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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
 
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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