Karen--
As an American, I, personally, do not take
offense. I completely agree with your statement!
As a postpartum doula and LLL I see all to often
the difficulties, and yes -- even the horrors of mothers
who do not receive the community care they and their
babies so rightly deserve!
I am currently working with a first-time-mom of TWINS
who woke up in a pool of her own blood almost
two weeks ago from her c-section incision. Her insurance
pays to have a nurse come everyday to pack her incision, but is not
there
to help her care for her twins! Her OB tells her she
is not allowed to bend over nor is she allowed to pick
up her babies for the next 6 - 8 WEEKS!!
This mom is fortunate--she can afford
to pay for my services--but what about the families who
cannot afford to pay for assistance! You know a mom of
less financial means is going to take care of those babies any way
she has too -- and more than likely, her family will EXPECT her
to care for her babies (because they cannot take off
from work)-- and will most likely end up BACK in the
hospital because she is doing too much!!
I've also been with mom's who suffer from terrible postpartum
depression! They lie crying and screaming in the darkness of their
rooms
screaming at me, at their families, anyone who is willing
to listen to the abuse because they know that this person
is not their beloved daughter/sister/wife, etc.
It is absolutely appalling, in my opinion, the manner in
which women are cared for during their postpartum.
And I stand firm when I say we, the birthing women of
this country, are partly to blame for this situation!!
We get caught up in the romance of decorating baby
nurseries, signing up for baby registries, etc., but
put forth barely a moments thought on what and how
we are going to handle things once our precious bundles
(that we might have paid thousands of dollars for!) come
home!
Things must change!
(currently forming a not-for-profit organization that
will contribute to birthing families on Long Island, NY,
including a doula crisis fund to allow families who cannot
afford doula services to have doula support.)
Kathy Koncelik
CPD(CAPPA)
LLLL
Breastfeeding Peer Support Counselor, LLLI
On Feb 8, 2006, at 4:49 AM, Lee & Karen Palmer wrote:
> Jeanette - I feel your frustation. Not that New Zealand is always
> a shining
> example of maternity care (or so the press states), but every
> mother is
> entitled to 5 - 10 home visits in the first 4 - 6 weeks
> postpartum. At
> least 3 of these would be in the first week following a 48 hour
> discharge.
> This is a seven day a week service with on-call availability out of
> hours.
> For this I am paid $400.00 by the Health Department. That is not a
> lot when
> you consider the work that is involved but it does increase
> breastfeeding
> rates and reduce hospital admissions.
>
> If I may make an observation of the US system - it appears that a
> lot of
> money is spent in the delivery room and little in the community. New
> Zealand used to be a bit the same until women lobbied to have a
> more women
> focused materntiy system that was based in the home. Alright - we
> have free
> maternity care and it is largely midwifery run-but surely it would
> be more
> cost effective for your insurance companies to put the resources
> where they
> are needed.
>
> Please - this is not a criticism. I do not want to offend anyone.
> But
> sometimes it is interesting to know what happens in other places.
>
> Karen Palmer
> Midwife and IBCLC
> New Zealand
>
> --- Original Message -----
> From: "Jeanette Panchula" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Wednesday, February 08, 2006 2:11 PM
> Subject: Breastfeeding and neonatal weight loss
>
>
>> Follow-up of our newborns has become a very sore subject for us in
>> Public
> Health. We are seeing a delay in first doctors' visits - and a false
> reassurance to mothers whose babies ARE seen early that it's
> "normal" to be
> losing weight on day 3, 5 or 7.
>>
>> They then schedule another visit at 2 months! With few
>> instructions
> about coming in if there is problem... between language barriers,
> the desire
> not to "bother" the doctor and feeling they are really
> "exaggerating" their
> concerns as new moms, situations have deteriorated quickly that
> could have
> been prevented by early and frequent contact.
>>
>> Where I work, our Public Health Nurses are NOT meant to be the
>> safety
> net for these children! They cannot make immediate home visits,
> though they
> do try, knowing that if they don't, either a baby will be terribly
> jaundiced, or weak or will be supplemented.
>>
>> In my "ideal breastfeeding system" - ALL mothers would get a
>> home visit
> on day 3 - and the decision on when and how often to visit will be
> dependent
> on the findings at that time:
>>
>> If we have a baby that is awake, alert, nursing well and a
>> mother that
> is showing signs of initiating good milk production, follow-up by
> phone for
> the next few days with a home visit again on day 5-7 would be OK.
>>
>> If the baby is sleepy, ineffective nurser, mother has no signs
>> of milk
> production, etc., then daily home visits and even possibly a breast
> pump to
> get a "jump start" on milk production that has not been initiated
> is the
> appropriate plan.
>>
>> Our problem is...who pays? If the mother is private insurance -
>> they
> won't pay for home visitors (at least those I know of here in
> California).
> If the mother is low-income, we usually can have a Public Health
> Nurse visit
> her in my county, but this isn't so in every county. If the PHN finds
> there's a problem she can't handle, I then make a visit WITH her
> (so I'm
> considered a "trainer" not providing "direct services").
>>
>> The fact that babies are better served in the home, less risk of
> catching the "virus of the day" as well as avoiding unnecessary
> visits to ER
> and hospitalizations due to jaundice, etc...
>>
>> Sorry...my frustration is showing!
>>
>> Jeanette Panchula BSW, RN, PHN, IBCLC
>> California, USA
>>
>>
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