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Women & Family Health : Healthy Pregnancy and Parenting

Welcome!

Pregnancy can be one of the happiest times of your life but with it can also come an overwhelming array of questions and concerns about what to expect. When it comes to parenting advice, let’s face it, there’s a ton of information available, but often it’s hard to discern what information is accurate or not. South Shore Hospital’s new Healthy Pregnancy and Parenting blog has been created by a trusted community of expert colleagues from our maternity team as well as other experts throughout our system of care. The main goal of the blog is to disseminate accurate, useful information focused on healthy pregnancy and parenting to the community at large.

The interactive platform of the blog allows readers to engage with our team of experts as well as other readers on a variety of pregnancy and parenting-related topics. 

Our Blogs

About Our Authors

  Amy Baron
  Becky Fay
  Chris Just
  Debbie Carlson
  Elizabeth Bwogi
  emilee
  Jessie Wilson
  Julie Honan
  Julie Paul
  Mary Hogan-Donaldson
  Nannette Landry
  Rebecca Dunk, RN, MPH
  Susan Scotti Smith
  Susan Yount
Archives
 
Monday, September 28, 2015
Q & A: Creating Families through Surrogacy at South Shore Hospital
by Rebecca Dunk, RN, MPH at 09:22 AM

South Shore Hospital has pioneered a special program, Families through Surrogacy, designed to enhance care for every family using surrogacy to Mom_Holding_Baby_Hand.jpggrow.  We offer expert pregnancy care for women acting as surrogates and welcome inclusion and education for parents-to-be. 

At South Shore Hospital, we embrace our special families and promote dialogue to create a safe, satisfying pregnancy and birth experience for all.   We are here to be your guide to surrogacy—answering all your questions about our program.

Q:  What is the Families through Surrogacy Program at South Shore Hospital?

A: The program is designed for intended parents working with a surrogate who will assist them to build their family.  Parents using surrogacy have special concerns.  They choose surrogacy for a wide variety of reasons, and each family is different.  The women who partner with them to provide a healthy safe place for the baby to grow until delivery also have distinct considerations since they will not parent the babies they carry. 

Q:  Is there only one type of surrogacy?

A:  No, actually there are 2 types of surrogacy—traditional surrogacy and gestational surrogacy.
In traditional surrogacy, a woman donates her egg for fertilization and then grows the baby in her uterus. This may or may not involve in-vitro fertilization (IVF).  The traditional surrogate is the genetic parent, but does not intend to raise the baby herself. Instead, she plans for the intended parents to raise the baby.Gestational surrogacy tends to be more common.  In this case, the surrogate carries the baby but does not donate her egg.  Through IVF, she becomes pregnant with the child of the intended parents and provides a place for the baby to grow.  A gestational surrogate is not the genetic parent of the baby. 

Q:  Are there different issues facing intended parents with each type of surrogacy?

A: As you might imagine, parents using traditional surrogacy face different issues from those using gestational surrogacy.  Birth certificates, social security numbers, insurance and legal custody of the baby are handled differently, and there are also practical concerns such as preparing for the birth, making decisions for the newborn, and becoming informed about bonding, infant care, and parenting.
 
Q:  What is the unique role of the surrogate? 

A:  Being a surrogate is special work.  Surrogates provide a wonderful service for parents and accept the challenges of being pregnant, having prenatal care, and giving birth to another family’s child.  While their physical care is consistent with other pregnant women, surrogates also engage in learning how the parents would like to be involved with pregnancy and birth, explaining the arrangement to their other children, extended family, friends, and co-workers, and finally returning home after delivery to resume their usual lives and adjust to daily routines while being post-partum.

Q:  How does South Shore Hospital embrace these families?

A:  At South Shore, we practice patient and family-centered care.  That means we identify both the surrogate and her family, and the baby and his/or her parents, as our patients.  We offer expert pregnancy care to women acting as surrogates, and we treat intended parents as parents right from the start.  For each family group, we provide beautiful handbooks covering a wide array of topics parents and surrogates should consider. In addition, we link each family to their own nurse navigator, a registered nurse who will share her expertise, answer questions, arrange for special requests, tour families through the birthing center, and assist in formulating and coordinating birth plans.  The Families through Surrogacy Team works together with the Birthing and Maternity Center staffs to handle the details behind the scenes according to our families’ wishes.   The result is a seamless and satisfying birth experience for all, one where families can focus on themselves and the newborn baby.

If you are a surrogate, a family using surrogacy, or know someone who is, South Shore Hospital is here for you, ready to answer questions or help you plan your birth experience.  For more information please call the Maternal Fetal Medicine department at 781-624-8430 to speak with one of our navigators.

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Tuesday, April 07, 2015
Free Healthy Pregnancy Essentials Class at South Shore Hospital
by Chris Just at 09:00 AM

Are you newly pregnant and eager to meet other women that are going through the same life altering experience? Are you brimming with questions and seeking expert advice on healthy nutrition, safe exercise, what to expect for prenatal care, genetic screening options, and more? If so, then Healthy Pregnancy Essentials is the class for you.

Taught by South Shore Hospital’s Susan Scotti Smith, nurse-midwife & hospitalist, and Rebecca Dunk, nurse coordinator for maternal fetal medicine, this class will give you the opportunity to ask all the questions you’ve had ever since you peed on the stick.

You will learn about:

  • Your options for prenatal care
  • Genetic screening choices
  • Ways to manage common discomforts of pregnancy
  • Recommendations for prenatal nutrition
  • Food safety
  • Safe prenatal exercise
  • Healthy weight gain
  • Warning signs
  • Optional: A tour of the birthing and maternity units and review of the amenities and options available at South Shore Hospital, including: labor tub, midwife hospitalists, nitrous oxide, level 3 NICU, newly renovated birthing unit, free parking and more.

Navigating the do’s and don’ts of pregnancy can be overwhelming. You and your baby deserve valid, evidence-based material delivered to you by experts, as opposed to online pregnancy information which may come from untrustworthy sources. Treat yourself to the best and get off to a great start!

FREE Healthy Pregnancy Essentials Class Details:

Who: Women in their early- to mid-first trimester and one support person

When: Next class is May 6th, 6:30 – 8:30 pm

Where: South Shore Hospital

For more details and to register: For online registration, view our calendar of events. For assistance, call 781-624-3300 or email childbirth@sshosp.org.

Join us and meet other women that are experiencing pregnancy just like you!

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Tuesday, March 24, 2015
Pregnancy and Omega-3 Fatty Acids
by Chris Just at 07:21 AM

drinking%20water_Blog.jpgBy now most people know that trans-fats are bad and saturated fats should be kept to a minimum but that’s only part of the conversation regarding fats and health. Did you know that there are good fats (in the form of oils) that you need in order to survive? The fatty foods that are most healthy for you contain omega 3s, essential fatty acids necessary for optimal health. The most beneficial of these fatty acids are EPA and DHA which play an important role in preventing heart disease, cancer, and depression and may help treat other disorders such as arthritis and diabetes. To assist the public in getting enough of these vital nutrients, some foods are now fortified with omega 3s, including certain brands of eggs, pasta, and yogurt.

When it comes to babies, these same nutrients promote brain and eye growth and have been found to help prevent the onset of asthma, allergies, low birth weight and preterm labor. Hence, many providers prescribe prenatal vitamin supplements that contain DHA and recommend that women take them during pregnancy and while breastfeeding.  

One of the best natural sources of omega 3 fatty acids is fish. The FDA advises that pregnant and breastfeeding women (and young children) consume 2 – 3 weekly servings of low-mercury fish (such as salmon, light canned tuna, tilapia, cod, shrimp, catfish, pollock). In addition to providing omega 3, fish contain high quality protein and a significant amount of vitamins and minerals yet are low in saturated fat. Fish to avoid, due to high mercury content, include shark, king mackerel, tilefish and swordfish. White albacore tuna should be limited to 6 ounces per week. No amount of raw or undercooked fish is OK during pregnancy.

Despite all of its benefits, fish is generally under-consumed by many pregnancy women. Reasons for avoiding fish may include cost, availability, fear of mercury, dislike of the taste or texture of fish, or a lack of knowledge on how to prepare seafood. It is important for women to feel confident in following the FDA guidelines. Safe fish is highly recommended and the benefits are numerous. Find local deals on fish to cut costs – some markets and farms host fish trucks on a weekly basis, allowing you to purchase fresh fish from a convenient location. Don’t be afraid to ask the seller for ideas on how to prepare the fish. If you or your family are not huge fans of seafood, try fish tacos or salmon burgers - when mixed with lots of ingredients, the fish is barely perceptible. With a quick google search you can find several recipes and choose the most appealing one for your taste. If cooking isn’t your pleasure then ask friends or investigate online to find the best seafood restaurants in town.

For more information on fish and pregnancy, check out the latest draft of guidelines from the U.S. Food and Drug Administration, Fish: What Pregnant Women and Parents Should Know. Remember, food can be your best pharmacy and fish provides a list of health benefits that is unrivaled by most other food types.

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Tuesday, March 10, 2015
Birth Control After Baby
by Becky Fay at 10:39 AM

family_blog.jpgBelieve it or not, a few weeks after the birth of your baby you will be interested in resuming intimacy with your partner. Many couples may plan to add to their family in the future, and others may feel that their family is complete. The average age of menopause, when women are no longer able to conceive, is just over 51-years-old in the United States—an age that may leave you with many years of pregnancy prevention ahead. One half of all pregnancies are unintended, and one half of those unintended pregnancies are the result of a contraceptive failure. There are many options available to couples who want to have some control over their fertility. Below is a brief over review of some different methods that are available. As you consider your options, you should consider effectiveness and safety, as well as your personal lifestyle. Of course, you should discuss your plans with your partner and your provider to make sure you are making the best choice for you.

Options range from permanent to reversible. Permanent options include male sterilization (Vasectomy) and female sterilization (laparoscopic tubal ligation and the newer non-invasive approach ESSURE). Reversible methods include hormonal methods such as pills, patches, vaginal rings, injections, and implants. Other reversible methods include two different types of intrauterine devices (IUDs).

For those couples who do not want to use hormones, or have medical conditions that prevent them from using hormones, barrier methods such as male condoms, diaphragms, or female condoms are safe and effective. Other non-hormonal methods include fertility awareness-based (FAB) methods and lactational amenorrhea method (LAM).

With the many choices available, you should feel confident that you and your partner will choose a method that fits both your fertility needs and your lifestyle. You should plan to speak with your provider to discuss all your options at your six week post-partum visit.

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Tuesday, February 03, 2015
Fostering Community Among Pregnant Women
by Chris Just at 10:08 AM

Preg%20Group.jpg I recently saw the movie, 40 Weeks, a documentary about the individual journeys of a group of diverse pregnant women. The women share their stories in words and film from their personal video cameras, creating what the filmmakers refer to as a “virtual tribe” of support. The stories are funny, poignant, and intimate in a very natural way. These are genuine women with complex lives. There is no glossing over the realities of pregnancy and no airbrushing of stretch marks. The honesty of the participants was refreshing. After just a couple of minutes the movie had my attention and, as the film rolled on, I found myself caring more and more about each and every one of the expecting moms.

If a film about a group of pregnant women can succeed in creating a sense of community for expecting moms, imagine what a face-to-face group can do. The need for peer support is one reason why women seek out CenteringPregnancy®, a form of group prenatal care. In a Centering group, 8 – 12 women, all within a limited due date range, attend 10 prenatal sessions together for assessment, care, education, and interaction. Each session lasts 90 – 120 minutes, allowing ample time for bonding and learning between participants.

Centering groups have two facilitators, one of whom is the midwife that will assess the mother’s health and the baby’s heartbeat and growth. Participants are encouraged to partake in their own care after being taught the proper techniques to check their blood pressure, weight and urine dip. After the women have completed their individual check-ups, they gather together in a group for learning and sharing. With each session, the group becomes more and more cohesive, with input from the co-facilitators to elicit comments, answer questions, or introduce an interactive exercise.

Advocates for Centering groups feel this type of care should be an option for all women in addition to the choice of standard, traditional, one-on-one prenatal appointments. Joanna Weiss asks the question, in her Boston Globe op-ed, Could Group Care be the New Model for Pregnancy?. Only time will tell, but one thing is clear: Centering groups can positively influence the lives of expecting women. Studies have shown that Centering participants experience lower preterm birth rates, deliver babies with higher birth weights, and demonstrate higher breastfeeding initiation rates when compared to non-participants.

In this day and age, extended families rarely live under the same roof. In the past, an expecting woman or new mom may have lived with or near her mother, aunt, or grandmother, receiving support and being cared for by others on a daily basis. Today, many women need to seek out their own community. Centering groups are here to help.

Centering groups are available at South Shore Medical Center and Crown ObGyn. For more information regarding Centering at SSMC call 781-682-8000 and ask for the ob-gyn receptionist. To learn about Centering at Crown, call 617-479-6636.

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Wednesday, January 28, 2015
All You Need to Know About Birth ‘Terms’
by Chris Just at 05:50 AM

Pregnant%20woman%20and%20friend_websize.jpgIn the past, healthcare providers defined “term” to be the period of time from 37 to 42 weeks of pregnancy. This 5 week range was believed to be the healthiest time for a baby’s birth as most organs were thought to be adequately developed and functional; however, numerous studies over the last several years support a more narrowly demarcated range for “term” due to evidence that babies can experience different outcomes within that 5 week period.

As a result, the American College of Obstetricians and Gynecologists redefined “term” and created these 4 separate categories:

  • Early Term: Between 37 weeks 0 days and 38 weeks 6 days
  • Full Term: Between 39 weeks 0 days and 40 weeks 6 days
  • Late Term: Between 41 weeks 0 days and 41 weeks 6 days
  • Post-term: Between 42 weeks 0 days and beyond

Early Term

Did you know that at 35 weeks, a baby’s brain weighs only two-thirds of what it will weigh at 39 – 40 weeks? Every week counts in fetal development. Unless there is a medical condition that necessitates an earlier delivery, babies are better off if they are born at full term. Babies born in early term can be at risk for jaundice, low birth weight, respiratory distress, and other conditions that are typically associated with premature babies and require medical intervention. For these reasons, organizations such as the March of Dimes and the Association of Women’s Health Obstetric and Neonatal Nursing developed campaigns to educate women and providers on the benefits of avoiding elective inductions and Cesareans; “elective” meaning these interventions are not medically necessary but performed due to the woman’s or provider’s choice.

Full Term

For a low-risk pregnancy, this two week period is considered the optimal time for a baby to be born. All organs are fully developed and the placenta is typically healthy and functioning at full capacity. Babies born at full term have a lesser chance of experiencing negative outcomes; however, birthing a baby at full term is only half the picture. The method of delivery is an additional factor. Currently, one out of three women will deliver by Cesarean section in the United States. Cesarean involves the same risks as any surgical intervention (including risk of infection, bleeding, blood clots) and should be avoided unless medically necessary. The American College of Obstetricians and Gynecologists promotes Safe Prevention of the Primary Cesarean Delivery, or preventing cesareans for first time pregnancies in which there is one baby in a head down position at term. To avoid unnecessary cesareans, ACOG recommends redefining stalled labor, utilizing improved and standardized definitions for fetal heart rate assessment, and integrating non-medical interventions such as continuous labor support, among other suggestions.

Late Term

Before defining a pregnancy as late term, your provider should confirm that the estimated due date is accurate. Because of an increased risk of stillbirth from 41 weeks on, ACOG states that special tests, known as antepartum fetal surveillance, “may be warranted” to assess the baby’s well-being. ACOG also notes that induction of labor between 41 weeks 0 days and 41 weeks 6 days “can be considered”.

Post Term

During post term, there is evidence that risks for both baby and mother increase. In addition to the increased likelihood of stillbirth, there is also increased risk of forceps or vacuum delivery, cesarean delivery, shoulder dystocia, meconium aspiration, neonatal seizures, and low Apgar scores. Per ACOG, induction of labor after 42 weeks and 0 days and by 42 weeks and 6 days of gestation “is recommended”, due to this elevated risk.

As you can see, there’s a Goldilocks component to birth – best not to deliver too early or too late and full term is “just right”. You may begin to feel tired of being pregnant when you’re in the latter part of your third trimester. It may make sense on an emotional level that you want to meet your baby sooner rather than later but be aware of the potential consequences and let nature take its course. Early delivery is justified when there is a medical complication but, for low-risk pregnancies, remember what the March of Dimes promotes: “healthy babies are worth the wait”.

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Tuesday, January 20, 2015
Childbirth Education Classes: Top 4 Reasons to Sign Up NOW!
by Chris Just at 09:57 AM

Centering_resized.jpgRecent history has shown an overall rise in induction and Cesarean rates, while, at the same time, attendance in childbirth classes has declined. Could there be some relation between these two trends? We don’t have a definite answer but one could surmise that patients who are inclined to choose elective induction or Cesarean might think twice after taking a childbirth class and discussing the risks and benefits of these options.

The value of on-site prenatal classes has been questioned ever since high quality, web-based and digital information came on the scene. You might ask, “Why waste the time on on-site classes when I can get similar content online and have the freedom to review it at my own pace?” While it’s true there are plenty of websites and apps that can answer your questions and help you gain knowledge about birthing and parenting, there’s still a lot to be gained from an on-site class. Benefits include the opportunity to bond with your birth partner, a chance to meet other couples going through the same life-altering experience, and the ability to interact face-to-face with the instructor and ask questions.

Here are 4 more major reasons you should sign up for prenatal education:

1. Reduce Fear & Increase Confidence

In prenatal class evaluations and postpartum surveys, birthing mothers and their partners routinely comment on how classes reduced their fear of labor; made them feel more confident about birth, breastfeeding and parenting; and helped the partners become more involved in the pregnancy. In a childbirth class, for example, you will learn about the connection between fear, tension and pain in labor and ways to maintain a relaxed and confident state to reduce the symptoms of anxiety and tension.

2. Gain Knowledge of Evidence-Based Guidelines

Prenatal education classes of the highest quality are routinely updated with current research and relevant resources for class participants. Recommendations are constantly changing and organizations such as the American College of Obstetricians & Gynecologists, the American College of Nurse-Midwives and the American Academy of Pediatrics regularly revise their guidelines and policy statements. For this reason, even second- and third-time moms will benefit from re-taking prenatal education classes. As an example, in just the last couple of years, new CDC guidelines have been instituted which recommend that every pregnant woman receives a pertussis booster during each pregnancy to protect the baby from whooping cough. Chances are several new recommendations are in place since the delivery of your last baby.

3. Develop Awareness of Your Options

In childbirth education classes, participants learn about pharmacologic pain relief for labor, natural comfort measures and risks and benefits of different types of medical interventions. These classes also cover effective ways to relay your birth preferences and communicate with your provider when you have questions or concerns. Breastfeeding classes teach a variety of breastfeeding holds and, for special situations, alternate ways to feed breast milk to your baby. Newborn care classes offer an assortment of comfort techniques to soothe your baby.

4. Practice Hands-On Techniques

In birthing, breastfeeding and newborn care classes, participants practice breathing, labor positions, relaxation exercises, effective breastfeeding holds, infant massage, dressing the baby, diapering and many other techniques. You will also learn some of these skills at your birth site after you have the baby; however, the first couple of postpartum days are not the best time for retaining information due to lack of sleep, visitor interruptions and being overwhelmed by your new beginning. Taking a prenatal education class gives you time to absorb the information you need to know so postpartum practice at your birth site can reinforce what you learned before.

The best prenatal education is research-based, objective and presents various options in care. Birthing and parenting information can be delivered in an on-site class, online or as part of group prenatal care such as Centering Pregnancy. Make sure your class is completed by one-month before your due date (earlier for twins) just in case you go into labor on the early side. Becoming a parent is an amazing life-changing event that should involve the preparation and attention it deserves. Get off to the right start and take time to learn, practice and ask questions while you can.

All South Shore Hospital prenatal classes are taught by experienced nurses and lactation consultants. To register for childbirth, newborn care or breastfeeding classes at South Shore Hospital click here.

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Monday, December 15, 2014
Free Early Pregnancy Education Class
by Chris Just at 05:26 AM

Centering_resized.jpgAre you newly pregnant and full of questions you can’t wait to get answered? Are you wondering which fish are safe to eat and which are not? Whether or not you can still dye your hair? Or which medications are OK to take while pregnant? If so, then this FREE Early Pregnancy Education class is for you.

Taught by South Shore Hospital nurse-midwife, Nannette Landry, and nurse-practitioner, Jaimie Kullack, this class will give you the opportunity to ask all the questions you’ve had ever since the test showed you were positively pregnant.

The class includes the following topics:

  • Your options for prenatal care
  • Genetic screening choices
  • Ways to manage common discomforts of pregnancy
  • Prenatal nutrition
  • Food safety
  • Safe prenatal exercise
  • Healthy weight gain
  • Warning signs

Get off to a great start by educating yourself in early pregnancy. You may be reading lots of information on the internet but how do you know which pieces are based on valid, evidence-based material? In this class you will hear the real deal directly from the experts.

FREE Early Pregnancy Education Class Registration Details:

Who:
Any woman in early pregnancy and one support person
When: Tuesday, January 20, 2015 at 6:30 – 7:30 pm
Where: Crown OB, Quincy, MA

When: Tuesday, January 27, 2015 at 6:30 – 7:30 pm
Where: Crown OB, Pembroke, MA

To register or learn about future dates for this class: Call 617-479-6636

Join us and meet other women that are experiencing pregnancy just like you!

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Tuesday, January 13, 2015
When Men Experience Pregnancy Symptoms
by Chris Just at 09:41 AM

woman%20and%20husband_websize.jpgCouvade Syndrome or “sympathetic pregnancy” is a condition in which a partner experiences some of the same symptoms as his or her pregnant companion, such as bloating, morning sickness, weight gain, and food cravings. As real as these symptoms may be for the afflicted, this syndrome is not officially recognized as a medical condition and much remains unclear about the details surrounding it. The rate of incidence is a bit murky due to inconsistencies in reporting - some partners may be hesitant to admit having pregnancy symptoms. Also, researchers are not yet sure what provokes the syndrome. Is it a psychosomatic condition, i.e. a physical condition caused by mental factors? Or is this phenomenon more biological in nature and due to hormonal changes in the partners of expecting mothers?

These questions involve a bit of a “chicken and the egg” conundrum and are not fully answerable at this time; however, the role of hormonal changes in the male partners of pregnant women has been studied in more depth over the last decade. For some time, researchers have known that new dads have lower testosterone levels than single men and also experience a rise in prolactin and oxytocin, hormones that promote love, nurturing, fidelity, and bonding between a man and his partner and baby.  

Findings from a more recent study out of the University of Michigan suggest that a drop in testosterone may even start occurring during the pregnancy and not just after the birth. While testosterone can play an important role in a man’s desire and ability to conceive a baby, lower levels after conception can set the groundwork for a healthier and more successful parent-child experience and relationship; that is, this biological change could promote a gentler approach to fatherhood.

Couvade Syndrome (from the French word couver, meaning “to hatch) may seem strange to some at first; however, there is comfort in knowing that the partners of pregnant women are also becoming biologically prepared to parent. While it may take a village to raise a child, having two prepared parents, rather than just one, is not a bad start.

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Wednesday, December 31, 2014
Pregnant, Productive & Practical: Taking the Negative Out of Nesting
by Chris Just at 08:16 AM

Cleaning_websize.jpgAt some point during the third trimester of pregnancy, many expecting women find that their nesting instinct kicks in with a bang. In the latter part of your pregnancy, as the impending birth day gets closer, your excitement and nervousness combine to create an explosion of uncontrollable energy and desire to get stuff done. Nesting can manifest in different ways. You might start by making lots of “to do” lists and then suddenly find yourself shopping for important items, cleaning the entire house, rearranging furniture, and designing the baby’s nursery, all within a short period of time.

As productive and efficient as this burst of accomplishments may seem, unbridled exertion and cleaning during pregnancy are not necessarily risk-free. Heed the following precautions so you can accomplish your nesting goals while keeping yourself and baby safe – a win-win-win!

Take the Load Off

Heavy lifting is not recommended during pregnancy. Non-stop work, without periods of rest, may begin to take its toll and shortness of breath, a common side effect of pregnancy, can become exacerbated if you strain yourself. Leave the heavy lifting to family and friends, rest periodically, and be sure to stay well hydrated while you buzz around in nesting mode.

Go Green

Household cleaners can also pose a risk. Read labels carefully and avoid products that contain the word “toxic” or “poison” in their description, including many oven, carpet and toilet bowl cleaners. Some products, such as bleach, are not harmful to your baby but may give off potent fumes that cause nausea. When cleaning, wear rubber gloves, don’t mix chemicals, and open several windows to protect yourself and your baby. Whenever possible, use more natural, “greener” products, such as baking soda to scrub your bath and toilet and vinegar to wash your kitchen floors.

Prudent Painting

The fumes associated with household painting are thought to carry very little risk in pregnancy; nevertheless, taking the following precautions is wise: wear protective clothing, use a mask, make sure the area is well-ventilated, and do not eat or drink in the paint area. Better yet, ask a family member or a friend to paint for you. Stick with latex paint and steer clear of oil-based paints, solvents and thinners.

Nesting can be extremely fun and rewarding—allowing a great deal of satisfaction in knowing you’ve checked off your “to dos” one by one! If you have concerns or questions about the safety of certain products, ask your provider or contact the Pregnancy Exposure InfoLine at (800) 322-5014 or visit www.thepeil.org for more information. You’ll feel more confident if you have answers and just think…that will be one less item on your “to do” list!

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Monday, December 22, 2014
Coping with Early Labor: Keep Calm and Labor On
by Nannette Landry at 10:41 AM

Labor_resized.jpgYou are nearing your due date and beginning to wonder how you will ever get through labor. Maybe you took some classes to prepare, or maybe like most, were too busy with all the other million things you needed to get done. Perhaps you read a book or two. Maybe a family member or friend told you all you need to know to prepare. Regardless, now you are beginning to panic.

Labor, just like the term implies, is work. Yes, it is the hardest work you will do in your life and the most amazing work too. You, like all women, were born to birth. Labor and birth are normal physiological events. Labor is not unlike running the Boston Marathon. You would never just wake up one day, without preparing and decide to just go run a marathon. You would prepare for almost a year by eating well, working out and conditioning and training your body for the event. Perhaps you would look at the course and make a plan or instead, maybe even put together a team of folks to help you along the way. Preparing for labor and birth is much the same.

It helps to find out about labor. Knowledge is power and will decrease the fear of the unknown. Take a class or read about labor (www.childbirthconnection.org is a wonderful resource). Most first time labors are about 24 hours long and most of that time will be spent at home. Often in the beginning of labor, you may feel cramps similar to period pain.

It’s important to know what to expect during early labor and how to help yourself get through it. Let me share some tools with you:

  • Put together a team of people who have unconditional love for you—people you can really count on. At South Shore Hospital, you can have up to 3 labor support people helping you. If you feel you may not need them all at once, perhaps they can take shifts.
  • Stay well hydrated. Early labor can go on for a while. Drink a glass or 2 of water, juice or Gatorade every hour. Being dehydrated will cause painful but useless contractions.
  • Eat if you are hungry.
  • Try to sleep if you are tired or if it’s nighttime. A heating pad or hot water bottle will ease the pain. If you cannot sleep, walk around.
  • Stay busy with distractions such as shopping or cleaning.
  • Ignore the pains until you can no longer walk or talk through them.
  • If the pain worsens, try a nice warm shower. The warm water will relax you and ease the pain. A long soak in a warm bath will also ease your pain and allow you to relax—even helping labor move along.
  • If your back hurts, apply an ice pack to the lower back, get on all fours and rock back and forth or stand and lean over the back of a chair. Lower back pain is common and often it helps to have your partner push on the sore area with the heel of his/her hand during a contraction and rub the lower back between contractions. Ice is a natural anesthetic. Try putting a bag of peas in a pillow case and apply it to your lower back.
  • Try a yoga ball—which makes a nice chair in labor by supporting you in a squatting position to help open the pelvis.
  • Soft music, dim lights and slow deep breathing will provide further relaxation and encourage your body to open for you to birth your child.

Bottom line: keep Calm and Labor on.

Remember to always call your provider with signs of labor, leaking fluid, vaginal bleeding or any concerns at all. Your provider will help you decide the appropriate time to come to the hospital.

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Wednesday, December 17, 2014
New at South Shore Hospital: Nitrous Oxide for Labor Pain Relief
by Chris Just at 10:39 AM

Gas%20mask_websize.jpgNitrous oxide, often referred to as “laughing gas”, is an odorless, tasteless gas made for inhalation to provide analgesia. Today, nitrous oxide is used for pain relief by 60% -70% of laboring women in countries across the globe including Canada, New Zealand, the United Kingdom and Sweden. Only recently has it begun to resurface in some birthing units across the United States, including here in MA, where only 3 hospitals have implemented the use of nitrous oxide…that is, until now.

South Shore Hospital is the first hospital on the South Shore and fourth overall in the state of Massachusetts to join the ranks of innovative hospitals that are offering nitrous oxide. Providing the option of nitrous oxide for labor patients is yet another example of South Shore Hospital’s commitment to offering choices in childbirth, a list that includes midwifery care (in local practices and through their hospitalist program), a tub for laboring in the water, and the support of Centering group prenatal care.

Most women would agree that labor is no laughing matter. So how does nitrous oxide help improve the experience? Below are some answers to common questions related to nitrous oxide:

How is nitrous oxide used?

The concentration ratio of nitrous oxide found to be safe for use during labor and immediate postpartum is 50% nitrous oxide and 50% oxygen. The gas is self-administered, meaning that the patient holds the mask over her face, on her own, and then naturally releases it as she begins to feel more relaxed; thus providing a safeguard against administering too much nitrous oxide. The gas is fast-acting and quickly cleared as it is eliminated via the lungs. The peak effect of nitrous oxide for the laboring woman occurs approximately 30-50 seconds after inhalation.

What are the effects/benefits of nitrous oxide?

Nitrous oxide helps laboring women feel more comfortable because it helps generate a state of relaxation and a reduced perception of pain. It does not take all the pain away; however, for many women, it keeps their discomfort level within their threshold of tolerance. Some women are satisfied with nitrous oxide alone; others decide they want a stronger or alternative method of pain relief as their labor becomes more active or if they experience negative side effects from nitrous oxide.

What are some of the other ways nitrous oxide can be used?

In addition to relieving general labor pain, nitrous oxide can be used during forceps or vacuum delivery, manual removal of placenta, repair of perineal lacerations, and additional procedures which may cause the mother anxiety and impact her ability to cope.

What are the side effects?

Some women experience side effects when they inhale nitrous oxide while others do not. Potential side effects associated with using nitrous oxide include nausea, vomiting, drowsiness, dry mouth, vertigo, tingling of the fingers and toes, and an altered sense of taste and smell. These effects typically subside soon after discontinuing use of the gas.

If you are interested in trying nitrous oxide for pain relief, let your nurse or provider know when you arrive in labor. S/he will give you a detailed explanation of how the gas works and answer any questions you may have.

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Friday, December 05, 2014
Take a Tour of the New Text4baby App
by Chris Just at 12:30 PM

text4baby_websize.jpgGreat news for expecting women and new moms: Text4baby has just recently launched their own free app. The free text messaging service of the nonprofit, National Healthy Mothers, Healthy Babies Coalition, was first introduced in 2010, and the market of female smartphone users exploded from 25% to over 55% of women in the US—indicating it’s clearly time to meet the millennials where they’re at.

I downloaded the app to check it out and found it to be extremely easy to use as I poked around the various features. The information is valuable and straightforward without being overwhelming. Content is broken into two sections: “pregnancy” (from week 4 through 42) and “baby” (from week 1 through 52, or the first year of life).

Three tabs offer an array of valuable features to support you during pregnancy and early parenting. These include:

The Timeline Tab

The “Timeline” tab gives you a weekly update on fetal development along with a “to do” list that corresponds to each week and helps you keep track of all the details related to your lifestyle and self-care during pregnancy. It includes some fun polls that allow you to see how other Text4baby moms respond to a variety of topics, such as pregnancy symptoms, physical changes, baby development and emotional experiences.

 The Appointment Tab

The “Appointment” tab lets you know what to expect at each visit with your doctor or midwife, provides detailed information to prepare you for the appointment, and offers the option for you to set a text message reminder for each scheduled visit.

 The Topics Tab

The “Topics” tab sends you to a whole library of information on prenatal care, nutrition, health issues, weight, exercise, labor and delivery, community resources and health hotlines. The app notes that the information provided on health issues has been provided in partnership with two organizations: the American Congress of Obstetricians and Gynecologists and Healthy Children.

The app provides the information and organizational support you need right at your fingertips. Convenient, fun, evidence-based, and useful—the free Text4baby app provides a perfect way to stay on track – with your health, your knowledge, and your calendar!

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Friday, November 21, 2014
The use of Gas and Air (Nitrous Oxide) in Labor
by Julie Paul at 10:02 AM

Gas%20mask_websize.jpgNitrous Oxide has been used as a method of pain relief since post-World War II in Europe and most recently, the United States. Many people are most familiar with its use in the dentist office—often referred to as “laughing gas.” On the television program, Call the Midwife, Gas and Air (Nitrous Oxide) was introduced in one of the episodes as a method of pain relief for women in labor.

What is Nitrous Oxide?

Nitrous oxide is a mixture of nitrous and oxygen (50/50 blend). It is self-administered through a machine that delivers just the right amount at any point in labor.

How can the use of Nitrous Oxide help me during labor?

As a pain relief during labor, Nitrous Oxide delivers a number of benefits including no limit as to how long you choose to use it during labor. Benefits include:

  • Ability to use it in the labor tub
  • Ability to delay the use of an epidural (if needed)
  • Minimal to no effect on the infant
  • Wears off quickly
  • It doesn’t impede the natural process of labor
  • Minimal side effects to the mother

So why isn’t everyone using Nitrous?

Pain relief in labor is such a personal choice. There are many things that can affect how a woman perceives pain in labor such as length of labor, pain tolerance, position of the baby or if you are having an induction of labor.

Nitrous Oxide will be an option coming soon to South Shore Hospital. If the use of this method of pain relief is something that you may be interested in, be sure to ask your provider if you are a candidate.

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Monday, November 17, 2014
Pregnancy & Yoga - A Match Made in Heaven
by Chris Just at 07:53 AM

yoga_web.jpg“Sit up straight, shoulders back!”, the common mantra of many mothers, is not so easy to follow when you’re expecting. Normal changes in your pregnant body can affect prenatal posture in challenging ways. When the breasts and belly expand during pregnancy, the shoulders pull forward leading to a hunched and strained upper back. In addition, the curve in the lower spine becomes more pronounced as your center of gravity adjusts to compensate for the extra weight in the front of the body. Consequently, the muscles and ligaments in the lower back become shorter, tighter and weaker, potentially leading to discomfort and even sciatica. Poor posture in pregnancy can also interfere with your baby getting into the most optimal position for birth. Furthermore, you may experience balance issues due to the shift in your center of gravity.

Sounds unattractive and unpleasant, right? Never fear – you can manage these changes with prenatal yoga. Yoga positions involve stretching, strengthening, balance and relaxation - the perfect remedy for the musculo-skeletal mayhem that arises in pregnancy. Add to that the benefits of meeting a community of women involved in the same life event and you’ve got a full package of physical fitness and peer support. A prenatal yoga class with an experienced and qualified instructor will include a variety of safe positions and movements, such as shoulder rolls, chest openers, pelvic tilts, forward bends, and lunges. Modifications of certain yoga poses will be suggested depending on your gestational age, yoga experience, level of flexibility, and any conditions that could affect your performance or require alternative options. In a prenatal yoga class, participants do not engage in positions that involve lying directly on one’s belly and are instructed to avoid lying on one’s back for an extended period.

The American College of Obstetrics & Gynecology recommends a minimum of 30 minutes of prenatal exercise per day. In addition to prenatal yoga, other safe exercise options include walking, swimming and stationary biking. Remember to hydrate well during any fitness activity and call your doctor or midwife if you experience bleeding, cramps or shortness of breath with exercise. Group prenatal yoga classes offer a chance to meet other women; however, if a class is not possible, consider using a DVD at home. You may even be able to sign one out for free at your local library.

Prenatal yoga can offer you many potential benefits, including increased energy, relief of constipation and leg cramps, improved mood, increased stamina, better sleep, control of gestational diabetes, increased endurance during labor, and an easier postpartum recovery. So don’t delay on your “namaste”. Start practicing yoga today and you’ll feel like heaven.

To learn more, check out these video segments on yoga positions for the upperback & shoulders and yoga positions for the lower back.

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Friday, November 14, 2014
Skin to Skin Care
by Nannette Landry at 09:40 AM

Skin%20to%20Skin_resized.jpgI have been attending women at birth for decades. It has always seemed natural to me to just put the baby up on mom’s chest or abdomen first. I would then dry and cover the baby with a warm blanket. Women seemed to want to just reach down and bring the baby up to their chest.

Today, we call this practice skin to skin care and we encourage it at all births, even Cesarean births. The baby is placed chest to chest on Mom with her baby’s face turned to one side. Research has shown that skin to skin contact between Mom and baby at birth helps to stabilize the baby’s breathing, body temperature and blood sugar levels. It offers a familiar environment in which the baby recognizes mom’s heartbeat, voice, and smell to make an easier transition to life outside the womb. It provides a calm place; it is soothing and babies cry less when on mom. The skin to skin contact helps the baby smell mom’s milk and this in turn helps initiate breastfeeding.

It has been 19 years since the birth of my daughter, yet I still recall the feeling of that warm wet baby born into my arms and placed on my abdomen, dried and covered with a warm blanket. It is a memory imprinted in my brain as my most joyous moment ever. Still attached to by her cord, she began to open her eyes and look at me, began to know me and I her. I will carry the memory forever and am so grateful for the midwife who gently and lovingly placed my baby on me.

Skin to skin care can be done anytime, not just at birth. If for some reason, you are unable to do skin to skin at birth, you may do it as soon as you are able. Dad’s can do skin to skin too. Ask your nurse to show you how. It is such a precious way for you and your baby to bond.

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Wednesday, November 12, 2014
Urinary Incontinence and Pregnancy: Kegel Exercises Can Help
by SSHMaternity at 08:57 AM
Author: Abraham (Nick) Morse, MD, MBA
Boston Urogyn

drinking%20water_Blog.jpgPregnancy can be a joyful and a stressful time all at once!  The ability of a woman’s body to adapt to the incredible demands of a growing baby is breathtaking.  However, particularly as the end of pregnancy approaches, the ability of the body to adapt can still be overwhelming.  Did you know that urinary and bowel incontinence are both surprisingly common as the end of pregnancy approaches?  These experiences may not be ones that all pregnant women are willing to share with their family or friends but it is important to know that if you are experiencing problems with bowel or bladder control you are not alone.

Reports from all over the world on this topic documents that on average 30 to 40 percent of women in the third trimester experience at least occasional urinary incontinence and anywhere from 5 to 10 percent experience occasional leakage of stool.  For the vast majority of these women (who have a lot of other things to pay attention to) these leakage episodes were rated as a minor bother, but for a small percentage (less than 10 percentage) the problem was described as significantly disruptive to their quality of life.

Does the problem go away after delivery?  As you would expect, the answer is: sometimes.  But there will be more discussion about that in a separate post.

One thing that you can do to help improve the health of your pelvic floor and reduce the impact of bladder and bowel leakage is to do your pelvic floor exercises (Kegels) daily during pregnancy.  If you don’t know how to do these key pelvic floor muscle contractions, or you are not sure whether you are doing them correctly ask your obstetric provider to check and see how you are doing.

If problems with bowel or bladder control are becoming significantly disruptive, then don’t hesitate to ask your obstetric provider for support and suggestions.  Even though some interventions would not be appropriate during pregnancy, there are still ways of helping with the problem.  Your obstetrician or midwife may consider referring you to a urogynecologist-a specialist in female pelvic floor problems such as urinary and bowel incontinence.

 

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Friday, November 07, 2014
The Woes of Whooping Cough
by Chris Just at 11:11 AM

Flu%20Shot.jpgSneezing, a mild cough and a runny nose…sounds like a benign cold, right? Maybe so, but if severe, violent coughing occurs after 1-2 weeks it is important to rule out whooping cough, named for the characteristic “whoop” sound that may occur during a coughing fit. Whooping cough, or pertussis, is a highly contagious disease that’s especially concerning when it strikes vulnerable populations, especially babies and young children. The U.S. gained the upper hand on pertussis after a vaccine was introduced in the 1940’s; however, just before the turn of the century we began to see a persistent rise in rates of this dangerous disease. Why? Investigators are not completely sure, but the increase in whooping cough cases may be related to the introduction of a new pertussis vaccine in the 1980’s—an overall safer version when compared to the previous vaccine, but perhaps somewhat less effective.

What we do know is this: Complications of pertussis include pneumonia and seizures. About half of infants who get pertussis are hospitalized, and 1-2 in 100 hospitalized infants die. What’s more, symptoms are not always so obvious, especially in babies. The cough may be subtle or not even be present; instead, some infants experience apnea or concerning pauses in breathing. For these reasons the CDC developed new guidelines over the last couple of years to help protect families:

For Pregnant Women

All pregnant women should get one dose of the pertussis booster, or Tdap, during the third trimester of each pregnancy to allow transfer of maternal pertussis antibodies to the newborn. These antibodies will provide protection until the infant is vaccinated with 5 doses of DTaP (pertussis vaccine) at 2, 4 and 6 months, at 15 through 18 months, and again at 4 through 6 years.

For Preteens and Teens

Vaccine protection for pertussis, tetanus, and diphtheria can decrease with time which is why the booster vaccine (Tdap) is given to preteens at age 11 or 12 years. Teens and young adults that didn't receive Tdap as a preteen should get one dose when they visit their health care provider.

For Adults

Adults 19 years of age and older who didn't get Tdap as a preteen or teen should get one dose of Tdap. Family members, close friends and caregivers that are not up-to-date with their age appropriate vaccine (DTaP or Tdap) should be vaccinated at least two weeks before coming into close contact with a new infant.

Non-vaccinated children are 8 times more likely to get pertussis. Take charge of your family’s collective health by keeping up-to-date with each family member’s vaccine schedule and encouraging others to do the same. Vaccines are the most effective tool available to prevent the spread of pertussis as well as many other diseases. Let’s each do our share to protect each other!

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Tuesday, November 04, 2014
Do you need to take childbirth preparation classes?
by Nannette Landry at 08:06 AM

Centering_resized.jpgA question I often hear from pregnant women and their partners is, “Do I need to take childbirth preparation classes?”

I believe that all women and partners will benefit from becoming educated about normal labor and birth. Myths are dispelled and women learn about what to expect. The "knowing what to expect”, actually reduces the fear of the unknown and empowers women for the process.

Taking childbirth classes does not mean that you have to have an un-medicated labor. On the contrary, you still have the option of many types of pain relief and are more fully informed about the options. Thirty years ago, all women having a first baby took classes. I taught those classes and recall watching pregnant women grow in knowledge and confidence as they approached the greatest physical and emotional event of their lives.

One patient recently said to me, “I don’t need to prepare for labor.” That’s like saying, “I am going to run the Boston marathon but I do not need to prepare.”  Before running a marathon, you would look over the course, work out a bit ahead of time, set up support systems and get prepared.  That is exactly what classes will do for you.

We see women coming in to labor who are unprepared, uninformed and fearful. Fear increases pain. I have noticed that our Cesarean birth rates have increased over 30 years. It may have something to do with our culture of fear surrounding childbirth rather than the awareness that labor and birth are normal physiologic events. Prepared childbirth classes are a good place to help women start believing in their ability to birth normally. I am so proud that SSH offers childbirth classes. Sign up today!

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Wednesday, October 29, 2014
Title: Myths vs. Reality: Rooming-In & Couplet Care
by SSHMaternity at 01:05 PM

South Shore Hospital recently rolled out changes in maternity care practice with Rooming-In and Couplet Care—which resulted in lots of attention, engagement and questions. We would like to address some of the questions and concerns you sent us.

Couplet Care is a change in maternity nursing practice. It allows for mom and baby to be cared for one-on-one by the same nurse for the entire shift. Nurses will be assigned 3 to 4 mother and baby “couplets” per shift, allowing for personalized and complete care.

Rooming-In is a strongly encouraged practice allowing for the new baby to be with the family 24/7 while in the hospital. While the baby is in the room and not in the nursery, it does not mean mom is providing care without support. The nurse may be called whenever assistance is needed. Rooming-In has been proven healthier for both mom and baby, and is endorsed by the American Academy of Pediatrics (AAP), World Health Organization and UNICEF, among most other maternity and pediatric professional organizations.

MYTH: Rooming-In is required for all mothers delivering at South Shore Hospital.

FACT: Rooming-In is strongly encouraged, and is now the standard of care at most hospitals in Eastern Massachusetts. There is nothing healthier for new babies than to be together with their moms in the earliest days of life.  However, moms are still in charge of their own care and that of their babies, so patient choice, medical considerations and other factors may not allow for Rooming-In during the entire duration of your hospital stay.

MYTH: South Shore Hospital is closing its nursery.

FACT: South Shore Hospital is NOT closing its nursery. The nursery is still open and available for those circumstances when babies need to be cared for in the nursery and not in the mom’s room.

MYTH:  Rooming-In means mothers don’t get support in caring for their baby.

FACT: Rooming-In does not mean that you and your family are left alone to care for your new baby. Rooming-In, combined with the Couplet Care nursing practice, actually provides more support and a better transition home for the new or expanded family. Moms and families will receive valuable one-on-one care from their nurse, who, if moms and families wish, will be available for feedings and diaper changes as needed. The nurse is also able to teach new families valuable infant care practices, including soothing, bathing, changing, swaddling and feeding.

Additionally, we are moving toward having nursing assessments, pediatrician assessments, vital signs, weights, hearing screening, medication administration and labs performed in the room with families present—reducing stress on both babies and parents.

MYTH: Rooming-In means less rest for moms.

FACT: Research actually shows the opposite, that both mom and baby sleep better while in the same room. Traditionally at South Shore Hospital moms have fed babies throughout the night and Rooming-In makes this easier.

MYTH:  Moms will not be given time to recover from labor or C-sections.

FACT: The health of mother and baby are a priority for everyone in the Maternity Division. Our nurses work one-on-one with mothers and families to make sure mothers recover safely from the birth experience. For example, women who have had a C-section are not expected to lift, bend or move unsafely, and are given 100% support and assistance from the nursing staff.

MYTH: Rooming-In is stressful for moms.

FACT: Research shows the opposite, that Rooming-In reduces moms’ stress. Mothers and families who keep their babies in the room at the hospital, bond more easily, learn more about the baby’s normal responses and sleep-wake cycle, and are more confident about caring for the infant on their own when they go home.

Research also shows, a baby who stays with mom and family will cry less, maintain a more stable body temperature, and stay healthier.

MYTH: South Shore Hospital is the only hospital in the area encouraging Rooming-In.

FACT: Most Boston-area hospitals encourage Rooming-In including Beth Israel Deaconess Hospital-Plymouth, Tobey Hospital, Cape Cod Hospital, Falmouth Hospital, Brigham and Women’s Hospital, Tufts Medical Center, Massachusetts General Hospital, Beth Israel Deaconess Medical Center and Good Samaritan Medical Center.

MYTH: South Shore Hospital has a ‘no-pacifier’ policy.

FACT: South Shore Hospital does not supply pacifiers to healthy, full-term babies; however they can be brought from home or purchased in the hospital’s Friendly Shop and used at the parents discretion. Best practices shows not using pacifiers in the first few days of life helps parents learn newborn sounds and feeding cues. Whether breastfeeding or formula-feeding, pacifiers are not recommended until the baby is about a month old, so that feeding schedules and cues are firmly established. We continue to provide pacifiers for medically-necessary procedures such as circumcisions and heel sticks, as needed.

We encourage you to leave a comment on this blog post, or on the SSH Babies Facebook page and we will continue to work to address your questions and concerns.  Thank you very much for your engagement with us and allowing us the opportunity to communicate important information about our Maternity programs and services.

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Monday, October 27, 2014
All the Peas Together in One Pod
by SSHMaternity at 01:49 PM

rooming%20in.jpgCouplet Care/Rooming In

For years, it has been a frequent request from new Moms that they not be separated from their newborns.  South Shore Hospital is listening and now offering this wonderful way for new families to bond.  The team of experts within our maternal services division is excited to provide family-centered care, known as Couplet Care to the patients who deliver their babies here. 

Dozens of hospitals around the country are offering this contemporary and thoughtful approach to caring for both Mother and baby.  We acknowledge that a birthing experience is a major life event for a mother and family and current research has shown that outcomes are best when mothers and infants stay together.  

What exactly is Couplet Care?

Couplet care is an evidence-based best practice in maternity care that promotes family bonding, supports successful breastfeeding and ultimately increases patient satisfaction.  The process of caring for mothers and babies together while rooming in together allows for consistent newborn and postpartum education for you and your partner in order to be better prepared to care for yourself and newborn upon discharge.

Mom and baby remain together throughout their hospital stay, cared for as a pair in the same room after birth, with nursing care provided by the same nurse or nursing team.  In addition to forming an instant family unit immediately after birth, communication between health care providers, including obstetricians and pediatricians is further enhanced.

Our goal is to minimize separation between you and your baby, while making you feel comfortable and confident caring for your new baby when you go home.

Benefits of Couplet Care/Rooming In?  

Rooming in with your newborn baby is the latest recommendation from leading pediatric and obstetric foundations. The benefits of couplet care and rooming in are countless, including better feeding success and adequate time to learn your baby’s individual cues and needs while still having support from your nurse. 

Your baby benefits tremendously by being in a familiar, calm and quiet environment, where he or she recognizes Mom’s voice, heartbeat and smell.  Your baby will cry less, sleep longer and deeper near you, as opposed to a bright noisy nursery, reducing stress for your baby.  Along with decreased risk of infection due to less exposure to other newborns and staff, rooming in allows more skin to skin time with Mom and Dad, which promotes feeding success, better weight gain, and a more stable temperature for your baby.

Benefits to Mom include more opportunity to bond with your baby while gaining confidence in baby care and greater feeding success—whether breast or bottle.  Also, in addition to decreasing a Mother’s anxiety when separated from her baby, Mothers tend to sleep better with baby nearby and report feeling more confident when going home.

Does this mean South Shore Hospital’s newborn nursery will be closing?

No, the nursery will still be available to provide care for those babies requiring closer observation and some procedures such as circumcision.  While there may occasionally be a need to send a baby to the nursery for a short period of time, all babies are returned to the mother and/or partner for feeding.

A Mother’s Testimonial:

“Having my baby room in with me was an amazing experience.  I felt very in tune with all of her cues and it decreased my anxiety by having her with me at all times.  I loved never having to be separated from her. Having the nurses and doctors provide care for my baby right in front of me made me feel very comfortable and confident in the care she was receiving.  I was always in the loop with what was going on and the information was direct because I was able to talk face to face and get all of my questions answered with my baby right in front of me.  I felt it helpful to have my baby in the room because I was able to pick up on her feeding cues before she got to the point of complete frustration. It was a very calm and relaxing experience.”  ~ Grace McGonigle

Crenshaw, J. Care Practice #6: No Separation of Mothers and Baby, With Unlimited Opportunities for Breastfeeding. Journal of Perinatal Education, 16, 39-43. Retrieved, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948089/

Lowe, N. (2007).  Highlights of Listening to Mothers II Survey.  JOGNN. 36 (1), 1-2. 

Mullen, K., Conrad, L., Hoadley, G., Iannone, D. (2007). Family-Centered Maternity Care: One Hospital’s Quest for Excellence.  Nursing for Women’s Health. 11(3), 282-290.

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Thursday, September 25, 2014
Calling all Supermoms: Learn the Flu Facts for Pregnancy!
by Chris Just at 08:57 AM
Susan%20Yount%20Video.jpg
Click above to hear Certified Nurse Midwife, Dr. Susan Yount, discuss Flu and TDap vaccinations during pregnancy.

Today, I look forward to every fall when I pack up the family and head to the community center for our free flu vaccine, a program supported by the town I live in.  It’s a family and community event that even my kids can appreciate—especially since we see lots of neighbors and friends and get free candy to boot!

The foolishness of my younger years has now been replaced with a true understanding and appreciation of protecting oneself and others from the terrible effects of the flu which can be severe, and even deadly.  Pregnancy poses an especially vulnerable time to be exposed to influenza due to changes in the woman’s immune system.  The risk of complications, such as pneumonia and dehydration, are higher and pregnant women are more likely to be hospitalized with the flu compared to non-pregnant women.  Expecting women who receive the flu vaccine not only protect themselves but are much less likely to have a preterm birth or a baby born at a low birth weight. 

The injectable, inactive flu vaccine is safe anytime during your pregnancy.  The nasal spray flu vaccine, however, includes live virus and is not recommended for pregnant women.  If you are vaccinated during pregnancy, you decrease your baby’s risk of getting the flu for up to 6 months after birth at which time babies start to receive their own annual vaccine.

So be a supermom—don a cape, make a muscle, and get that flu shot to help protect yourself, your baby, your family and others from the flu!

For more information on vaccines during pregnancy, check out this video with South Shore Hospital nurse-midwife, Susan Yount, and take a peek at the American College of Nurse-Midwives’ Supermom materials, including FAQs About the Flu.     

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Wednesday, October 15, 2014
Pregnancy and Fish: Finding a Healthy Balance
by SSHMaternity at 06:04 AM

Authors: Carole McCorry MS, RD, CSP—Maternal Health Dietitian at South Shore Hospital, specializing in nutrition for pregnancy, preterm infants and pediatric patients & Wendy Barrett MS RD, CDE—Maternal Health Specialist at South Shore Hospital’s Diabetes Center.

Healthy%20Fish_resized.jpgPregnancy has a way of bringing out a mother’s sense of urgency to become an expert in all areas concerning the health and well-being of her and the precious cargo she carries.  Nutrition is one such area that can have women feeling overwhelmed—usually because of the overabundance of information available (some accurate, some not)—that often make dietary decisions during pregnancy rather challenging. 

The fact is:  a woman’s choice of food intake during pregnancy and lactation can have significant effects on her child’s lifetime health and development.  Over time it is proven that a well-balanced diet will yield optimum outcomes for mothers and infants.  The question of including fish in this well-balanced equation has been debated for years, with many women even avoiding fish altogether due to the negative media attention about potential contaminants. 

Fish can be a great source of protein, iron and zinc—all vital nutrients for your baby's growth and development. Additionally, fish contain unique nutrients such as choline and omega-3 fatty acids (DHA), which collectively play a role on brain and eye development—even promoting IQ scores later in life.

The current recommendations by the US FDA state that all pregnant women and women of reproductive age should consume 8-12 ounces of a variety of fish per week, or 2-3 servings per week.  Wild or farmed, low mercury fish should be a regular part of the diet.  Choose fish such as salmon, shrimp, pollock, light canned tuna, tilapia, or cod. 

Some types of seafood—particularly larger fish such as shark, swordfish, king mackerel and tilefish from the Gulf of Mexico contain higher levels of mercury, which during pregnancy should be eaten with precaution.  Too much mercury in your bloodstream could ultimately damage your baby's developing brain and nervous system.  Also limit consumption of white albacore tuna to 6 ounces per week. 

For children, 3-6 ounces of fish per week, is sufficient to have beneficial effects on brain development.

Research from around the world was evaluated by the World Health Organization (WHO).   The overall finding is that consuming fish while pregnant contributes to optimal brain and nervous system development in the offspring and the risks of not eating fish outweigh the risks of eating fish.  The WHO recommends consumption of up to three ounces per day of low mercury fish.

From WHO Paper:

1) The Expert Consultation finds the evidence convincing that maternal fish consumption contributes to optimal neurodevelopment in their offspring.

2) With a central estimate of methylmercury risk, neurodevelopmental risks of not eating fish exceed risks of eating fish for up to at least seven 100 g servings per week and methylmercury levels up to at least 1 μg/g.

3) With an upper estimate of methylmercury risk, neurodevelopmental risks of not eating fish exceed risks of eating fish for up to at least seven 100 g servings per week for all fish containing less than 0.5 μg/g methylmercury.

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Monday, October 13, 2014
Prenatal Aquatic Exercise
by SSHMaternity at 10:04 AM

Author: Jenn Logan, MS, MHA, RCEPsm, CCET, Community and Aquatics Programs Manager, South Shore Hospital

Prenatal%20acquatics.jpgDid you know South Shore Hospital offers a prenatal aquatic exercise class? Exercising while you are pregnant is beneficial to both you and your baby, and a great way to get a good workout in is in the water.  Water provides buoyancy assistance, resistance, and support, making it an ideal environment to exercise in while pregnant.

The buoyant properties of water can assist with decreasing symptoms of sciatic pain, carpal tunnel, and generalized low back pain to name a few.  By exercising in a non-weight bearing environment, any additional stress put on your frame from pregnancy can be decreased, resulting in less discomfort.

Water is also a great place to work on developing core musculature which will be beneficial for childbirth and returning to pre-pregnancy shape.  Water provides a consistently challenging environment for your posture, making your core muscles work harder to keep you in one position.

In addition to keeping your muscles stronger, water also provides a great environment to work on your cardiovascular (aerobic) health.  Your heart rate will be an average of ten to twenty beats lower in the pool as compared to when doing land cardiovascular exercises.  This means you can do more work for your heart for a longer period of time in water, which can be especially beneficial to maintaining a healthy weight gain while pregnant.

Water is a safe and fun environment to exercise in while pregnant, but you should consider the following suggestions to make the experience as positive as possible:

  • Make sure you hydrate before and have water readily available to you as you exercise
  • Check in with your midwife or obstetrician prior to beginning an exercise regime to make sure it is safe for you
  • Find an exercise professional to guide you through your aquatic workout for exercises and form
  • Be careful not to overheat.  Your workout should be challenging for you in a way that is fatiguing without being exhausting

Looking for a class?  Please contact our Center for Physical Wellness at (781) 624-4367 or email Jennifer_Logan@sshosp.org for more information.

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Friday, October 10, 2014
CenteringPregnancy® Comes to South Shore Hospital
by Chris Just at 11:17 AM

Centering_resized.jpgIn addition to offering traditional prenatal care, two ObGyn practices have partnered with South Shore Hospital to provide the option of CenteringPregnancy® for expecting women.  Centering® is a form of group prenatal care that includes a prenatal health check-up with additional time for learning and sharing with others. Studies have shown that participants in Centering groups prefer the group model, are 33% less likely to have a preterm baby, and demonstrate higher breastfeeding rates.

Supported by a grant from the March of Dimes and donations from South Shore Hospital Charitable Foundation and The Friends of South Shore Hospital, Centering is yet another example of South Shore Hospital’s commitment to offering a variety of choices in maternity care to meet the individual needs of their patients. This alternative for prenatal care joins an extensive list that already includes midwifery care, a tub for labor and, coming soon, nitrous oxide for labor pain relief. 

In a Centering group, an expectant woman meets with her healthcare provider and other women who are due near the same time for 10 sessions over the course of her pregnancy. The sessions are about 2 hours long and involve two co-facilitators, one of whom is a provider (OB or midwife). Session dates are scheduled in advance and groups start and end on time to make planning easy.  The group sessions begin at about 16 weeks of pregnancy.  (The first OB visit, which includes a physical, is a traditional, individual appointment.) Below are some FAQs about group prenatal care.

What will I experience in a group session?

At each session you will be involved in some of your own care.  You will check your own weight and learn how to take your own blood pressure. After your individual check-up with the provider, you will join the group for discussion and activities. In this setting, expectant mothers often develop close bonds and learn from each other as they share questions, advice and experiences. The groups are interactive, relaxed and fun. Each woman receives a book that includes the topics for each session as well as a multitude of self-assessment tools. Snacks will be provided.

Who can attend? Is this just for first-time moms? Can I bring a support person?

The groups are not just for first-time pregnancies.  Any pregnant woman that has registered for the group can come with a support person or by herself. Children are not allowed in the groups.  Each participant will sign a confidentiality form - what happens in group stays in group!

What if I cannot make every session?

If you miss a group session you can schedule an individual visit with your provider.

How do I know if group prenatal care is right for me?

You can try the first session or two and test it out.  If you decide that group prenatal care is not the right fit then you can resume your traditional visits.

How do I register for group prenatal care?

Centering groups are currently being offered at Atrius Health Women’s Center in Weymouth. Just call 781-682-8000 and ask for the Ob-Gyn receptionist. She will tell you the group session dates that work with your due date and then register you.  Groups will soon be offered at Crown Ob-Gyn too – stay tuned for more information in the coming weeks!

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Thursday, October 09, 2014
Esther Nganga Discovers the Art of Midwifery Care
by SSHMaternity at 11:11 AM

Mother%20and%20Baby.jpgAs Weymouth resident, Esther Nganga sat holding her beautiful 11-week old son, Jabari, she laughed recalling her initial skepticism of having a midwife birthing experience.  “Growing up in Kenya, I always heard tales of midwives—tales of women laboring and giving birth without the option for pain intervention,” Esther said.   After a friend’s suggestion, however, Esther decided to explore the option of midwifery care by attending South Shore Hospital’s Meet with the Midwivesan open forum for expecting moms and coaches to meet the certified nurse midwives who are available day and night to assist with your labor and birth.   “I was so impressed not only with the feedback from other mothers who have had a midwife birthing experience, but also by the midwives’ vast knowledge and credentials,” she said.   

The midwifery program at South Shore Hospital complements our obstetrics service 24 hours a day, seven days a week.  Our certified nurse midwives see patients both at affiliated community OB/GYN practice settings including Crown OB/GYN and Atrius and at South Shore Hospital.  The collaborative relationship between doctors and midwives share the common goal of improving patient care through preserving the normal aspects of birth while also providing rapid access to technology and advanced care when it’s needed.  Though midwives are best known for care in pregnancy and delivery, many patients don’t realize that midwives provide care throughout all stages of a woman’s life—from teenage years through menopause and beyond.  In fact, many women visit a midwife for health needs including yearly gynecology exams, pregnancy planning, breastfeeding, and postpartum care. 

As a first time mom, Esther Nganga was naturally filled with fear and questions about the birthing experience and what to expect.  Esther chose Jessica Wilson, CNM of Crown OB/GYN as her primary caregiver.  “Initially I was worried about the process, but the midwives were incredible.  During visits at Crown OB/GYN, I never felt rushed and always walked away more educated about the process my body was going through,” Esther described.  “My midwife, Jessie encouraged me every step of the way and taught me to listen to my body and follow its cues.” 

Jessie Wilson, CNM is passionate about the care she provides and the healthy outcomes of her patients, both mother and child.  “The entire birthing experience is one of the most significant times in a woman’s life.  I enjoy being there for each woman, offering quality care, encouragement, and above all compassionate support.  It is so empowering for a woman to overcome the obstacle of fear and even negative thoughts about birth by instead creating a positive experience through supportive caregivers who believe in you,” Jessie said.

Hydrotub_resized.jpg
Jessica Wilson, CNM who is expecting her first child is shown in front of a hydrotherapy tub in one of the labor and delivery rooms at South Shore Hospital

The highly skilled team of certified nurse midwives and physicians affiliated with South Shore Hospital have more collective experience delivering babies than any team in the region.  We are currently the only community-based hospital in Massachusetts with a level III neonatal intensive care unit (NICU). For midwife patients like Esther Nganga, it’s reassuring to know that there are neonatologists, anesthesiologists and maternal fetal medicine specialists on site 24 hours a day, 7 days a week. “It was comforting to know an entire emergency care team would be just a few feet away,” Esther said.

The compassionate care Esther experienced during her entire prenatal journey through delivery and beyond has prompted her to share her amazing story with friends and family who may not understand the midwifery model of care.  “I am so grateful beyond words and for me, I honestly can’t imagine going through a birthing experience any other way.  As my primary caregiver, Jessie was always there for me, assuring me pain intervention is always an option.”

At South Shore Hospital, our Certified Nurse Midwives are experts in obstetrics—caring for, supporting and enhancing normal, uncomplicated pregnancies, while also knowing precisely how to identify an abnormal situation that may require a physician’s intervention.  The close partnership is complementary, with our highly skilled physicians typically having primary responsibility for the care of pregnant women who are at risk of diseases or serious complications.     

For more information on South Shore Hospital’s team of Certified Nurse Midwives, please visit us at southshorehospital.org/obgynsandmidwivesteam

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Thursday, October 09, 2014
Share Your Story!
by SSHMaternity at 06:07 AM

I had Mary Hogan Donaldson for my midwife and just the way she made me felt and how I wanted a natural birth. I felt she went above and beyond between helping me bath and sooth my contractions until it was time. And she kept everything calm. Also after giving birth she helped me to clean up and breast feed my son. She truly was the best for me.

-Mariana

I am currently 31 weeks pregnant and have been calling South Shore Hospital my home by being on bed rest for almost 3 weeks. Even though I have not had my baby yet, I am so thankful for the support of the midwives! Since I am now considered a high risk pregnancy, they are no longer in charge of my direct care, but they still stop by to check in on me and want to help in any and every way possible! They are concerned not only about the health of my baby, but about my entire body’s well-being and have helped process this unexpected and scary experience. Nannette is teaching me how knitting is a great use of time and has helped me learn and get started on a baby blanket for my little guy! She has given me so many helpful resources and things to make the time go by faster. Like I said, I am so grateful for the support of the midwives during this time, they really are awesome! 

-Kari

I had the most amazing experience working with the midwives and nurses at SSH...mainly Mary, Julie and Jess. I was determined to deliver naturally and didn't want any interventions. They were all so supportive of this decision. Mary was my main provider during my pregnancy. She was so supportive and informative (and funny) but also hands off in a good way. I had a great pregnancy for the most part and appreciated the midwife approach of honoring the body and trusting it more than we normally do. Jess was the one to actually deliver my baby. Her words of encouragement and guidance in how to push the right way made a world of difference. I was so happy I was able to get support from them and that I was able to labor and give birth the way I wanted. I'm forever grateful!

-Chelsea

I was lucky enough to work with Nannette Landry through my pregnancy, she became like a second mother to me. She was beyond anything I could've hoped for, and despite my fears of delivering in a hospital...the midwifed and nurses at south shore were absolutely amazing. My partner and I were both so impressed with the maternity team as a whole. We had such a fantastic experience and I can't wait to deliver baby #2 with the midwife team at south shore!

-Sarah

I loved having both of my babies at south shore hospital. The midwives were amazing. They followed my plan and never gave up on me. They checked on me after my births also. They felt like part of my family. Thank you for the amazing experience.

-Maria

 Mary is amazing. I don't have enough kind words to say about her! She gave me the birth of my dreams & I couldn't have done it without her encouragement!

-Mandy

After losing my mother four months pregnant with my son, I did not think I could possibly get through it. With the help of Nannette Landry and many of the other midwives at South Shore Hospital, I would not have had it any other way. When I first met Nannette at 4 months pregnant, I told her I had just lost my mother. She held me so tight I thought I had known her for years. She suggested many helpful things to me which I followed through with my entire pregnancy. At 41 weeks and 5 days pregnant, I was called in for my induction. My son was not dropping and I was only a fingertip dilated for a couple weeks. After multiple non-stress tests and ultrasounds, we decided it was time to evict my little man. I was very much ready to meet my son. I went in Monday July 7th at 1 p.m. and first met with a nurse and started Cytotec. I had 3 doses of that and did not feel my first contraction until Tuesday morning at 6 a.m. I was encouraged to walk around (which I did). As my contractions became stronger, they began Pitocin. Midwife Jessie and nurse Kara were my saving graces! Jessie rocked with me through my contractions. Helped me walk up and down the halls and showed me how to use the birth ball. When I was clearly going through severe back labor (around 7 p.m. Tuesday night) I was given some options by Jessie. I could do saline shots in my back or get Nubaine. I opted for the saline shots so that I was still able to be mobile. Jessie and Kara were very up front with me, telling me it is extremely painful but that they would help me through it. They assured me that both of them had it with their own labors. OH BOY it hurt, but it was bittersweet relief. After the initial pain (which I was well told of) I felt amazing relief from my back pain. A few hours later, I eventually retreated to the Nubaine. I did not find a lot of help with the Nubaine. I wanted to wait as long as possible to get an epidural. I finally got my epidural around 10:00 p.m. Tuesday night. At this point Midwife Mary came in. My water had broken when she was checking me and I was a lip away from pushing. Around 3 a.m. I was told I was there and could begin my pushing. I pushed and pushed for 2 hours. At some point in my pushing, my epidural had been shut off and after 2 hours I needed a break. My epidural was put back on and I was told to relax for a little bit. Mary switched with Elizabeth. We continued my pushing at 9:00 a.m.  After another 1 1/2 hours, Elizabeth asked me if she could consult with Dr. Champion. The doctor came in and explained that even after 3 1/2 hours of pushing I had made almost no progress. He would let me push for another hour, but that I was more than likely looking at a C-section. I asked to be alone with my husband. I cried as it was the last thing that I wanted. I finally decided it was the best thing for me and my baby. I was so grateful that my midwives let me try as long as they did. They encouraged me in so many ways and really gave me the opportunity. Elizabeth came back in the room and asked if I was ok. She said no one ever asked her that when she had her babies and she wished someone did. That meant so much to me. At 11:40 a.m.  Michael Henry made his grand appearance at 10 lbs. 11 oz and 22 inches long. THANK GOODNESS he came the way he did. While in the maternity floor, all of the midwives continued to check on me, helping with me everything from calming the baby down to providing back massages. They helped me through tears and gave tons of hugs. I do not think I would have been able to do it without you ladies. Nannette is such a wonderful woman. She has been an angel on earth. I honestly cannot wait to have more children simply to see these amazing women.

 -Nicole

 I had the best experience with Nannette. She will forever be a part of my family’s lives, even if she doesn't know it. Nanette took me on a beautiful snowy day in February. I was just beginning to have contractions. She got me the best room with a window view (unbeknownst to her it was the same room I delivered my son in!) she brought twinkling lights for ambience; she was calming, confident and paid attention to all my notes on my "birthing plan". She was in tune with my progression and recognized my "signs”. She knew I was having my baby before I did! She gave me the confidence I needed to deliver without an epidural. She coached me every step of the way. To say I wouldn't want to deliver without her would be an understatement! She really made the birth of our daughter special and I’ll never forget that. Please tell her this!

-The Warner Family

October 5th, was my son's third birthday and my three year anniversary of becoming a mother. Early during my prenatal care, it became a goal of mine to have a natural childbirth with the care of a midwife alongside me. Despite having this as my birth plan, I was keeping an open mind as we all know now that anything can happen during labor. Upon admission to the hospital, my midwife was thoughtful enough to arrange for me to have the room with the tub knowing that it was my goal to have a natural childbirth. Almost immediately, I was in the tub, then the shower, then the ball and eventually all sorts of other positions laboring with the relentless and tireless support of my midwife and labor and delivery nurse. Without an epidural and after hours of pushing my son was starting to show distress and I ended up being consulted by the OB to have a cesarean. Knowing my wishes were to have a natural childbirth, both the midwife and OB supported me to continue having contractions and pushing with intervals of rest to see if there was any more progress which meant a lot to me. Unfortunately, there came a point where I had to have a cesarean for the well-being of my son. By then it was change of shift however my midwife and nurse me stayed by my side in the OR to show their support for myself, my husband and my son. Due to the stressful labor, my son had to immediately go to the NICU in order to receive glucose which prolonged our skin to skin bonding. Fortunately, as soon as I could feel my legs after surgery, my midwife arranged for my stretcher to be wheeled to the NICU in order for me to have skin to skin contact with my son and breast feed, which again meant a lot to me. The entire experience was truly filled with love, support and a feeling of team work. It was above and beyond what I had expected and it has forever changed my life. During my maternity leave, I decided to change careers, return to school and become a registered nurse in order to give back selflessly to patients the way that I was cared for during my labor experience at SSH alongside my midwife and nurse.

Thank you! Thank you!

-Bridget

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Wednesday, October 08, 2014
Choosing Midwifery Care: What Was Your Moment of Truth?
by Chris Just at 06:36 AM

Midwife%20and%20mom.jpgIn the free dictionary, “a moment of truth” is defined as “a critical or decisive time on which much depends; a crucial moment.”  For many women, choosing and experiencing midwifery-led care feels like a “moment of truth.”  Don’t believe me?  Just take a look at the comments on the South Shore Hospital Babies Facebook page whenever a midwife-related post is added! 

As one can imagine, any decision made during the amazing yet vulnerable time of pregnancy can feel critically important to an expecting mom; however, with such an overload of information on the internet, women often struggle to weigh the pros and cons of every choice available to them, including who to choose as their health care provider.   

Most people, if they know about midwives at all, are only aware of their role in maternity care and do not realize that midwives provide expert care to women from adolescence to beyond menopause. The American College of Nurse-Midwives is spreading the word about the expansive role of midwives in their campaign, Our Moment of Truth™: A New Understanding of Midwifery Care., a site that presents evidence of women’s healthcare needs (through surveys) and testimonials related to women’s experiences with midwifery care.

According to the Listening to Mothers III landmark report, women prefer to have choices available to them when it comes to their health care.  Additionally, an ACNM survey showed a major gap in what women say they want from their health care and what women are actually getting across a spectrum of health needs. Midwives and Obstetricians working together can help fill that gap and offer women more options for their care.

South Shore Hospital celebrates National Midwifery Week and supports choices in maternity care.  The SSH midwives are available as hospitalists to offer midwifery care as an option for all laboring women that are low risk.  Additionally, the hospital provides other unique alternatives for expecting women, including a tub for hydrotherapy, nitrous oxide for pain relief (coming soon!), and  CenteringPregnancy®, a model of group prenatal care that has been shown to improve outcomes for moms and babies.

We hope that you too, will consider getting involved in this important initiative to support choices in maternity care as part of our celebration of National Midwifery Week.  You can start by sharing your own moment of truth. What made you realize that midwifery care was right for you? Have you had a positive experience with a midwifery birth?  Do you see a midwife for your primary care?

If you have received care from a midwife, please submit your story through a private message at South Shore Hospital Babies. We will post your birth stories this Friday via our blog and on Facebook. To preserve anonymity, no names will be attached to your submissions.  We’d love to hear from you.  Spread the word so more women can learn about the option of midwifery-led care!

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Tuesday, October 07, 2014
Midwifery Reborn: Debunking the Myths of an Age-Old Yet Modernized Profession
by Nannette Landry at 06:17 AM

Group%20Midwifery%20photo_updated.jpgIf you think midwifery is an ancient, outdated art that consists of a fringe group of women in Birkenstocks and tie dye then think again.  Midwives are highly educated, skilled professionals and midwifery care touches all groups of women.  The popularity of midwifery is growing partly due to media coverage of celebrities that have used midwives for their care and Ricki Lake’s documentary video, The Business of Being Born

While the use of midwives has climbed over the last few years in the United States, there is still a large percentage of the population that doesn’t understand the nature of a midwife—perhaps due to the myths surrounding who midwives are and exactly what they do.  Today’s theme for National Midwifery Week is “Bust a Myth”.  Here are the most common myths related to midwifery and the facts that refute them:

Myth #1:  Midwives only handle pregnancy and birth.

Fact:  Midwives provide expert knowledge, skill and health care services to women in all stages of life, including general health check-ups, gynecological exams, screenings, birth control, etc. Midwives enjoy caring for women for a lifetime.

Myth #2:  Midwives only deliver home births.

Fact:  Midwives practice in many different settings, the most common being a hospital setting.  Midwives also attend birth in birth centers.

Myth #3:  Midwives aren’t formally educated.

Fact:  There are different types of midwives in the US, each representing a variety of approaches to education and training.  South Shore Hospital exclusively employs highly educated and skilled Certified Nurse-Midwives. Certified Nurse-Midwives have a degree in nursing as well as a master’s degree. Many Certified Nurse- Midwives now have a doctorate degree as well.  The skills and expertise Certified Nurse-Midwives have through their advanced training allows for their expert care in obstetrics and gynecology, as well as primary and newborn care.  Certified Nurse-Midwives focus on pregnancy and birth as normal physiologic events but are always on the lookout for signs of trouble.

Myth #4:  Midwives don’t allow pain medicine and epidurals in birth.

Fact:  Midwives partner with their patients to determine a plan that fits their needs and desires.  Midwives understand that each person’s level of pain is unique and they provide expert knowledge in how to best cope with pain during labor—both medicinally and non-medicinally depending on the patient’s need and desire. Experts in normal birth, midwives use a variety of options to assist a woman to move comfortable through labor, such as hydrotherapy- tubs and showers, massage, heat, positioning, relaxation techniques, music, guided imagery and by just being with the woman, talking her through the contractions.

Myth #5:  Midwives aren’t covered by insurance.

Fact:  In most states, it is required that private insurance companies pay for services provided by certified nurse midwives (CNMs), and Medicaid coverage is required in all states.  In states that do not require private insurance coverage, many insurance plans still cover the services provided by a CNM.

Myth #6:  Midwives don’t handle chronic health conditions, high-risk pregnancies or complications.

Fact:  Though midwives are considered experts in normal or low-risk pregnancies, they can still co-manage high-risk patients with an OB/GYN.  The collaborative relationship between physicians and midwives and their combined expertise allow optimal care to be provided to each patient.  Midwives are trained to spot problems ahead of time and collaborate with their obstetrical colleagues who are right there in the Birthing Unit. Together, midwives, OBs and nurses work as a team to provide safe care for moms and babies. 

To learn more about midwifery care, attend the Meet With the Midwives gathering the second Wednesday of every month at South Shore Hospital.

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Monday, October 06, 2014
Essential Facts about the Midwives at South Shore Hospital
by Julie Paul at 07:01 AM

By:  Julie Paul, DNP, CNM and Susan Yount, PhD, CNM, WHNP-BC

Hydrotub_resized.jpgThough the rich history of midwifery-led care goes way back, only within the last few years have we seen it grow exponentially in popularity—primarily due to the enhanced education surrounding the myths and facts of what a midwife does.  In 2011, Certified Nurse Midwives (CNMs) attended 309,514 births in the United States.  The history of South Shore Hospital’s (SSH) midwives started in 1987—with one midwife on staff.  In 2014, the midwifery group has now grown to 10 CNMs.  So far this year, from January through August, the midwives have attended 406 births.

If you choose a midwife at South Shore Hospital, what can you expect?

South Shore Hospital’s midwives are available 24 hours a day/7 days a week for your labor, birth and postpartum experience.  The SSH midwives and obstetricians work closely together in a collaborative approach to ensure safety for all mothers and babies. In fact, though the national Cesarean section (C-section) rate is 32%, the primary c-section rate in births attended by a midwife at South Shore Hospital is only 8.8% in 2014.

The midwives care doesn’t stop at labor and delivery, instead it extends beyond the hospital to a variety of different locations in the community, where they see women for regular office visits—treating women from puberty to menopause and prenatal to postpartum.

When it comes to pain management during labor, our team at SSH offers a wide array of options, including:

  • Therapeutic presence:  partner, family member, nurses, CNMs (Research has shown this is the number one method to effectively manage pain in labor)
  • Non-medicated comfort measures:  position changes, massage, heat (warm packs),
  • Relaxation techniques:  breathing, music, visual imagery
  • Hydrotherapy- tub and shower
  • Labor balls
  • Nitrous Oxide (coming soon to SSH)
  • Pain medication
  • Epidural anesthesia

The South Shore Hospital community also offers different types of prenatal care including:

  • Traditional prenatal care:  individual appointment—typically prenatal care starts at 8-12 weeks and consists of between 10-12, 15-minute-long visits.
  • Group prenatal care:  In this setting, groups of 8-10 women and their partners are seen for 10, two-hour sessions.  This time frame includes an individual, private checkup and interactive group education.  The benefit—Total time spent with a provider is 20 hours versus 1 hour and 30 minutes of face to face time.  Research shows decreased rate of preterm-birth, increased satisfaction with prenatal care and increased success with breastfeeding.
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Wednesday, September 24, 2014
What Happens When You Get Pregnant Again after Your First Birth Didn’t Go As Expected?
by Julie Paul at 10:47 AM

Pregnancy%20test_resized.jpgMy first baby was an unexpected Cesarean section—and by unexpected, I mean it was never even a thought on my birth plan “radar,” if you will.  So, what was my first thought after I found out I was pregnant the second time? “Oh no, I don’t want another c-section!”   So, I guess one could say my initial feeling was less bliss and more a confused mix of fear and excitement.

First and foremost—I knew I did not want another cesarean, but what does that mean exactly?  Is it even possible to have a vaginal birth after cesarean?  If so, how can I make it happen?  Could I possibly do something differently to get a different result this time?  Can I still have a midwife?

First, in most cases, it is quite possible to have a vaginal birth after c-section—also known as a VBAC (vaginal birth after cesarean).  That being said, it is always a conversation you should first have with your provider, who is instrumental in helping you map out options, because he or she knows your case personally and is intimately involved with all aspects of your care.  There are certain circumstances when a VBAC is not possible, and because it varies from person to person, I won’t list them all here.  The good news is that having a VBAC never prohibits your freedom in choosing a midwife for your care during pregnancy and birth.

My experience the second time around began very similar to the first.  Again, in the middle of the night, my water broke.  Filled with excitement, fear, joy, and terror at that very moment, my new plan was to attempt a VBAC.  I decided to do things very different than the first time around.  I decided I wanted no pain medication, no epidural, and no Pitocin (a drug commonly used to induce labor).  I can’t say I was sure how to make that plan stick, but I placed that as a mental forefront goal. 

For the most part, my labor began as planned.  Though I had lots of back pain, the shower and massage seemed to help.  I didn’t feel like I needed an epidural, though I did settle on a bit of Nubain to help with pain.  It seemed to be just enough to get my cervix fully-dilated.

My ultimate plan seemed on track until the baby’s heart rate began to dip whenever I pushed.  It went so low in fact, that they needed to help me get the baby out sooner.  They gave me the option to try vacuum extraction, which helps guide the baby's head out of the birth canal and is sometimes used when the baby's health depends on an immediate delivery.  I opted to try the vacuum and episiotomy, an incision made to assist in vaginal birth, knowing that if that didn’t work, I would likely have another c-section.  Again, none of it was what I expected or hoped for, but a healthy delivery was of utmost importance.  The baby came out with a healthy scream soon after the vacuum was used—and that scream was joy to my ears.

The baby was put right on my chest—skin-to-skin (before it was actually referred to as that).  Now, though I would love to tell you that it was a picture-perfect moment, to honestly share the reality of that blissful day—along with my happiness, came a great deal of discomfort down below.  I felt like a loser at the time—I mean really, just giving birth means you should be the happiest person in the world, right?  But the pain had my mind preoccupied.  Like everything else, however, I went with the flow and it the pain subsided.

The best thing to take away from my experience is this:  go with the flow. Don’t be so fixated on a set plan, because more often than not, it won’t go the way you plan.  A healthy, safe mom and a healthy, safe baby should be the ultimate priorities.  Be educated, be prepared, and by all means ask as many questions as you’d like—but don’t be so fixated on the small details or your perfect mental plan—those thoughts can control you.  Instead embrace flexibility…realizing that labor and birth are not black and white; instead there’s a great deal of gray in the mix.  Above all—remember:  every labor and birth experience will be unique and special.

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Tuesday, September 23, 2014
What Happens When Your Labor and Delivery Don’t Go as You Expected?
by Julie Paul at 07:26 AM

Labor_resized.jpgLet’s face it, when you are expecting, you’ve diligently planned for the day for nine long months—exploring all the right books and videos—even attending childbirth classes well in advance.  Actually, when I look back at that time, I didn’t think I could have been any more prepared if I tried.  

So, when my water broke at 37 weeks, I was truly excited and ready to get the show on the road.  There I was, awakened at 3 a.m. by a sudden “pop” sensation.  Jumping out of bed, I realized I was gushing fluid all over the wood floor (at the time I thought—hey, at least not on the bed!).  So being “well-prepared,” I immediately noted the color of my fluid and called my midwife.  Though a bit nervous, I was so excited with the anticipation of my baby’s imminent birthday!  

After taking a shower and getting a bite to eat, I arrived at the hospital a few hours later, where I met my midwife.  She didn’t check me right away to see if I was dilating, because I was already ruptured (my water broke), and checking too often, could increase the chance of infection.  So once I was monitored, I was encouraged to go for a walk and let the contractions get stronger…and yes, stronger they got!

It was around 9 a.m. when I had become really uncomfortable.  I had already checked off my organized list of planned approaches to pain during labor—used the labor ball, walked a great deal, took a shower…yet I felt still in need of pain relief.  So along came Nubain, a common narcotic painkiller that is used to help stimulate the brain to increase the threshold to pain.  Though I admit, it helped for a bit, I still felt I needed something stronger.  So around 2 p.m. and 4 cm dilated, I got an epidural to help ease the pain.

But wait … this wasn’t in the plan!  What about all my preparation?  The reality is, as prepared as I thought I was and as disappointing as it seemed at the moment to go off course—by using medication and an epidural—the reality was, I really needed those methods of pain relief. 

So once I settled into the notion of the all-encompassing philosophy:  “it is what it is,” I got comfortable and waited for that anticipated urge to push.  The baby, however, had other ideas.  His heartbeat kept dipping lower and lower—which meant I had to be flipped and tossed in many different positions to try to help influence the baby’s position.  This went on for a while.  While the unexpected chaos was happening, my temperature went up, and as fever set in, the baby’s heartbeat began to dangerously increase, indicating he was potentially getting an infection as well.

Again, this was not in the plan!  After I got treated for the infection, the baby was still showing signs of stress, which meant only one thing—Cesarean birth.  Of all the things happening that were not “in the plan,” THIS was by far the most disappointing moment on the list.  However, my head and heart both knew that the baby’s safety preceded any manmade agenda.  So, the cesarean section went well and four days later I went home with a healthy, bouncing baby boy.

In the days to follow, everyone kept telling me, “at least you had a healthy baby.”  Absolutely, of course I was thrilled beyond words about that—but the truth was that the actual labor and birth was not what I expected.  To be quite honest, it took a while for me to be ok with everything that had happened.  It was almost like I had to grieve for what didn’t happen.

As a midwife, I have encountered this many times.  Women need time to grieve when the birth doesn’t go as expected—and it’s perfectly normal.  If this happens to you, please don’t hesitate to talk with your provider.

So what happens when you get pregnant again after your first birth didn’t go as expected? How do you cope? Can you expect the same outcome?  … New blog post on this topic coming soon!

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Friday, September 19, 2014
Proper Prenatal Dental Care Achieves More Than a Nice Smile
by Chris Just at 08:03 AM

Dental%20Care.jpgMaintaining healthy oral hygiene should always be a priority but especially during pregnancy when the risk for periodontal disease is higher. First, nausea with vomiting in pregnancy gives stomach acids the opportunity to enter the mouth and erode tooth enamel; therefore, allowing cavities to form more easily. Second, pregnancy hormones help create the perfect environment within which gingivitis can occur. Here’s how: Estrogen and progesterone cause mucous membranes to become engorged; as a result, expecting women are more prone to annoying symptoms such as nose bleeds and bleeding of the gums. Swollen, bleeding gums are more susceptible to inflammation (gingivitis) which can lead to infection of the gums. In pregnancy, periodontal disease is even more concerning because the bacteria that causes the infection also increases the risk of preterm birth and having a low birth weight baby. 

To prevent these risks, keep in mind the following 6 simple tips for proper prenatal dental hygiene:

  1. Brush your teeth and tongue twice a day with a fluoride toothpaste and a soft toothbrush.
  2. Swish and gargle twice a day with an anti-microbial, alcohol-free mouth rinse.
  3. Floss, floss, floss – every day!
  4. Eat a healthy, calcium-rich diet and avoid sweets and carbonated beverages.
  5. Maintain your twice yearly dental appointments (more if necessary).
  6. Dental caries can be treated in pregnancy and local anesthesia is safe to use. Postpone routine x-rays until after the pregnancy; however, if you need an x-ray because of a dental issue, just be sure your dentist covers you with a lead apron to protect your baby as well as a lead collar to protect your thyroid.

According to the American College of Obstetricians and Gynecologists, in 2007-2009, over 50% of women reported that they did not visit a dentist during pregnancy.  Don’t be part of that statistic. Take time to engage in healthy dental care to prevent periodontal disease and protect yourself and your baby. For more information, visit the American Dental Association’s pregnancy information at http://www.mouthhealthy.org/en/pregnancy/. Happy brushing, swishing and flossing!

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Thursday, September 18, 2014
Postpartum tranquility. Savor the moments. Wait…what?
by Susan Scotti Smith at 05:49 AM

Mother%20and%20Baby.jpgYes, that’s right, postpartum peace and tranquility. Ok, well, as much as can be realistically attained. This blog post aims to share some tips and tricks to get you and your new family off to the best possible start. I’m writing as a Certified Nurse Midwife but also as a mom of four. I’ve lived and learned and hope to help you avoid some common pitfalls that can take a toll on a new mom and family. 

As midwives we send many moms home from the hospital with their new little bundles of joy. We often give instructions for postpartum rest that seem stern and strict. We know you want to be active, that you feel great and, of course, that you “can’t sit still”. BUT, you will likely be trading off feeling good for a short time now, for feeling run down and exhausted down the road. Sleep deprivation and the trials that come with parenting a newborn will have a cumulative effect and in a month or two you will likely wind up paying the price for being a “rock star” and bringing your five-day-old to the neighborhood BBQ. If you jump back into your activities full swing too soon you will find yourself feeling run down and exhausted at two or four months out. Just like there is no trophy at the end of your natural childbirth, though I highly recommend it, there is no badge awaiting you for being out and about soonest after giving birth; no one is waiting with balloons when you arrive to preschool drop-off with your two-day-old.  And, while you will definitely get accolades from strangers at Tedeschi’s when you tell them your baby is “only five days old!”, that’s nowhere near enough reward when, at five months postpartum, you find yourself crying at four in the afternoon because you just. want. to. lay. down.  

Following are my top tips for postpartum families.

Create your cocoon.  You can do this before your birth. It’s as simple as creating a space for your recuperation. A clean room and bed, clean clothes and linens ready for your arrival. Ideally this is a bedroom or somewhere you can shut the door to the household chores. Have your fridge stocked with healthy snacks (fruits, raw cut up veggies, peanut butter/crackers, cheese, yogurt, trail mix) and have a large pitcher for water at your bedside. If you have access to a dorm size fridge this can come in very handy for keeping things at your fingertips. The more you have on hand the less you will need to ask for help—this “asking for help” can be a stumbling block for some moms (who me?).  A few chairs are helpful for the rare visitor (see below: limit visitors). Ideally you will remain in your cocoon until you are recuperated. The less you venture “out” (even in the house) the less likely you are to try to jump back into your routines of cleaning/cooking/whatever it is you do. Staying in your cocoon will keep you on task recuperating and keep you in the proper mindset. During my recuperations, I napped whenever I was able, talked on the phone—a good way to connect with family and friends on your terms, read People magazine medical journals, cleaned out the TiVo, read stories with younger kids, wrote thank you notes, designed a birth announcement…did I mention sleep?

Have help.  Arrange for help to care for the NEW MOM and to assist with housework and childcare if you are welcoming a sibling. Partners are able to do a good deal of this, though outside help of either a close family member/friend or a professional postpartum doula will make for an even smoother transition for the new family. As a new mom your only responsibilities should be caring for yourself, your newborn and your immediate space.  All meal prep, laundry, vacuuming, bill paying, getting gum out of hair, butt wiping, floor mopping, dog feeding, you get the idea, should be done by *someone else*.

Limit visitors.  When I say limit I mean don’t have any or, if you insist, be as strict and selective as you possibly can with the people you allow into your cocoon. The days after childbirth can be very stressful on the new family as you adjust and as mom heals. The sleep deprivation and mom’s hormonal changes make for emotional ups and downs. Even sitting and chatting with a close friend can takes its toll. It’s impossible to know a perfect time for visiting so it’s best to put most off for a week at least. If you’re very up front and clear about this before the baby arrives it will be better received at the time.  Most will be understanding, and those that aren’t are likely the ones that need the message the most. Please realize the magnitude of importance of this time for you and your new family. You’ll never have these moments again, put yourselves first and keep this special time for yourselves.

When you’ve spent your first days postpartum well, you will heal physically from your childbirth and will be ready to resume your normal activities in short order. It’s best if you start small with venturing out and getting back into routines of home and childcare. Pay attention to your body. Any increase in vaginal bleeding can be a sign that you’ve been overly active and you may need to cut back again. Please take care in building up your activity level slowly. In a few weeks you will get through your days with good energy and without a hitch…a rock star! Enjoy your new bundle of love! (If you’re not feeling the whole “bundle of love” thing…call us!)

The information in this blog post is meant for women recuperating from a normal vaginal or cesarean birth, and is designed for educational purposes only. Information is not provided as medical advice or as a substitute for professional medical advice or care. Always seek the advice of your physican or provider with any questions relating specifically to your case and care.

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Tuesday, September 16, 2014
Birth Preferences
by Julie Paul at 07:13 AM

Pregnantwoman.jpgHave you ever Googled the phrases ‘birth preferences’ or ‘birth plan’? I just did and got 189,000,000 hits.  No wonder pregnant women get confused when they consider writing a birth plan. If this is your first baby, how are you supposed to know where to start? There are so many different options and everyone has an opinion of how your birth should go. This is an opportunity for you to learn more about pregnancy and birth. It can be a bit overwhelming so let’s review some of the more basic questions.

  • What is a birth plan?  Simply, a birth plan is a list of what you may or may not want for yourself and your baby during labor, birth and postpartum.
  • Would I benefit from a birth plan?   It is always a good idea to start educating yourself about the labor and birth process. Even if you don’t have a formal document, the process can be very helpful.
  • Where do I want to have my baby?  Women can have babies at home, birth centers and hospitals.  A birth center is a location (usually separate from the hospital) where healthy; low-risk women can have a natural childbirth. If you are unsure where to have your baby, talk with your provider.
  • Who should care for me during my pregnancy and birth?  The different type of providers include:  obstetricians, certified-nurse midwives (CNMs) and certified professional midwives (usually attend home births).  An obstetrician is a medical doctor with expertise in high and low risk pregnancies.  Obstetricians mainly practice in hospital settings but occasionally you may find one in a birth center.  Certified Nurse-Midwives are experts in normal care for healthy, low-risk women (which most women are!).  You will find midwives in hospitals and birth centers.
  • How do I prepare for a normal vaginal birth?  Ideally this starts before you are even pregnant.  However, let’s just assume you are already pregnant. Eat right, exercise and don’t do drugs or alcohol. Most important- trust in the process and yourself!
  • How will I manage the labor pain? Labor pain can be managed by changing positions, using the labor ball, get in the bath tub or shower. Using water while you are in labor can be very comforting.  Eat what you want and drink often- water that is. Get enough rest! I can tell you- you are stronger than you think! Most women can do it without anything. However, in the event that you may need something—pain medication or epidurals (only in hospital) are available.
  • Should I breastfeed?  How you feed your baby is very personal. Do the research—what are the benefits of breastfeeding? Here are just a few:
    • Protects your baby from illnesses like asthma and ear infections
    • Increases bonding
    • Protects your baby from developing allergies
    • Protects against obesity
    • Lowers risk of SIDS (sudden infant death syndrome)
    • May boost your child’s intelligence
    • Reduces mom’s risk of breast and ovarian cancer
  • What is skin-to-skin?  This happens when the baby is put right on your chest right after the birth. Skin to skin can help regulate the baby’s temperature and help promote breastfeeding and bonding. This is a great time to celebrate everything you just did!
  • Is delayed cord clamping a good idea?  Delayed cord clamping is when the baby is still attached to the umbilical cord just after birth. This allows your baby to get an extra boost of blood volume to help prevent anemia. Sometimes the cord will be cut right after birth—if your baby needs extra support.

Once you have done your research, bring whatever questions you still have to your provider. They can help you develop a realistic plan and get your 3 page document down to one. A birth plan is a great way to start asking the right questions. The most important thing to keep in mind is that a birth plan is a list of desires. Birth doesn’t always go the way we want it to go. The best way to approach labor is with an open mind.  Finally, there are many different paths you can take when having a baby, however, the goal is always Healthy Mom and Healthy Baby.

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Monday, September 15, 2014
Calling Moms: We Invite You to Share Your Midwifery-led Birth or Pregnancy Story
by SSHMaternity at 05:55 AM

momandbaby.jpgEvery birth story, just like every baby—is unique and special. It’s nearly impossible for women to forget the details of their birth(s) because each story is such an intimate part of one’s life. Because every story is important, as National Midwifery week approaches in early October, we want to put a special emphasis on sharing personal stories and the women behind them.

We would love to hear from you! Knowledge is power, and sharing your experience helps others make informed decisions, while giving clarity and peace to women embarking on their own journeys. Your submission will be added to a special gift drawing that will take place at the end of National Midwifery week. Be as brief or as lengthy as you want and feel free to include photos of you and your baby—if you wish to share. Some thoughts to keep in mind as you write:

  • What contributed to making your midwife birth a positive experience?
  • How did you handle any fear and/or stress, if any?
  • Did you feel there were any outside pressures that influenced your decisions during pregnancy?
  • If you’ve had multiple births, what were differences that contributed to having a positive experience?

Help be a voice in the community and share your journey with others. If you’d like to share your midwife experience with the SSH Babies community, please send us your story in a private message. Upon submission, you will automatically be added to a drawing to receive a special gift and your story could be included as part of our upcoming Midwives week celebrations!

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Friday, September 12, 2014
“I can hear you dilating”: A Midwife Listens
by Chris Just at 05:54 AM

Midwives%20with%20baby.jpgOnce a month, the midwives of South Shore Hospital host a free program, Meet With the Midwives, an open forum for expecting moms and support persons to become introduced to the team of certified nurse-midwives, learn about midwifery care, and find answers to their questions as they consider the option of choosing a midwife as their provider.

Being a midwife myself, I was looking forward to attending the June 11th program, as an observer, to see what kinds of questions came up from the attendees.  As I entered the room I was pleasantly surprised to see it packed with at least 20 expecting women, most of whom were accompanied by a birth partner. As we all introduced ourselves, one woman explained that she was pregnant with her seventh baby and all six of her other children were born with midwives. She couldn’t say enough in praise of the care she received.

In addition to the expecting women, their companions, and the midwives, there was a new mom in attendance with her one-week old baby that was born naturally (without the use of pain medication) despite a birth weight of 11 pounds, 6 ounces!  She was a patient of one of the midwives and her presence was a highlight of the evening.  This new mom was so immensely happy with her birth experience she felt compelled to share her story, even if it meant leaving her house so soon after birth.  She spoke at length about her appreciation for her midwife and how respected and supported she felt during her prenatal care and birth.  She reported how grateful she was that her caregivers avoided mentioning the word “epidural” per her request, to help her achieve her goal of having an un-medicated birth.  She then comically shared that Nannette, her midwife, told her at one point during labor, when she especially needed encouragement, “I can hear you dilating.” 

Everyone in the room chuckled at that line because it was funny to imagine being able to hear someone dilate - an impossibility, right? …..Or is it??

OK, it’s true that one cannot literally hear the cervix dilate but did you know that a midwife can acquire a significant amount of information about one’s labor and birth just by listening?

  • A midwife hears the deep sound of a woman’s groans as her contractions become stronger and more frequent, a sign that her labor is more active and dilation is occurring more rapidly. 
  • She listens for the soft rustle of the sheets as a woman’s toes begin to curl, often a sign that labor is more advanced and she is getting closer to having an urge to push. 
  • She hears the resistance in a woman’s breath as she begins to bear down, ready to birth her baby.
  • She can tell by the sound of a baby’s cries if all is well.

Most of all, however, a midwife will listen to YOU!  She will ask you what kind of birth you are looking for and support your choice, as long as it’s safe, of course.  Some people believe that a midwife only attends “natural” or un-medicated births but that is not true.  If you are planning to use an epidural, no problem – you can still have a midwife.

Shared decision-making between provider and patient is a national maternity care initiative that helps improve outcomes and increase patient satisfaction.  Shared decision-making is when your midwife or OB offers you options for your care, fully describes evidence-based risks and benefits for those options, listens to your preferences and supports your choices as long as they are medically reasonable.  Having a voice in your own care is empowering and will help you feel more in control of your labor and birth.  Having a voice means someone is listening. 

Educated in the disciplines of nursing and midwifery on a master's level, South Shore Hospital’s 10 + nurse-midwives are members of the American College of Nurse-Midwives and certified by the American Midwifery Certification Board. They see patients both at affiliated community OB/GYN practice settings, including Crown OB/GYN and Atrius, and on our main campus at South Shore Hospital. To gather more information about the South Shore Hospital Midwives, be sure to attend the next Meet With the Midwives program.  No registration is required.

 

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