Saturday, June 30, 2012

Pregnant Patients' Bill of Rights...by Lynnette


     All healthcare providers get into this profession for their own reasons. Over the years I've considered my own reasons and have come to the conclusion my strongest passion is to give personal, individualized care. A pet peeve of mine is when a rational reason cannot be given for doing a procedure, or when something is being done for the convenience of a provider rather than comfort of the patient, or just because "it's what we always do". 
     When people are in the hospital the combination of being in unfamiliar territory and the attitude of care providers that they are the experts makes it difficult for patients to voice their individual requests. Women deserve and have the right to care that they are actively involved in formulating. The pregnant women's bill of rights defines those rights. !
     As the third trimester advances most women settle into the reality of the work they have before them and start preparing for the birth of their baby. Part of that preparation involves dealing with questions about what is going to happen at the hospital. Unfortunately, birth has been hidden away in hospitals for years now and has become a medical event where many families feel they lose control over decisions about their care. Many women have never been a "patient" in the hospital prior to labor and the institutional aspects of a hospital takes them out of their comfort zone. That along with the feeling that nurses and doctors are "experts" who deal with birth everyday so they must know what's best for them make women more willing to hand over control or less likely to question "routine " procedures. Often procedures are just "done" without fully informed consent or explanation- IV starts, continuous monitoring, withholding solid food, limiting ambulation. Knowing your rights will enable you to assert your rights when it comes to procedures you may or may not want or need!
     In addition many providers are so busy in the office there is very little time during visits to ask questions or discuss what the birth will actually be like. Women need to remember that as consumers, paying for the services they are there to get, they have the right to have input in their care. Women also need to keep in mind their provider is in charge of their care, not the hospital staff or institution. Nurses are carrying out orders from the provider, so it is essential that you've discussed and participated in the formulation of the plan of care for you labor, birth, newborn care and postpartum care. You along with your provider make the decisions for yourself and your newborn after you obtained informed consent from your provider. Keep in mind that the consents you sign as you enter the hospital are very broad and that you the right to question and amend those consents. 
     The Alliance for the Improvement of Maternity Services (AIMS) has outlined the Pregnant Patient's bill of rights. It's an important document that all pregnant women should read and consider as they prepare for birth. Birth should not be a "one size fits all" event. It's a very individualized, very personal experience that will be remembered for a lifetime. Women and their partners should have input into their care and the bill or rights helps to ensure they are given informed consent regarding procedures so they can have that input, knowing also that plans may need to be changed under various circumstances. But knowing your rights will strengthen your ability to deal with changes as they arise. The bill of rights gives you freedom in making choices for you and your baby that are aligned with your personal desires to make your birth something to happily anticipated and remember with satisfaction. Please follow this link to read and learn more about the Bill of Rights. www.aimsusa.org/ppbr.htm

Friday, April 13, 2012

Skin 2 Skin

From Kate Paxton...

Early this morning, I was called to a birth of young woman.  Her labor had progressed significantly and it became obvious she would inevitably deliver her baby at just 33 weeks and 5 days.  We called in one of my favorite Neonatology Nurse Practitioners (NNP) – she’s aware of the need to evaluate and help babies transition as smoothly as possible.  Now this kind little boy – Brannon – helped us tremendously by flinging out his tiny arms and giving a nice big howl.  I placed the baby onto the mother’s abdomen and he continued to cry and transition well – allowing us to delay clamping or cutting the cord, so he could get all the extra blood he could from his placenta.  The mother was able to speak with the baby and welcome him to this world.

Perhaps the sweetest moment of every birth is that moment when the baby arrives and snuggles up, babies chest to mother's chest, in mother’s arms.  This moment is not just a nice scene – there’s a lot of science to support the practice of skin-to-skin contact in the immediate postpartum period.

My favorite way to help a baby transition to the “extrauterine environment” – that’s science-speak for ‘the world outside the womb’ – is to deliver the baby to the mother’s abdomen.  As long as the babe is stable, this allows for delayed cord clamping and skin-to-skin contact.  Delayed cord clamping has been shown to result in improved iron status of babies up to even six months of age.  The baby can obtain about a fifth of its blood volume through placental transfusion following the birth – and this may make a big difference in the health and well-being of a baby.  For preterm babies – like little Brannon this morning  - delaying cord clamping for even a short time can help the babies transition more smoothly.  The World Health Organization Reproductive Health Library and the Cochrane review suggest delayed cord clamping is the standard for care of stable infants.

As we allow the cord to pulse oxygen-rich blood into the baby, who is using his lungs to breathe air for the very first time, a lovely place to put that baby is on the mother’s chest.  In a Chochrane review of over 30 studies, the research showed “that babies interacted more with their mothers, stayed warmer, and cried less. Babies were more likely to be breastfed, and to breastfeed for longer, if they had early skin-to-skin contact. Babies were also, possibly, more likely to have a good early relationship with their mothers, but this was difficult to measure.”  The WHO Reproductive Health Library described the ideal situation – that “early skin-to-skin contact (SSC) begins immediately after birth by placing the naked newborn baby prone on the mother’s bare chest.”  This library also reviewed a great number of studies and found that SSC after birth helped reduce crying, improve the mother-infant interaction, keeps the baby warm, and helps the mother successfully breastfeed.

The International Breastfeeding Center lists a number of benefits of SSC from birth to the first hour: The baby…
•  Is more likely to latch on

•  Is more likely to latch on well

•  Maintains his body temperature normal better even than in an incubator

•  Maintains his heart rate, respiratory rate and blood pressure normal

•  Has higher blood sugar

•  Is less likely to cry

•  Is more likely to breastfeed exclusively and breastfeed longer

•  Will indicate to his mother when he is ready to feed

Although we understand how special these first moments are on an intuitive level, there are untold numbers of hormonal and sensory interactions occurring in these precious moments – perhaps areas available for future research.  Until then, we can trust that there’s good science to support these midwifery practices.  Mothers should be encouraged to hold, smell, kiss and snuggle their newborns on their own chest, with direct skin to skin contact.  This is the time when mothers are learning their baby’s cues and babies are learning their mother’s environment.  So, consider these practices when writing your birth plan.  The midwives at Bethany Womens Healthcare are happy to support these practices for your birth.

Friday, December 16, 2011

"The Twelve Gifts of Birth" at Christmas

Everyone remembers the classic Christmas song " The Twelve Days of Christmas". It reminds us of this special time of year when we share gifts, enjoy family and friends and fill our hearts with love. For some, it is also a time to celebrate birth!


"The Twelve Gifts of Birth" by Charlene Costanzo captures the spirit of this joyous season and reminds us of the miracle of birth and the wondrous gifts that we all are born with. I would like to share it with you.


The first gift is Strength...May you remember to call upon it whenever you need it.

The second gift is Beauty...May your deeds reflect its depth.

The third gift is Courage...May you speak and act with confidence and use courage to follow your own path.

The fourth gift is Compassion...May you be gentle with yourself and others. May you forgive those who hurt you and yourself when you make mistakes.

The fifth gift is Hope...Through each passage and season, may you trust the goodness of life.

The sixth gift is Joy...May it keep your heart open and filled with light.

The seventh gift is Talent...May you discover your own special abilities and contribute them toward a better world.

The eighth gift is Imagination...May it nourish your visions and dreams.

The ninth gift is Reverence...May you appreciate the wonder that you are and the miracle of all creation.

The tenth gift is Wisdom...Guiding your way, wisdom will lead you through knowledge to understanding. May you hear its soft voice.

The eleventh gift is Love...It will grow each time you give it away.

The twelfth gift is Faith...May you believe.


May your gifts be Peace, Love and Joy this Holiday season!

Donna

Thursday, October 20, 2011

Open house

Open house is at our BWHC location: 3660 W Bethany Home Rd (south bldg)

Open House

Hope to see everyone today for the Open House. 4-8PM! Lots of great prizes, food and fun!

Wednesday, September 14, 2011

Save the date!!


October 20, 2011
4-8PM
Bethany Womens Healthcare Midwifery Center
3660 W. Bethany Home Road
Phoenix, AZ 85019

You are happily invited to join the Midwives of Bethany Womens Healthcare for the 

Grand Opening Celebration

of our Midwifery Center. We can't wait to share all our new programs, our renovated space and patient-centered care with you. 

Come bring your family, friends and  have some fun with us celebrating our new digs! 

Friday, August 19, 2011

The Change goes on...

Donna's here and Kim's coming!! Our newest midwife, Donna Barisich, has started! She's hopped right in and is nearly up to speed already! Kim Flanders will be joining us in about a week. We will then be fully staffed once again (with 6 CNMs).

We are excited about Kim bringing Centering Pregnancy into the practice. She has "trained the trainers", so will be offering valuable insight and strategy for our implementation.

We are also very excited about the expansion of our practice into the "Midwifery Center" at BWHC (into the South-old Birth Center building where ultrasound and billing are now located). Painting is happening at the moment and we will begin the moving of furniture, desks, etc. today! On Monday, the midwives will be officially moved into the newly renovated space. And Dr. Alan Schapker will be moving back into the North building with our other physicians and nurse practitioner. We hope this move will more efficiently utilize our space and afford a more comfortable waiting room environment (no more SRO).

Stay tuned.  We'll be having an open house soon. Will post the date on both blog and facebook.

Sunday, July 31, 2011

Birth Story

Here's a sweet birth story...please follow the link:
http://kimandgarybarnes.blogspot.com