Family-Centered Care: The Value of Choice

• Last night I had the opportunity to speak on a panel at The Scarborough Hospital (Grace Campus). The discussion was organized by the Family Advisory Council on Maternal and Infant Care. My role as a member of the Advisory Council was to speak on the valuable role that choice plays in improving outcomes in pregnancy and birth care.

  Overall, I think the presentation went very well! I was very pleased with the points that I chose to raise, as well as the audience response. The bad news is that my digital recorder failed on me (or maybe I failed on it) — so was not able to present My First Podcast (as I’d hoped). Well, maybe next time. Instead, I’ve listed some of my notes here of the main points that I put forward in my presentation. Your feedback and comments are always appreciated.

  • What solidified my interest in Family-Centered Care (FCC) is what I call my two-track prenatal experience
  • RELATIONSHIP WITH PHYSICIAN: My physician and I had a good relationship prior to my pregnancy
  • She was open and kept me informed on all matters, illnesses, checkups, etc.
  • Bonus: We also had a shared cultural background so she understood my issues and perspective, jokes i.e. “I’m wearing my Sunday baggie.”
  • My pregnancy changed the Code of Conduct, script, choreography of visits
  • I lacked an understanding of this new “prenatal culture” — i.e., concept of “trying to get pregnant” and question of “are you keeping it?”
  • Suddenly I was not qualified to participate in my own care
  • Even shared cultural background wasn’t enough to bridge the gap (the culture of prenatal care trumped our previous relationship)
  • Handouts were not culturally relevant
  • Ongoing issues around diet, midwifery, homebirth, birthplan, sick vs. healthy attitude, etc.
  • My husband and I would joke about what government secrets were lurking in my med file (information not shared, results of tests not forthcoming)
  • Increased tension; not enough information provided to make informed choices and doctor seemed offended by my questions
  • Issue of control of my care at a time when I was “losing” control of my bodily function — control of any kind was very important to me
  • Parted ways with physician over issue of HIV Test (physician made bad judgement call when I refused an HIV Test that I believed was optional)
  • MIDWIVES: I transitioned my care into that of midwives
  • I was treated with respect
  • I was allowed and encouraged to participate in my care
  • Weighed self, tested own urine and reported results to midwives — medical file always open on the desk, I could see and comment on the comments
  • Debated pros and cons of all tests, final choice always mine
  • Birth plan was encouraged, discussed and respected
  • I didn’t always get my own way but discussion helped me to understand why not
  • My culture was respected
  • BLACK WOMAN AND CHILD: At that time, I felt that mothers of any cultural difference or having any difference in perspective could not get fair treatment or choice in a physician-run hospital system
  • As a result, I began publishing a magazine to promote and validate the cultural perspectives of Black women around the world
  • I held fast to the ideology that “smart,” healthy, empowered women gave birth at home with midwives and only “sick,” scared women gave birth in hospitals with physicians
  • home birth = choice and hospital births = challenges
  • Working with the magazine, I had an opportunity to speak to many different kinds of women
  • Learned that some women were having healthy, safe, empowered and successful births in hospitals too — what made the difference was the level of involvement or choice
  • I learned that it doesn’t have to be polar opposites
  • Home birth is not for everyone but having choice can empower birth outcomes for families even in a hospital
  • NEW VIEWS: Hospitals like TSH are promoting that they are open to Family-Centered Care
  • Women and their families can benefit from having options, benefits also roll over to staff and overall view of hospital
  • Example: a birth plan helps to address issues and opens dialogue between pregnant mothers and caregivers
  • A birthplan also takes pressure off staff: the hospital is note solely responsible for successful birth outcomes
  • Example: Cultural ideals can be good ideas that staff can learn and pass on to other patients
  • Culture doesn’t happen in a vacuum
  • We all want to belong; not check our culture at the hospital door
  • In childbirth, we may be at our most vulnerable but mothers are not monsters — we can actually be reasonable
  • Example: I like to eat barley porridge right after giving birth. I don’t expect to get that in the hospital cafeteria BUT is the hospital open to having a family member bring some for me? Let’s work together.
  • When a mother is relaxed, happy and confident, we get better outcomes, better births, less snapping at nurses and bad attitudes
  • The input of relatives is validated, helps mother, speeds healing
  • The birth experience, whether hospital or home, set the tone for future attitudes about childbearing and child-raising
  • I am on Baby Number Four, so I know that there’s some truth to this

  Nicole Osbourne James

Theme for World Breastfeeding Week 2008

Announcement: Theme for World Breastfeeding Week 2008 announced!

“The World Alliance for Breastfeeding Action has released the theme for next year’s World Breastfeeding Week celebrations. The theme “Mother Support: Going for the Gold” coincides with next years landmark Summer Olympics in Beijing, and was designed to direct focus on the need to support mothers in achieving the gold standard of infant feeding practices: exclusive breastfeeding for six months, followed by appropriate complementary foods and continued breastfeeding for two years and beyond.

 

World Breastfeeding Week is celebrated October 1-7 in Canada, and August 1-7 in the rest of the world.”

 

 

>> Sisters, let’s get on board with our own celebrations for World Breastfeeding Week. To be honest, I’m starting to feel a little funny about being the ONLY Black woman out at some of these events. If we’d feel more comfortable doing our own thing, by all means let’s do our own thing. Are any sisters out there organizing events for WBW? Let us know what you’ve been doing. Send some pictures!

 

 

I have to say I can really appreciate the theme. When I was a new mother just learning how to breastfeed, it really DID seem like an Olympic sport and, let me tell you, I was FAR from winning any medals! At least that’s how I felt anyway. But I persevered…if my son could remember, I’m sure he would be telling some pitiful stories about me. Yes, I stuck it out and now I am a breastfeeding guru with healthy children to prove it. Yes, when you see that woman nursing a baby on the park bench, in the shopping mall, in line at the grocery store, in church (before “security” escorted me out — no food or drink in the sanctuary, I’ve been told!), wherever…when you see her, come on over and say hi because it might be me. Then again, it might be somebody else but say hi anyway.

 

 

Find out more about WBW at www.infactcanada.ca.

Practical Application: RSS Feeds

Feel free to congratulate me! After I spent the whole weekend immersed in the world of eNewsletters, SEO, digital editions, old code vs. new code, SNS, del.icio.us and God knows what else, I came home to my three kids (and football-watching husband), headed for the kitchen and executed an admirable RSS feed!

RSS feed might mean something hip and tech-savvy in the online world, tonight in my kitchen, it stands for Really Simple Stew. Here’s the recipe if you don’t have a lot (or any) time on your hands:

• 2 cups of red lentils
• 3 cups of water or vegetable broth
• half a jar of tomato sauce (or whatever was left at the back of my fridge)
• seasoning (mixed herbs, bebere, Caribbean green seasoning,, whatever you have)
• 2 cloves of garlic, minced (or crushed, it’s faster)
• 1 onion, chopped (watch your fingers)

Put it all in whatever medium-sized clean pot or frying pan you can find. Bring it to a boil then cook, semi-covered, on medium-low heat. Try not to let it boil over (but that always happens to me, I just wipe it up and turn on the fan to get rid of the burning smell). When the lentils are soft, it’s ready (about 10-15 minutes).

Toss it over some couscous, quinoa or rice (couscous is faster — I pour it in a bowl with boiling water from the kettle and cover it. It will steam while the stew is cooking and be done right on time).

Well, my children ate it down and asked for seconds (OK, maybe they were just that hungry). It might not have been the RSS feed that I had in mind at Web Weekend but it worked! And on top of that, here I am blogging away. I guess it was a double success.