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Tuesday, December 18, 2012

Episode 64 (Epilogue): State of Maternity Care

We opened our episode tonight with a discussion of the tragic events in Newtown, CT, and in particular how to talk to your children. Some of this advice will be given at the bottom portion of this epilogue. Laura also had this to say: “Our goal on this show is to facilitate conversations that make positive change for parents. Clearly, a conversation on the local level is necessary to carve out a plan of action toward necessary reform in many areas. We envision a public forum to which all of our elected officials, school board members, mental health alliances, media outlets and concerned parents and educators would be invited. If you would like to be a part of this discussion, date and time to be announced, please email us at”

Tonight’s episode was focused on the current state of maternity care in Sarasota. Our hostesses, Laura and Ryan, talked to a panel of experts in different areas of this field: Harmony Miller, a Licensed Midwife and owner of Rosemary Birthing Home, Dr. Kyle Garner, the Sarasota Memorial Hospital Chief of Obstetrics, and retiring perinatologist Dr. Washington Hill, who is board certified in Obstetrics and Gynecology and Maternal-Fetal Medicine.

Dr. Hill started the conversation off, as we talked to him about his retirement in the Sarasota area, and his upcoming work with the Clinton Foundation . He also shared wisdom with us about how his experience with the Sarasota community, and how it has taught him about the importance of communication between various professionals in the realm of maternity health care, as well as between mothers and care providers.

Next we spoke with Dr. Garner, who echoed this need for open communication. He also talked with us about the OB Hospitalist program at Sarasota Memorial, and how it has benefited both patients and doctors in emergency situations and situations in which the patient does not have a primary care provider. He also talked with us about VBAC care at SMH, and how having an Obstetrician on staff at all times may prove to make this option more attractive for both patients and doctors.

Harmony Miller than joined the conversation, and explained various aspects of the midwife model of care. We spoke with her about licensure for midwives, how risk is evaluated for individuals attempting to have an out-of-hospital birth, and the importance of emotional support and education under the midwife model. All of our guests then spoke with us about the procedures for transfer from an out-of-hospital setting to a hospital setting.

Finally, Dr. Garner and Dr. Hill spoke with us about how Sarasota Memorial is working to support more natural labors, the role of cascading interventions in birth, and the negotiation of birth plans between patients and OB/GYN’s.  

In the wake of Friday's unthinkable events, we have collected some words of wisdom from former Maternally Yours guests on how to speak to our children about tragic events. We hope you'll find this helpful.

From Tim Seldin: "Those of us who have young children (age 7 or younger) should seriously heed the recommendations of psychiatrists, who are urging that, if possible, we shelter them from any media reports or discussions of this incident and certainly turn off the TV or radio if announcers are about to replay scenes of grief or violence. Small ones simply do not need this. Avoid speaking about this with other family members, neighbors, or friends if your young children are within your hearing. Older children will inevitably hear about this, either on the media or from friends. I would not recommend that you raise the subject, but if your children are present when this is discussed on-air or in a conversation with others, or if they ask you about what happened, we would suggest that you reassure them that such incidents are extremely rare; however, when they do occur, they receive a great deal of attention simply because they are so incredibly uncommon and horrible. Reassure them that the person, or persons, who committed this act are no longer able to hurt anyone, and that they are safe. We cannot live our lives in fear, but we can work for a better world."

From Peg Hughes: "If you can keep your kids from being exposed, do. But, if you can't or they are older, first, don't let them watch it on an endless loop. Turn off the news. Take some breaks from the news yourselves. Then what you say will depend on their age and maturity. Listen to them and be guided by what they are asking you. Watch for any changes in their behaviors and know they may have a range of emotions. Make it okay to talk about. Reassure them they are okay. Get them into their routines. Get them into community projects to help others. Let them know that it is okay to be sad and confused. And that they are safe. That this kind of thing, while very sad and hard to understand, are very rare. Hug them, a lot. Most importantly, grieve, be sad and then get yourself centered so that you're not giving off any anxiousness. Model for your kids how to handle tragedy."

From Karen Leonetti: "Older children will pick up bits and pieces here and there. However, please do not bring it up to discuss randomly with your children. I would suggest that if they ask you questions about the shootings, only answer exactly what they ask. Children need to feel safe in order to learn for the rest of their lives. Here is an exercise: Go through your home with your child if they are aware, worried or feel troubled from the event. Point out all the things that you have provided in your home for their safety. Ask them what makes them feel secure at home. What comforts them? What do they love? Go over safety measures you have implemented for your family. Tell them that YOUR job is to keep THEM safe. Give loads of hugs and watch comedies instead of the news."

For an in-depth insight from mother, midwife, healer and wise woman Aviva Jill Romm, please read Sheltering, Protecting, and Talking With Our Children: Parenting for Sanity in a Seemingly Insane World.

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