Image if this was the type of maternity care system we had. Where midwives and doctors (specialist O &G's and GP's) worked together in 'Collaboration not competition, Viva la health care revolution. if only we could have more people in Australia that could think like this.
This is my dream for maternity care in Australia. Where maternity care is about collaboration, not about power struggles. Where birth wars cease to exist and women are truly at the centre of their care, making their own decision - unbiased, empowered and collaboratively. I had the priviledge of working with an obstetrician who has this philosophy and I feel that it was a win win situation for all. - the women, the staff and the organisation. It will be interesting to see what happens in the coming months in relation to 'eligible midwives' and collaborative arrangements with Drs.
Wednesday, December 8, 2010
Tuesday, December 7, 2010
Women who choose to artifically feed - are we truly women centred?
I had an interesting discussion with a group of health professionals the other day. One of the midwives presented a piece of research she had completed for her Masters in Nursing. The qualitative (phenomenography) study looked at 'the experiences of postnatal women who choose to artifically feed'. The study was conducted in 2010 in a BFHI (Baby friendly hospital initiative) accredited hospital. This study has highlighted a couple of key issues and got me thinking:
1. There are posters around the hospital that say, "I look up to my mum because she breastfeeds". On one hand, this is literally what happens when you breastfeed your baby. The baby gazes up at his/her mum as they lay drinking at her breast - as can be seen in the poster. This is from the perspective of a breastfeeding mother and as I have seen that poster many times and have been a breastfeeding mother, that is exactly what I thought. On the other hand, from the perspective of a bottle feeding mother, does a poster like this make a women feel that if you bottle feed, you will be looked down upon, denoting feelings of 'I'm a bad mother' if I bottle feed'. This was some of the feedback provided in the study. It was argued that we can not be responsible for the guilt a mother feels for bottle feeding her baby, however as much as we are not responsible for the guilt, I feel we should also not be doing anything to foster these emotions either. We can not turn a blind eye to these 1 in 5 mothers that choose to bottle feed because we don't like or agree with their choice. As maternity health professionals, we are first and foremost patient advocates, providing 'women centred care'. Women centred care means focusing on the women's unique needs, expectations and aspirations rather than the needs of the institution or profession and recognises the women's right to self determination in terms of choice, control and continuity of care from a known caregiver etc. This is what we strive for above all else. Has our desire to improve the breastfeeding rates in Australia ( a major known health benefit for mother and baby) come at the cost of providing women centred care for mothers who choose to bottle feed. (It must be said that all mothers in the study were very happy with the care they received overall during their hospital stay but there were things that could be improved upon in relation to their choice to bottle feed their babies and the hospital is looking at ways to improve this.)
2. As part of BFHI accreditiation, the milk room in which formula is kept is locked to all mothers. It can only be accessed by staff. Mothers are given a demo on how to make up formula but when their babies need a bottle they must buzz a staff member and the staff member gets it for them, preventing the mothers from entering the formula room. The themes that emerged from the women included 'once I have made my decison to bottle feed, I want to be supported' and 'teach me - I want to be independant'. Not being able to make up their own bottles made women feel helpless and disempowered. Whilst I'm sure this was not the intention, how can a hospital support and empower bottle feeding mothers whilst still remaining BFHI accredited? Maybe the BFHI need to look at some of the requirements imposed on hospitals to receive and maintain accreditiation in the interest of women centred care and patient advocacy.
It is a double edged sword on which we sit as we try to improve the breastfeeding rates in Australia. We must educate our families about the benefits of breastfeeding, but I have to wonder if obtaining BFHI accreditation has in some unintentional way, sacrificed being 'women centred' for women choosing to bottle feed for the sake of it. What are your thoughts? I wonder what other hospitals are doing about this issue?
1. There are posters around the hospital that say, "I look up to my mum because she breastfeeds". On one hand, this is literally what happens when you breastfeed your baby. The baby gazes up at his/her mum as they lay drinking at her breast - as can be seen in the poster. This is from the perspective of a breastfeeding mother and as I have seen that poster many times and have been a breastfeeding mother, that is exactly what I thought. On the other hand, from the perspective of a bottle feeding mother, does a poster like this make a women feel that if you bottle feed, you will be looked down upon, denoting feelings of 'I'm a bad mother' if I bottle feed'. This was some of the feedback provided in the study. It was argued that we can not be responsible for the guilt a mother feels for bottle feeding her baby, however as much as we are not responsible for the guilt, I feel we should also not be doing anything to foster these emotions either. We can not turn a blind eye to these 1 in 5 mothers that choose to bottle feed because we don't like or agree with their choice. As maternity health professionals, we are first and foremost patient advocates, providing 'women centred care'. Women centred care means focusing on the women's unique needs, expectations and aspirations rather than the needs of the institution or profession and recognises the women's right to self determination in terms of choice, control and continuity of care from a known caregiver etc. This is what we strive for above all else. Has our desire to improve the breastfeeding rates in Australia ( a major known health benefit for mother and baby) come at the cost of providing women centred care for mothers who choose to bottle feed. (It must be said that all mothers in the study were very happy with the care they received overall during their hospital stay but there were things that could be improved upon in relation to their choice to bottle feed their babies and the hospital is looking at ways to improve this.)
2. As part of BFHI accreditiation, the milk room in which formula is kept is locked to all mothers. It can only be accessed by staff. Mothers are given a demo on how to make up formula but when their babies need a bottle they must buzz a staff member and the staff member gets it for them, preventing the mothers from entering the formula room. The themes that emerged from the women included 'once I have made my decison to bottle feed, I want to be supported' and 'teach me - I want to be independant'. Not being able to make up their own bottles made women feel helpless and disempowered. Whilst I'm sure this was not the intention, how can a hospital support and empower bottle feeding mothers whilst still remaining BFHI accredited? Maybe the BFHI need to look at some of the requirements imposed on hospitals to receive and maintain accreditiation in the interest of women centred care and patient advocacy.
It is a double edged sword on which we sit as we try to improve the breastfeeding rates in Australia. We must educate our families about the benefits of breastfeeding, but I have to wonder if obtaining BFHI accreditation has in some unintentional way, sacrificed being 'women centred' for women choosing to bottle feed for the sake of it. What are your thoughts? I wonder what other hospitals are doing about this issue?
Tuesday, August 31, 2010
Welcome
Welcome to the first of many blogs which I hope will generate a lively and indepth discussion on all things to do with maternity care. My hope is that all health professionals involved in caring for women and their babies will take part in an open collaborative forum that holds women needs at the centre of that care whilst also providing collegial support, information and education. I welcome students, midwives, doctors, academics, allied health professionals, consumers and women to be involved and contribute to an online forum that seeks to debate the real and relevant issues surrounding maternity care today.
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