Thank you, Pat or whoever it was, for re-opening this discussion re: early
prenatal "education".

When I worked in the hospital (covering the period of transition from 3-5
day pp stays for NSVDs to the current 24-48 hrs), my position was called
"Patient Education & Discharge Coordinator" - in other words, I was
responsible for seeing that this early pp ed. got "done". I gave this work
my heart and soul, I whipped up all kinds of policies & procedures, I
developed all kinds of teaching tools and charting tools and standards and
all kinds of stuff. When I left the hospital, I started to hear lots of bad
stuff from professionals who saw moms pp - basically that "no one was
teaching these moms anything" - and my first conclusion was," well, that's
because they don't have old Cathy Bargar up there any more".  Kind of
gratifying, to tell the truth...

My next conclusion, though, is that, exactly as Pat says, that is just not a
period of time in which women retain very much, no matter how great the
"teacher" or the program is. After I worked at WIC for a while, I had
absolute confirmation of this, as I saw women both pre- and post-delivery,
and some of them would swear that "no one ever told me______" when I *knew*
that I had discussed that very thing with them myself.

Now I'm pretty sure that only so much can be done prenatally and in those
first two or three days. And I'm pretty sure that how much is absorbed is
related to how the women themselves are cared for and treated - in other
words, women whose own individual needs are recognized and dealt with in a
manner that models good mothering (to the mom herself), who feels that *she*
has been heard and her needs addressed, will learn more efficiently how to
manage her baby & BFing experience. Which is still consistent w/Reva Rubin's
theories, because needs are different at 1 day pp than at 5 days. But
whatever stage, I'm convinced that women just plain "take in" better when
the message is wrapped in layers of loving support and gentleness. IF I were
still working at the hospital (perish the thought! - not in this lifetime,
sisters!) and IF that position were still in existence (it isn't), I would
do some things very differently. I wouldn't pretend that I was meeting new
parents' needs for "education" by rounding them up into a group class and
making them sit in an overcrowded, overheated room on their poor sore
bottoms while I "demonstrated" cord care or ran through a list of
"positions" for BFing.

And, while types of anesthesia used and other birthing policies probably do
have an impact on these stages of taking in & taking hold, I don't think it
makes nearly as big a difference as we might think. Having a baby is a
stunning experience, no matter how it's accomplished. Nowadays almost all
the women I see in private practice have had intrathecal anesthesia for
delivery, and while they may feel like they're in better shape, their babies
are clueless. Stone Cold Clueless when it comes to literally taking hold,
and sucking & swallowing efficiently. Doesn't matter how well-informed the
mother is if the babies just won't suck! We must get to the bottom of this!

Cathy Bargar RN IBCLC Ithaca NY

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