Delivering caring, personalized, quality healthcare to women in an environment that is supportive, education-focused and compassionate.

Labor and Delivery

Outpatient lactation services receiving support from TMC Mega Raffle

Little Kailey Nowak decided to enter the world five weeks ahead of her due date. Her mom, Kelly, experienced difficulties with breastfeeding almost immediately. “She wouldn’t latch on, or if she did, it would only be for a few seconds,” she said. “It was awful. I cried every single day for six weeks as I pumped and fed my baby through a bottle. My plan was to breastfeed, and when I couldn’t, it truly felt like I was failing as a mother. People were

The family lives in Sierra Vista and with few lactation support services available there, Nowak’s pediatrician suggested she seek expert advice from the lactation specialists at TMC, where she had previously rented her hospital-grade breast pump. “I didn’t know what to expect, but the lactation specialists solved my problems and had Kailey successfully breastfeeding just two minutes into my session. It was the most magical moment of being a mom. I finally felt like I was doing a good job for her, and I wish I would have pursued this help sooner.”

The Mega Raffle provides funding for new moms to visit the outpatient breastfeeding clinic even if the service is not covered by their insurance or if they cannot otherwise afford it.

 

 

 

This is the fifth of our six-part series of blogs that show how the TMC Mega Raffle is making a difference for patients and the community.

 

Togetherness for Mom & Baby Health – Why we promote rooming-in

Rooming in brings benefits for Mom & BabyIn a scene in the PBS series “Call the Midwife” , Nurse Jenny Lee (the main character) risks getting into trouble to sneak a newborn baby into an open ward so that a desperate mom can hold her child for the first time. It seems shocking today, but not so long ago, babies were kept in the nursery under observation while mom recovered in an open ward with other moms. Family and visitors would clamor for prime viewing spots outside the nursery window to see baby who lay swaddled and isolated beyond reach and comforting touch.

In recent years, as hospitals moved from open wards to private rooms, the practice of ‘rooming in’ has become common place, allowing moms and babies to stay together. Still, the practice of taking baby to the nursery to ‘give mom a break’ or a good night’s sleep continues. And indeed it would seem to make some sense, but research studies have shown that sleep patterns and breastfeeding are often better established when baby stays with mom and mom with support learns her child’s cues. For this reason we promote 24 hour rooming-in for new moms.

Mom to near 2 year old Felix, Cindy shares her experience rooming-in at TMC for Women,

I was going to the El Rio Birth Center and wanted to have a natural birth experience, but that wasn’t in the cards for me. At 41 weeks, it was time to go to the hospital. I was at TMC for two days before Felix was born via C-section. He was 10.5 lbs and a bit of a celebrity for the short time I was there. There hadn’t been such a big baby born in quite awhile. After the C-section, our midwife gave Felix to me right away…

Placed on Cindy’s chest immediately, Felix stayed with mom except for testing and a short time when Cindy cleaned up following the C-section.

The nurses at TMC were very kind and supportive and respectful of my need to have Felix with me at all times. I was there after the surgery for 3 days…It was amazing to have that little guy close to me, I wouldn’t have traded that experience for anything in the world.

What is the Newborn Nursery for?

Our Newborn Nursery is reserved for only those babies who need intensive observation or are having problems that prevent them from staying in their mother’s room.

Moms are encouraged to always keep their baby with them, and at the hospital their partner or a support person is welcome to stay overnight to help them with the baby, as they bond and get to know one another.

Why rooming-in is important

• Rooming-in promotes successful breastfeeding
• Keeping your baby with you at all times helps both of you sleep better
• The safest place for the baby is with the parent
• Being together strengthens your bond – the more time you spend together, the better you will know each other
• You will learn your baby’s cues, and the baby will be calmer hearing your familiar voice and your heartbeat
• You will feel more confident in your ability to care for the baby when you go home from the hospital

Resources
Keefe, MR.  Comparison of neonatal nighttime sleep-wake patterns in nursery versus rooming-in environments. Nurs Res. 1987 May-Jun;36(3):140-4. [Accessed 6-6-2014]

In the Golden Hour – Why this sacred moment between mom and baby matters

Babytoes.jpg

There is magic in the moment when you meet your child for the first time. Something so precious, so indescribably powerful, it’s hard to imagine any aspect of it is quantified. And yet, it is.

Why is this Golden Hour so important?

Studies* show that a close mother-child bond is critical for the baby’s ongoing growth and development. Skin-to-Skin contact in the first hours and days of your baby’s life will play a key role in helping you become bonded. Months after birth those moms and babies who spent this time together skin to skin following birth show more positive contact with their child.

Benefits to both moms and babies from holding skin-to-skin

Babies:
• Are happier, calmer and cry less
• Stay warmer
• Have higher blood sugar levels
• Are protected by some of your good bacteria
• Have more stable heart, respiratory, and oxygen rates
• Breastfeed better, which helps them be healthier with less risk of getting ear infections, asthma, diarrhea, RSV, diabetes, obesity, and SIDS (Sudden Infant Death Syndrome).

Mothers:
• Bond more easily with the baby
• Gain confidence and satisfaction from caring for the baby
• Learn when the baby is getting hungry and what the eating cues are
• Make more breast milk and breastfeed more easily, which is good for moms too! Breastfeeding helps you bleed less, lose weight, and decrease your risk of breast cancer, ovarian cancer, diabetes and heart disease.

What to expect during the Golden Hour

The Golden Hour is a time for mother and baby to bond without having the interruption of procedures such as medications, footprints, etc. that can be done after the one hour bonding time with mom. It’s also a time for the nuclear family, parents and baby, to bond.

We ask that families and friends visit after the golden hour not during this time, allowing mom and baby to focus entirely on each other during this critical period.
1. When does the Golden Hour begin?

Immediately after delivery, as long as mom is stable and baby is healthy, the baby is placed skin to skin on mom’s chest with a blanket covering the baby. (If you have to have a Cesarean section baby placed skin to skin with you immediately on your return to the Labor and Delivery room as long as you and baby are stable.)Baby stays in Labor and Delivery unit with mom for 2 hours after the first vital sign is done on baby, usually done within 5-15 minutes after birth. Baby will stay with mom and bypass the nursery as long as baby meets criteria of a healthy term baby.

2. What will baby do during the Golden Hour?

Expect baby to cry at first and then relax. Following this relaxation baby begins to open their eyes a little and perhaps even look at mom’s eyes. Baby might begin to salivate a little and begin to root, moving their head around on your chest. Often baby will bring their hands to their mouths and to mom’s breasts.Baby will be placed at the breast, but baby initiates actual feeding. It’s okay if all baby is doing at this point is nuzzling and licking explains Alicia Lang RN., Director of Women’s and Children’s Services at TMC. Expect periods of rest amid the activity, that’s perfectly normal.

3. What about breastfeeding? Shouldn’t baby be eating straight away?

Debra Derck Clinical Manager of Labor and Delivery states, “A nurse is there to support the mother and baby and breast-feeding is not forced at this time; instead the baby is given the time to seek out the breast and the nurse is there for guidance and encouragement.”

4. What happens if there are some concerns about baby?

Babies need a little closer observation will be in a room designated for transitioning babies. After the transition period is over, baby will either go to mother’s room or be admitted to NICU.

5. What happens after the Golden Hour?

After an hour or so, baby may begin suckle on the breast, and after the first feed it isn’t unusual for both mom and baby to sleep. You should continue to enjoy this special closeness as often as possible during your postpartum stay with us on the Mother Baby Unit, and in your early weeks at home. Our Mother Baby Unit is designed so that mothers and newborns remain together as much as possible. Read more about why rooming in is important in our upcoming post.

The best place for baby is with YOU!

Resources

The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial
Sari Goldstein Ferber, PhD*, Imad R. Makhoul, MD, DSc‡ PEDIATRICS Vol. 113 No. 4 April 1, 2004 pp. 858 -865

Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding, Jeannette Crenshaw, RN, MSN, IBCLC, LCCE, FACCE J Perinat Educ. 2007 Summer; 16(3): 39–43.doi: 10.1624/105812407X217147

Kate Middleton has a baby AND a baby bump! More about the Postpartum Body

So it seems to be big news that Kate Middleton was photographed with a visible bump when she and Prince William left the hospital with wee baby George. Some posted comments on both news and gossip blogs pondering how it was possible that she was ALREADY pregnant and showing. Really? That would be quite a miracle. This response unfortunately reflects the unrealistic expectations for new mothers to return to their pre-pregnancy bodies immediately following giving birth.

The truth is, of course, that it takes a while for the uterus, that a day or two before held a dozen pounds of baby, placenta, and fluid to shrink to its usual size (that of a fist). It takes up to eight weeks for this process to be complete. So that bump is perfectly normal.

Breastfeeding aides in the return of the uterus to its original size.  Breastfeeding releases oxytocin, which causes uterine contractions, slowing bleeding and helping the organ to shrink. For women who’ve already given birth, these contractions are sometimes painful, like early labor–typically not the case for first births. But there is no way that any woman, breastfeeding or not, will have a flat postpartum belly.

Tucson’s own Jade Beall, whose photographs of mothers’ bodies in all their un-Photoshopped glory have received staggering attention around the globe recently, commented on the Kate’s post-baby photo on The Daily Beast:

This is a historic moment for women around the world. Kate has chosen to confidently show what our bodies can look like after undergoing one of the most life-changing feats a human can experience.”

I, for one, was thrilled to see Kate not only hiding under a tent-like dress, as was done in previous generations, but actually rocking an empire waist, accentuating the perfectly normal body of a brand-new mom. (Of course she also had perfectly coiffed hair, but that’s how it works when you have your own full-time stylist. Hey, I wouldn’t have minded a nice shampoo and blow-out after delivery…)

It’s so wonderful that what must be the most widely seen photo of a new mom this year is both beautiful and educational.Thank you, Kate, for not hiding the normal belly of a new mother. And thank you Jade, for your work in sharing the beauty of bodies in all their glorious forms.

Tara’s Birth Story

This story is part of a series of birth stories on TucsonMama that was sponsored by Tucson Medical Center.

“When I was about four months pregnant, my husband of five years left me and my young son. I always believed he would return, but he didn’t.

I had a great support system, including other girlfriends who were also pregnant. At first, I didn’t gain the necessary weight so the doctor was concerned. After a visit by my father, always my best friend, from Florida, his presence gave me the jolt I needed and things began to improve. During this time, I did have a part-time job and my little boy was in day care. Eventually, Dad flew back to Florida and I was once again on my own.

When I was 37 weeks along, my water broke in the wee morning hours. I knew I had to get to the hospital fairly soon, so after the arrangements were made for my son’s care, I headed to TMC. I was barely dilated, so I walked around a lot anticipating and hoping for a fast dilation to kick in. It didn’t. I had taken the Bradley childbirth course and was trying to focus on breathing and concentrating on pretty pictures. However, I only dilated to a 5, at most. Then they told me if I didn’t dilate by noon, I would have to be induced. I had always heard that a pit-drip (pitocin) would make the contractions harder, so I wanted no part of that! For some reason, I soon became fully dilated and they proceeded with an epidural. The fetal monitor indicated a fast heartbeat, so I was pretty sure it would be a girl being informed that a girl’s heartbeat is usually faster than a boy’s heartbeat.

My first childbirth was wonderful and comfortable with the epidural, but this one seemed different. It didn’t work. It was painful and I pushed for what seemed to be a long time (it was about an hour) and finally her head and shoulders were out! The doctor then told me to pull her out and complete the birth. I said “no way am I going to do that”, as he folded his arms and said, “Well, neither am I”.”

Find out what happens next here.

The story of Tara’s birth is part of a series on TucsonMama and was sponsored by Tucson Medical Center as part of our commitment to maternal and family health, and in an effort to build and maintain a strong and supportive community. Not all the births featured in this series take place at TMC, or even in a hospital. If you would like to share your birth story please contact TMCforWomen at gmail dot com.