
depression and
could represent a
new chapter in the
effort to accurately
diagnose and better
treat mood
disorders.”
Even short periods
of sleep deprivation
can increase the
release of stress
chemicals and
adversely affect
blood sugar levels.
Poor sleep quality
and depression
often go hand in
hand.
McEwen, Biological Psychiatry
2003; 54:200-207
Kendall-Tackett, Trauma,
Violence & Abuse; 8, 117-126
Depression increases
the risk of both heart
and vein disease.
Negative
Mental States
Inflammation
Chronic Disease
Why Breastfeeding Prevents Maternal Metabolic
Syndrome and CVD
Kathleen Kendall-Tackett, Ph.D.,IBCLC, FAPA
 Is
the precursor syndrome to Type-2
diabetes
 Includes symptoms such as: abnormal
blood sugar processing, abnormal
cholesterol levels and abdominal obesity
These conditions also increase the
chance of heart and vein disease.
Chronic stress, depression and hostility increases the risk of
these diseases as well as metabolic syndrome, diabetes and
degenerative brain diseases.
Hostile people are more likely to experience constriction of
the heart blood vessels when under stress as well as
additional new heart problems.
Why Breastfeeding Prevents Maternal Metabolic Syndrome
and CVD Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA
Social connections are vital for good health and for
parents to successfully welcome a newborn into
their lives.
Health Care Providers and Family supporters play an essential key role in
educating and guiding parents .
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In my 35 years caring for parents and their newborns
the NH family has changed. Most have short term help
only, because of family members geographical
locations, their place in the work force and peers/
friends being co-workers.
A new mother (parents) must be encouraged on a daily
basis. Whether this is their first or fifth baby, they must
be told they are doing a wonderful job.
Karen Kleiman states in her book Therapy and the
Postpartum Woman “More than one woman has
confessed to us that she secretly wishes her mother
would look over her shoulder during the 3AM feeding
and sweetly whisper: You must be so tired. You are
doing a wonderful job, I’m so proud of you.
You are such a good mother.”
Promises of help give way to every
day life in spite of everyone’s best
intentions to stop by and help.
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Assist the new family with household management and care so
the focus can be on rest and feeding.
Education for the parents on proper positioning and
assessment of their baby’s nursing/ feeding behaviors.
Light housekeeping, grocery shopping, errand running and
family meal preparation are options families like.
Sibling care, assistance to get out for walks, appointments, an
outing to a favorite store/ café all lift their spirits.
Guidance in setting and revising short and long term goals.
Assist parents to use shorter time availability to accomplish
more goals related to rest and recovery.
One of the most important things a helper can do is listen. So
much happens during pregnancy/birth/meeting the baby and
incorporating them into life. The parents need time to sort it
all out and to begin to accept the experience.
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They can be a skillful art.
Active listening is listening to
understand the complete message
as opposed to listening to
respond.
Restatement allows clarification.
Interpretive listening enables you
to gain an understanding of the
underlying feelings.
The considered response is
preceded by compassionate
thought.
Please, come sit with me…
Though baby shower gifts are nice, it is recommended to
ask instead for someone to come sit with you, "listen wisely
and non-judgmentally to all your questions and feelings
after the baby comes".
Sally Placksin
Mothering the New Mother
Types of questions to avoid:
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close ended questions
why questions
rapid-fire questions
questions containing the
answer- these can be
manipulative
Instead try open ended
questions because they:
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focus on the speaker.
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encourage conversation.
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these questions also
usually stop conversation.
provide a model for
solving future problems.
move conversation
forward.
When you have to talk about something difficult…
B
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T
The goal must be to
BENEFIT.
The last
thing
we want
to do….
The motive must be
LOVE / genuine concern.
The situation must be
APPROPRIATE.
The terms must be SPECIFIC.
The context must be TRUST.
Short term
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Gain education through multimedia resources and supportive
friends and family.
Before the baby is born invite and solidify a support network
for day and night.
Long term
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Research community support groups and their contact
information.
Consider what elements of your lifestyle it is important to you
to retain (hobbies, outdoor interests, educational objectives).
Post numbers to reach health care providers with medical
questions.
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“Although women are
made to nurse babies
that doesn’t mean it is
easy.”
“I believe that happened
(achieved my goals)
because I knew someone,
with particular
knowledge and
expertise, was going to
be here for me a few
times a week.”
Can take the form of:
 Family
 Friends
 Coworkers
 Trusted Neighbors
 Older siblings
 Mother’s helpers
 Childbirth and Postpartum Doulas
 Lactation Consultants
 Visiting Nurses
 Postpartum Support/Depression Counselors
 Organizations who provide classes and support groups
 Social Workers
 Family Counselors
 WIC Counselors
 Social Clubs for parents
 Local stores who provide classes as a community service
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Classes
Center for Health Promotion
49 South Main Street
Concord, NH 03301
603-230-7300
Baby Steps
Prenatal Breastfeeding Class
Childbirth classes
Amazing Newborns
Back to Work Class (for
breastfeeding mothers)
Itsy Bitsy Yoga
Active Parenting Now
Art with Heart
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Nini Bambini - A Place to Grow
166 South River Road
Manchester, NH 03110
603-666-6464
www.ninibambini.com
multiple class offerings
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www.concordmoms.com
MOMS Club of Concord
www.greatbaydoulas.com
parenting, mom/baby activities/parent support
www.truebluematch.com
other parents new to area to find common
interests/ friendship
Postpartum support, including postpartum
depression support services
Gerry Mitchell- Post Partum Support Coordinator
Concord Hospital 603-225-2711 x4110
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Marisa McCutchen
Barrington Counseling Center 603-534-2558
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Child and Family Services of New Hampshire
Concord NH 800-894-5533
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www.postpartum.neton line support and direction
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Postpartum Support International
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Postpartum Dads- www.postpartumdads.org
S800-944-4PPD
The need for community support takes on a different meaning.
It is with a social support network that we feel a sense of
belonging and more secure.
As new parents increase their self-worth by not being
isolated and struggling alone, the baby will feel this as well.
We
did
WWWee
it!
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Lactationmatters.wordpress.com
8/5/13, 9/5/13
C.H. – Friend
11/9/13
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What is the Postpartum Period? By Rev. Pilar(Ma’at) Grant
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How Other Cultures Prevent Postpartum Depression:
Social Structures that Protect New Mothers’ Mental Health
10/3/13
by Kathleen Kendall-Tackett, Pd.D., IBCLC
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10/13
Why Breastfeeding Prevents Maternal Metabolic Syndrome and CVD
by Kathleen Kendall-Tackett Ph.D., IBCLC, FAPA
5/12
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Mother the New Mother by Sally Placksin p5
Fathers, Breastfeeding and Bonding
- Dr Lucas Godinez, MD,IBCLC
lactationmatters.wordpress.com
8/17/13
Haffner&Taegtmeyer, Circulation 2003; 108:1541-1545
Huffpost Healthy Living November 16, 2013
Red Orbit New Biological Links Between Sleep Deprivation and The
Immune System Discovered October 24, 2013