Debbie Chalk RNC, IBCLC-RLC, CPD

Certified Postpartum Doula603-340-7028

debbiechalk@familycareafterbirth.com 

Located in Bow, New Hampshire

Family RootsPostpartum Doula Care

&in home

Lactation Consultant

Today we will learn:1. about the universal need for family and

community support.2. to identify stressors and potential adverse

short term and long term health effects if not alleviated.

3. to assist the family in understanding the benefits of support, sources and how to access them.

Family Strength Requires Maternal and Family Support in the Postpartum Period

Studies have shown that women who have social support during the postpartum period tend to have less postpartum depression, breastfeed for a longer duration and make a better adjustment to parenthood.

Importance of Social Support

Native Americans- “Longhouse”

China- “Man yue jue”

South America- “La quarentina”

Burma- “Thie-dwin” Greece- “Doula” Holland- “Kraam

verz orgster”

World wide cultures

Communities

Historically, we recognized the importance of a community of

women helping women…

However help is provided it was

recognized that the new mother

couldn’t manage all these family duties herself, at least for

several weeks. These traditions

make a lot of sense!

Historically, in colonial America, there was a distinct postpartum period (6 weeks after birth). This was called a “lying in” period, a period of “apprenticeship” when more experienced mothers taught the new mother.

Boston Lying-In Hospital

Cultures who had low incidence of postpartum mood disorders all had rituals that provided support and care for new mothers.

Although different, they shared 5 protective social structures.

1. A distinct postpartum period- set apart from normal life

2. Protective measures recognizing need for physical healing from pregnancy and birth

3. Social seclusion- for rest, care and for the parents to get to know their new baby

4. Assistance in the home- parents only responsibility was to rest and care for their baby

5. Recognition and respect for their accomplishments in the new roles as parents

Five Protective Social Structures

A Day in the Life of Parents of a Newborn

First time parents: have no previous experience. are recovering from pregnancy and birth. are learning basic hands on infant care.

Experienced parents: may have had difficult previous

circumstances. are recovering from pregnancy and birth. are integrating the new sibling into family

life.

Identifying common obstacles

Sally Placksin, author of Mothering the New

Mother, identifies that “many women today are entering into motherhood in

unprecedented states of isolation”.

Unprecedented states of isolation.

Lots of changes occur instantly at the moment of birth.

They must nourish and love more than one person and divide their time into multiple unpredictable circumstances.

They have assisted the Mom during pregnancy, managing labor and birth and now must assist her in recovery.

Fathers are redefining their roles; they may also be adjusting to sleep deprivation, financial pressure and other stressors, as well.

The Partner’s need for support:

With most couples the partner must go back to work in a week or two with lots of sleep deprivation and added responsibilities on board.

They are expected to function fully in their job and pretend nothing ever happened.

Men can get “baby blues” and postpartum depression also.

Their signs and symptoms are different from the woman’s and can take the form of anger, irritability, physical pain and substance use.

They need a listening ear, support and an extra pair of hands too.

“Back to Work”

Long Term Health Risks Associated with

StressUnrelieved stress can begin a vicious cycle of heath problems to include negative mental states and depression.

“Researchers at the University of Helsinki have now shown what kinds of biological mechanisms related to sleep loss affect the immune system and trigger an inflammatory response.”

“These results corroborate the idea that sleep does not only impact brain function, but also interacts with our immune system and metabolism…

Some of these changes appear to be long term…”

Sleep Deprivation

red Orbit New Biological Links Between Sleep Deprivation and the Immune System Discovered 10/24/2013

“A molecule linked to inflammation could play a role in depressive symptoms caused by social stress, a new study in mice suggests.”

“This may represent a legitimate biomarker for depression and could represent a new chapter in the effort to accurately diagnose and better treat mood disorders.”

Inflammation Molecule Linked With Depression From Social Stress

HUFFPOST Healthy Living Inflammation Molecule Linked With Depression From Social Stress 11/13/2013

Even short periods of sleep deprivation

can increase the release of stress chemicals and

adversely affect blood sugar levels.

Poor sleep quality and depression often go hand in

hand.

McEwen, Biological Psychiatry 2003; 54:200-207

Kendall-Tackett, Trauma, Violence & Abuse; 8, 117-126

Depression increases the risk of both heart

and vein disease.

Negative Mental States

Inflammation

Chronic DiseaseWhy Breastfeeding Prevents Maternal Metabolic Syndrome and CVDKathleen Kendall-Tackett, Ph.D.,IBCLC, FAPA

Is the precursor syndrome to Type-2 diabetes

Includes symptoms such as: abnormal blood sugar processing, abnormal cholesterol levels and abdominal obesity

Metabolic syndrome

These conditions also increase the chance of heart and vein disease.

Heart and Artery/Vein DiseaseChronic stress, depression and hostility increases the risk of these diseases as well as metabolic syndrome, diabetes and degenerative brain diseases.

Hostile people are more likely to experience constriction of the heart blood vessels when under stress as well as additional new heart problems.

Why Breastfeeding Prevents Maternal Metabolic Syndrome and CVD Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA

Social connections are vital for good health and for parents to successfully welcome a newborn

into their lives.Health Care Providers and Family supporters play an essential

key role in educating and guiding parents .

Promises of help give way to every day life in spite of

everyone’s best intentions to stop by and help.

In my 35 years caring for parents and their newborns the NH family has changed. Most have short term help only, because of family members geographical locations, their place in the work force and peers/ friends being co-workers.

A new mother (parents) must be encouraged on a daily basis. Whether this is their first or fifth baby, they must be told they are doing a wonderful job.

Karen Kleiman states in her book Therapy and the Postpartum Woman “More than one woman has confessed to us that she secretly wishes her mother would look over her shoulder during the 3AM feeding and sweetly whisper: You must be so tired. You are

doing a wonderful job, I’m so proud of you. You are such a good mother.”

Assist the new family with household management and care so the focus can be on rest and feeding.

Education for the parents on proper positioning and assessment of their baby’s nursing/ feeding behaviors.

Light housekeeping, grocery shopping, errand running and family meal preparation are options families like.

Sibling care, assistance to get out for walks, appointments, an outing to a favorite store/ café all lift their spirits.

Guidance in setting and revising short and long term goals. Assist parents to use shorter time availability to accomplish

more goals related to rest and recovery. One of the most important things a helper can do is listen.

So much happens during pregnancy/birth/meeting the baby and incorporating them into life. The parents need time to sort it all out and to begin to accept the experience.

So what kinds of help do new parents need?

Listening Skills They can be a skillful art.

Active listening is listening to understand the complete message as opposed to listening to respond.

Restatement allows clarification.

Interpretive listening enables you to gain an understanding of the underlying feelings.

The considered response is preceded by compassionate thought.

Please, come sit with me…Though baby shower gifts are nice, it is recommended to

ask instead for someone to come sit with you, "listen wisely and non-judgmentally to all your questions and

feelings after the baby comes".Sally Placksin Mothering the New Mother

Good QuestionsTypes of questions to avoid:

• close ended questions

• why questions

• rapid-fire questions

• questions containing the answer- these can be manipulative

• these questions also usually stop conversation.

Instead try open ended questions because they:

• focus on the speaker.

• encourage conversation.

• provide a model for solving future problems.

• move conversation forward.

BLAST

The last thing we want to do….

The goal must be to BENEFIT.

The motive must be LOVE / genuine concern.

The situation must be APPROPRIATE.

The terms must be SPECIFIC.

The context must be TRUST.

When you have to talk about something difficult…

Short term• Gain education through multimedia resources and

supportive friends and family.• Before the baby is born invite and solidify a support

network for day and night.Long term• Research community support groups and their

contact information.• Consider what elements of your lifestyle it is

important to you to retain (hobbies, outdoor interests, educational objectives).

• Post numbers to reach health care providers with medical questions.

Determining goals

“Although women are made to nurse babies that doesn’t mean it is easy.”

“I believe that happened (achieved my goals) because I knew someone, with particular knowledge and expertise, was going to be here for me a few times a week.”

The challenges are universal…

Community HelpersCan take the form of: Family Friends Coworkers Trusted Neighbors Older siblings Mother’s helpers Childbirth and Postpartum Doulas Lactation Consultants Visiting Nurses Postpartum Support/Depression Counselors Organizations who provide classes and support groups Social Workers Family Counselors WIC Counselors Social Clubs for parents Local stores who provide classes as a community service

Classes Center for Health Promotion

49 South Main StreetConcord, NH

03301 603-230-7300Baby

StepsPrenatal Breastfeeding Class

Childbirth classesAmazing

Newborns Back to Work Class (for breastfeeding mothers) Itsy Bitsy Yoga Active Parenting Now Art with Heart

Nini Bambini - A Place to Grow166 South River

Road Manchester, NH 03110 603-666-6464

www.ninibambini.commultiple class offerings

www.concordmoms.com MOMS Club of Concord

www.greatbaydoulas.com  parenting, mom/baby activities/parent support

www.truebluematch.com    other parents new to area to find common interests/ friendship

Postpartum support, including postpartum depression support services Gerry Mitchell- Post Partum Support Coordinator Concord Hospital 603-225-2711 x4110

Marisa McCutchen Barrington Counseling Center 603-534-2558

Child and Family Services of New Hampshire Concord NH 800-894-5533

www.postpartum.net- on line support and direction

Postpartum Support International S800-944-4PPD

Postpartum Dads- www.postpartumdads.org

 

Capital Area Community Resources for Parents

The need for community support takes on a different meaning.It is with a social support network that we feel a sense of

belonging and more secure.As new parents increase their self-worth by not being

isolated and struggling alone, the baby will feel this as well.

WWWeeWe did it!

Lactationmatters.wordpress.com 8/5/13, 9/5/13 C.H. – Friend 11/9/13 What is the Postpartum Period? By Rev. Pilar(Ma’at) Grant

10/3/13 How Other Cultures Prevent Postpartum Depression: Social

Structures that Protect New Mothers’ Mental Health by Kathleen Kendall-Tackett, Pd.D., IBCLC 10/13

Why Breastfeeding Prevents Maternal Metabolic Syndrome and CVDby Kathleen Kendall-Tackett Ph.D., IBCLC, FAPA 5/12

Mother the New Mother by Sally Placksin p5 Fathers, Breastfeeding and Bonding - Dr Lucas Godinez, MD,IBCLC

lactationmatters.wordpress.com8/17/13 Haffner&Taegtmeyer, Circulation 2003; 108:1541-1545 Huffpost Healthy Living November 16, 2013 Red Orbit New Biological Links Between Sleep Deprivation and The

Immune System Discovered October 24, 2013

References