Hartford HealthCare Podcast
The Hartford HealthCare podcast covers a wider range of topics on health, wellbeing and career opportunities within the healthcare industry.
Hartford HealthCare Podcast
Happy Mother's Day: Let's start at the beginning...
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In this special Mother's Day edition of More Life, we are joined by Hartford Hospital's Jennifer Dowe, patient education manager for Women's Health Services, and Mary Marshall-Crimm, a family nurse practitioner, lactation consultant and the manager of the lactation program at the hospital.
They help to take us through the amazing journey of becoming a mom, from prenatal education to labor and delivery, breastfeeding, taking baby home - and beyond.
Jen and Mary describe some of the amazing resources now available to expectant and new parents including support groups, virtual classes and social media connections.
Be sure to explore some of the great programs and pages discussed in this episode:
HH Special Deliveries Childbirth Center (Facebook) – Open to the public
HHC Breastfeeding support group (Facebook) – Private group
Fourth Trimester and Postpartum Wellness class - Open to the public
Hartford HealthCare Parent Education classes - Open to the public
Webinar: What New Grandparents Should Know - Open to the public
Register for the weekly Breastfeeding Support Group HERE
Related More Life podcast episodes:
Midwifery: Back to the basics of birthing
Call the Hartford Hospital Lactation Center to schedule a phone consultation; virtual consultation or in person consultation: 860.972.2428
Call the Hispanic Health Council for follow up by a peer counselor: 860.527.0856
More breastbeeding resources:
That first, you know, couple minutes of having that seven-pound baby right on your chest, there's literally no better feeling.
SPEAKER_06Welcome to more life. I'm Enron DePierre, and we have a super special Mother's Day edition of the podcast today. It's all about moms, babies, and we'll even make a little room for the dead. I'm so excited to introduce you to my guests today who are Hartford Healthcare's Jennifer Doe, patient education manager for women's health services, and Mary Marshall Crimp, a family nurse practitioner, lactation consultant, and the manager of the lactation program at the hospital. So welcome, Jen and Mary.
SPEAKER_05Thank you so much for having us.
SPEAKER_06I'm so glad you're here. Will each of you give us an overview of your roles at Hartford Hospital, first off? And let's start with Jen.
SPEAKER_05Thank you. I always joke around that I have the best job in the hospital because I get to do a little bit of everything. So I oversee the patient education department. It consists of many different classes taught by 10 childbirth experts. I'm also responsible for the social media for the department and any written materials and education that goes out to our patients.
SPEAKER_06Oh, great. So those pamphlets and brochures that we might get or handouts, you're behind that magic. Let's see, Mary.
SPEAKER_04Yes, thank you. Thank you for having us. I am uh the um manager of the lactation program, which is a very comprehensive program. We will see everybody by a request from either the physician or the bedside nurse or the mother herself that if she would like to see a lactation consultant, we will see them. I do like to make it clear we don't do rounds and see everybody who's breastfeeding. Those that need help, want help, and really would like the support. And we actually have a comprehensive program that goes right through your postpartum time. We could do follow-ups with the phone or virtual or have someone come back in and see us also. So we have 10 board-certified lactation consultants that work in this program.
SPEAKER_06Oh, that's fantastic, Mary. And I know that first time out for those who choose to breastfeed can be really challenging, and I so appreciated the help that I got from my lactation consultant the first time out because there are challenges and rewards, and we're gonna get to all that good stuff later. So being Mother's Day, I'm gonna ask the obvious question Are you both moms?
SPEAKER_05We are.
SPEAKER_06Great.
SPEAKER_05Um, I have three children. I have a five-year-old, an eight-year-old, and a ten-year-old.
SPEAKER_04And I have four children, and I don't actually don't want to tell you how old they are, but I will say once a mother, always a mother, whether they live with you or they're out of the house.
SPEAKER_06Oh, it's so true. And happy Mother's Day to both of you. I also have four children, and yeah, giving up my age a little bit, now two little grandbabies. So it just that keeps on giving. It's fantastic. So um let's start off our conversation with some facts about prenatal education, especially for first-timers. That prenatal education is so critical. And can you just kind of give us an overview on you know what we can expect to learn and be prepared for?
SPEAKER_05Absolutely. So, prenatal education are classes that a birthing person and her family can take during pregnancy. Our topics here range from childbirth, breastfeeding, comfort measures for an unmedicated labor if she decides to do that, baby care basics, and actually my favorite class is a grandparents' prep class. Ooh. So it's so cute. Um, so grandparents that are first timers, they get to take a class and learn about all the new safety and changes from when they were raising their own children.
SPEAKER_06I love that because as a relatively new grandmother myself, you can you can't help but you kind of feel like you know it all and and you don't. So much has changed in lines of you know, safety in car seats and sleeping, you know, everything.
SPEAKER_05It's very well received. We love it.
SPEAKER_06And is that one in particular or any of them? Let's let's look at them overall. Are they virtual in person or both?
SPEAKER_05Right now, all of our classes are virtual with the hopes of going back in person soon.
SPEAKER_06Okay, great. And then are these classes intended for patients of Hartford Hospital or does it go beyond that?
SPEAKER_05It actually goes beyond that. The one good benefit of doing these classes virtually is that all of our Hartford Healthcare patients, if they so choose, could take a class with us.
SPEAKER_06Great. So as long as you're in the system somewhere, you'll have access to these classes.
SPEAKER_05Yes, absolutely.
SPEAKER_06Wonderful. So prenatal education is nothing new. It's been around for a while, but have have you seen it change over the years?
SPEAKER_05I would say now more than ever, it's important for the pregnant person or the birthing person to know where her education is coming from. Many families seek out information on the internet. Yes. Um the problem with that is it's not always accurate, and oftentimes it's just opinion. So here, if you take your classes with Hartford Healthcare, we know that we are providing safe education to our patients because it's evidence-based. Evidence-based education has so many benefits, including it decreases the odds of unplanned C-sections, decreases the risk of postpartum complications, even it decreases the fear around the labor pains that you might feel. And it also increases breastfeeding initiation rates.
SPEAKER_06Great.
SPEAKER_04I I would like to add just a little bit because over the years, what I've seen, the biggest thing about um having someone take a childbirth education class, it really prepares them to come into the hospital and what to expect. And the biggest change that I've seen over the years is how we manage labors with medication or without medication. And I think that's one of the biggest values for someone, so they could hopefully decrease maybe if they have any anxiety or any fear about the upcoming birth of their child.
SPEAKER_06I can really appreciate what you're saying about what to expect when you get there and about medication because I think we've come a long way there. Back in the day, I feel like you just kind of went in hoping for the best and kind of blind. And now we have the benefit of cool new technology like virtual tours, which we'll get into later. And speaking of cool new technology, tell us about the social media engagement, which has become such a valuable resource for expecting a new parent.
SPEAKER_05There's so many great social media influencers in the birthing and parenting world. I think the convenience of having all of the information at your fingertips, you can literally Google anything at this point, right? But on the flip side, it can be overwhelming and you might not know where to start. Recently, we launched a Facebook group for expecting families to join. It's called Hartford Hospital Special Deliveries Childbirth Center. It's a public page anyone can join, but it really is geared towards those who will be delivering at Hartford Hospital. It's becoming a small community of patients, nurses, midwives, doctors. I'm on there posting small evidence-based education tidbits, and patients have the opportunity to have their questions answered by a nurse who works in our department. So it's a nice way for the patients to feel connected to the place that they're going to give birth beforehand.
SPEAKER_06That's fantastic. And I'll be sure to get the links from you that we can put in the notes of this episode.
SPEAKER_05Great.
SPEAKER_06So if I wanted to check that page out, I can just go find it and scroll through and take a look.
SPEAKER_05Yes, absolutely.
SPEAKER_06Okay, now we're ready for the big moment. Can we discuss labor and delivery? Uh describe the setting, what happens when you first get there and you're in labor and you're ready to go.
SPEAKER_05Sure. My background is actually a labor and delivery nurse, so I feel like I can answer this question pretty well. We have two departments. Labor and delivery is its own unit. So you will have your baby on that unit and you'll recover for a couple hours there. And then you'll spend the bulk of your time on our postpartum unit where the nurses are experts in babies and education. So you very much learn a lot there.
SPEAKER_06So after you deliver, you're you're going to be continuously getting educated while you're there because it's a relatively short time that you're going to be in the hospital with your baby with professional support there. About how long is an average stay after delivery?
SPEAKER_05So it's personalized to everyone. It can depend on what type of delivery you've had, if there's any complications. But generally speaking, if you have a vaginal delivery, it's about two days, and a C-section is three to four days.
SPEAKER_06Okay, now COVID has thrown a bit of a wrench into the works as far as visitors go overall at hospitals all over the country. What's the deal now, you know, when you're going to go deliver a baby? Is your partner allowed to be there, your coach or a visitor?
SPEAKER_05Oh, absolutely. So on labor and delivery, you are allowed to support people at all times. We know babies like to come at 3 a.m. and that's okay. Um, so you can have those two support people with you at all hours. Once you've delivered and you've been transferred over to the postpartum unit, your primary support person, whether that's your spouse, a partner, maybe it's your mom, whoever that is, they can stay for 24-7. Also allowed one additional visitor during our visiting hours of 10 to 8.
SPEAKER_06That's great. We're getting back to normal, and that's really good news.
SPEAKER_05It's so nice. We would encourage you to take a maternity tour. They are online and join our Facebook group because that's where we post the most up-to-date information. So if anything changes with the visitor policy, we really like our patients to know first.
SPEAKER_06Great. That's great advice. Because of course, everything is subject to change and everything will be available and always updated on the webpage, correct? On HartfordHealthcare.org. Yes. Okay, now, Mary, uh, you had mentioned after delivery that you wanted to talk about the benefits of rooming in. So baby stays with mom, correct?
SPEAKER_04Absolutely. Um, that is the way to go right now, and that is the standard of care here at Hartford Hospital. And actually, I would say at most hospitals today, the standard of care is that the baby stays with you in the room. And really, the um evidence shows us that not only for um mom, she learns about her baby, but actually the baby learns about mom, and they become much more in sync with each other and getting into the rhythm of what the needs of the baby are and what the needs of the mother are. But um I do want to make it very clear that safety comes first, and if someone's had a very long labor or they're just um been up for many days before they come into the hospital, we always are gonna look at that to make sure the mom's ready to be able to take care of her child, or the family is a partner could be in the room, so again, the family could learn to become a family together and to integrate this new child into their family, and that's whether it's their first baby or whether it's their third or fourth baby, getting to know this new person, they get to know each other's cues, whether it's for feeding or I need a diaper change, or mom's up in the middle of the night and she's wondering, where is my baby? What's my baby doing right now? So, yes, uh rooming in is the standard of care.
SPEAKER_06That's wonderful. And what about skin to skin right after delivery? Is that a standard of care?
SPEAKER_04Oh, absolutely. Um, and again, here at Hartford Hospital, it certainly is, and I think most um hospitals are really encouraging that because the benefit of that is it's coming to the mother and the baby, keeps the babies warm, and uh bonding starts immediately. And I will even go as far as saying that when um the mother's not in a position to have skin to skin, we allow the partners to do um the skin to skin so the baby has that connection right after being born.
SPEAKER_06Oh, I love to hear that. And for anyone listening who maybe is an expectant parent, there is nothing like it in the world as that skin-to-skin bonding right after birth. It's it's a beautiful thing.
SPEAKER_05That first you know, couple minutes of having that seven-pound baby right on your chest, there's literally no better feeling. Absolutely.
SPEAKER_06Let's say mom needs a C-section. Is the skin to skin and rooming in still the standard?
SPEAKER_04Oh, um, absolutely. But there are some circumstances where if a mother doesn't have a partner, uh, we would take the baby to the nursery when she needs a break, when she needs a rest, and we want someone to be there that could help her in case the baby needed attention quickly after she had major surgery of a C-section. The other thing I wanted to just mention about that is when it comes to needing medication, whether you've had a vaginal birth or a C-section, if you're really exhausted and you need some pain medication, sometimes it's not the ideal situation to keep the baby in the room. And that's what our professional nurses are here to do, to really help you make that decision and make that decision of whether you can have the baby in the room and whether it's safest for you and the baby to just have a few hours of rest.
SPEAKER_06Right, and time to heal. And you had mentioned something in our talk off the air about um a risk of falls. And you know, I hadn't really thought of that with new mothers, but now that you mention that someone might have just had major surgery or be on pain meds, I guess risk of fall is something important to avoid.
SPEAKER_04Absolutely. It's in important for the mother getting out of bed and maybe having a folded catheter and some IV and that getting up for whatever she needs, whether she's having a lochia flow or needs to freshen up. And we're very much concerned also about the uh baby if mom is holding the baby in breastfeeding, because we do know that breastfeeding uh releases a hormone which ma makes mom even more sleepy. Again, if we think that there might be uh a baby at risk for a fall, we would say that this is a risk factor, and we really need mom to get her rest and to be able to process through what's happened to her in terms of the birth and the labor.
SPEAKER_06So perhaps a break for mom in some circumstances a break away from baby is the best course of action.
unknownCorrect.
SPEAKER_06Now, in some cases, mom and baby might need to be separated if the baby is required to be in the NICU, correct?
SPEAKER_05Yes.
SPEAKER_06And then how do you handle that? Does mom just visit with baby in the NICU? Does the baby leave the NICU or is it just per circumstance?
SPEAKER_05Um the mom is once she is up and able, she can go down to the NICU, which is located one floor down. It's actually Connecticut Children's Medical Center, NICU. So she can visit at all hours and her partner can as well.
SPEAKER_06What a great partnership we have with Connecticut Children's with Hartford Healthcare.
SPEAKER_05Absolutely. We work very closely with them.
SPEAKER_06Now, if your baby is in the NICU and you choose to breastfeed, how do you handle that?
SPEAKER_04Well, I think um that's where we shine here at Hartford Hospital. We have our Vabern delivery nurses who will um help protect mother's milk supply by immediately teaching them how to hand express their milk and start to pumping the breast so the baby could get that first initial colosterum, which is so high in antibodies, and protects the baby and helps the baby as the baby is healing from whatever the baby needs to heal from and why they're in the NICU. So that's one of the many benefits of skin to skin and early breastfeeding.
SPEAKER_06And in that case, then if the if the mother is encouraged to pump and provide the breast milk for the baby is fed uh via bottle in the NICU?
SPEAKER_04Well, that's a very good question. Um, we like to protect the baby and mom from getting to know each other a little bit better. So we're gonna use some alternative methods. We would actually use a little syringe, we could use a spoon or a cup. And the major reason we want to stay away from a bottle, which is often misunderstood, is when we bottle feed, often food comes out very quickly and in a high quantity. So the baby gets full quicker. But the real thing about trying to avoid a bottle is that we would miss a baby cue because the baby is so full with maybe a formula. But if it's just the small aloquats of breast milk, we're gonna syringe feed that baby and just give little drops at a time, let the baby swallow it down, and then all those wonderful antibodies protects the baby's gut.
SPEAKER_06That is fascinating. Would you call that a newer approach?
SPEAKER_04It's on the newer side, and I will say that's why we called it. Uh, colostrum is gold to the baby. Um, it's like the gold standard for the baby. The biggest, newest thing is when we talk about a baby being a nit the NICU is taking the little drops of breastfeeding, even on a cotton swab, like a Q-tip, and swabbing the baby's mouth. So we really want to um get the mom and baby together as much as they can during that time. So, yes, using alternative feeding methods really is something that's been more in the last probably 10 to 15 years.
SPEAKER_06That's so interesting. Is this something that mom and and maybe her partner could continue for the next few days at home?
SPEAKER_04Oh, that's a very good question, actually. Um, when we're using alternative feeding methods just short term, the goal is, and it depends on what mom's goal is, quite frankly, if her goal is to use her breast milk and she wants to pump her breast um and that's the way she's gonna supply the breast milk, then we would transition to a bottle because that is a very efficient way to feed a baby. Okay, so if her goal is is to keep the baby on the breast, we would probably keep those alternative methods for the first two or three days. But we really look at um the uh benefits for the baby as well as for the mom and how easy it is to use some, or maybe not so easy for the family.
SPEAKER_05It's very individualized to the patient, thank you. And her preferences.
SPEAKER_06Okay. And so let's talk about just standard breastfeeding. And for first-time moms, they're gonna need some coaching. And can you tell us about some of the challenges? I know there are some. We we've pretty much covered the rewards. Oh my gosh, how valuable that is. It is like liquid gold for that baby. But what are some of the challenges mom might have in those first few days?
SPEAKER_04I think probably one of the biggest challenges is the reality of how often a baby wants to feed and to understand newborn feeding behaviors. A baby will eat when the baby wants to, and it could be every hour, and it could be every three hours. And often you're gonna hear uh the professional staff, whether it's the OB, GYN, our pediatrician, or our nurses say, Oh, your baby has to eat eight times in a day or every three hours. Well, babies don't know that, and babies just say, I want to eat what I want to eat. So it could be an hour after being on the breast, or it could be three hours. That could be a challenge for some people because we hear so often every three hours. So as an adult, we mathematically calculate that out to eight times a day, every three hours. Oh, but the baby wants to eat in an hour and a half. What do we do? That's a challenge for many people.
SPEAKER_06Or if you have a sleepy baby, the fear of my baby's not getting enough. And there there are ways of determining that while you're still in the hospital, right? You guys know if the baby's getting enough.
SPEAKER_04Absolutely. And I want to assure people that our hospital staff would really make sure that a baby is getting enough by the number of times the baby is feeding, how many peas, and how many times they're having a dirty diaper. That really helps us along with their weight throughout the hospital stay.
SPEAKER_06Great. What about parents who choose to or for whatever reason cannot breastfeed?
SPEAKER_04Well, that's a another very good question. And I want to at this point say that uh we're a baby-friendly hospital, and what that means is that we're going to protect, promote, and support breastfeeding, but the tail end of that is it's an mom's informed decision of using formula or however she wants to feed her baby. So really it comes down to the mother's choice. And very often we'll have someone who comes in to say, Well, I want to breastfeed, but I also want to use formula. Formula too. Is that okay? And of course it's okay. It's the mother's decision, it's her choice. We are here to give her the education to how to get the best that she wants for her baby and her long-term goals. What does she need to do in the short term to get there? And sometimes a choose formula to help her get to her goal.
SPEAKER_06It's really mom's call, of course, in the end, and you you will support whatever decision they make.
SPEAKER_05Absolutely. Wonderful.
SPEAKER_06Okay, now it's the big day. It's time to take baby home, which is very exciting, but it can be a little scary and intimidating too. What does discharge from the hospital look like?
SPEAKER_04Well, hopefully people are feeling confident enough with the education they got from the postpartum nurses. Not only how to take care of yourself and your bodies and all the changes that are happening with you, but uh the car seat safety, um, feeding the baby, that's often a very big concern. And actually, actually, probably it's one of the biggest factors that create anxiety for mothers. So we do have a lot of additional resources that we would offer, but getting someone out the door and feeling confident, hopefully we've done that by giving written instructions that they're gonna have, and then we have other resources after once they go home too.
SPEAKER_06Great. So baby goes home with an instruction manual? Just kidding, just kidding. If only. Is there a defined amount of time that mom is considered postpartum?
SPEAKER_05Traditionally, postpartum was defined as the first six weeks after delivery. That's why you see everyone going back for their OB checkup at six weeks. Um that was really the term um or the time frame that we've traditionally used. But now we define postpartum as the first three months after delivery, and we often refer to it as the fourth trimester.
SPEAKER_06Oh, I love it. That's a great phrase. Okay.
SPEAKER_05It is. Um, it's the time of healing and body changes and fluctuating hormones, and on top of that, you're trying to integrate a whole new human into your life.
SPEAKER_06That's a huge responsibility, and in that postpartum period, we need to really keep our eye on the well-being of mom as well. We hear about postpartum depression, that's a big concern, correct?
SPEAKER_05It is. The term is actually perinatal mood disorders. So there's a lot of mood disorders during the postpartum period. It can be depression, it can be s simply baby blues, it can also be postpartum anxiety or postpartum OCD. So um we use the term perinatal mood disorders.
SPEAKER_06That's interesting. And how can mom or maybe her partner go about helping to identify that?
SPEAKER_05Normally the patient herself might be able to identify, gosh, I'm just not feeling right. Something is off. But oftentimes it's the other person in the house, it's the support person who notices these subtle changes and should have a conversation with their spouse um or partner and say, like, hey, I I I feel like you're not eating, you're not sleeping, you're having difficulty concentrating. How are you feeling? So it's normally the the support person who actually notices first.
SPEAKER_06Sure. And if that's a concern, where does mom turn? Would it be to her obstetrician?
SPEAKER_05Yep, absolutely. It should be her healthcare provider. Um, she can also start to do some things at home first while she's waiting for that appointment, making sure that she gets enough rest, eating appropriately, spending time with people who lift her up, um, and just making sure she feels supported.
SPEAKER_06Okay, and hadn't you mentioned before that um that there is a postpartum support group?
SPEAKER_04Yes, I'll I'll let Mary talk about that. Um we have one that we really call it the breastfeeding uh support group. However, I will say that the support goes beyond breastfeeding. It really talks about moths get to share their birth stories, they get to share what challenges. And I think one of the best things about the Facebook support group is that if a mother is up at two o'clock in the morning, they get to talk to each other because they go on Facebook and they could look at Facebook. Um and that is really such a benefit to the moms who join that, which is a closed group, because we do talk about more personal, intimate things such as breastfeeding and breast care as well as sleep too.
SPEAKER_05That support group actually has 4,000 members, which is really awesome.
SPEAKER_06Wow. What a great resource because it's relatively new where moms could be up at any given time of the day or night or have questions that they don't want to burden their partner or friends with. That's fantastic.
SPEAKER_04And I really think the benefit is it's really focused on mother-to-mother. Although we do uh moderate it and we look for uh people who may be having really difficult uh challenges uh with their mood and with their adjustment. And if we see something like that, we can also give some resources as a professional right on the Facebook page, also.
SPEAKER_06Oh, that's great news. I thought we could start to wrap it up with a class that Jen, I believe you're presenting. It starts in June and it's called Fourth Trimester and Postpartum Wellness. Can you tell us about it?
SPEAKER_05Yeah, I'm so excited. Um, myself and another registered nurse lactation consultant have designed this class for the mom and her support people to take late in pregnancy, and it really consists of postpartum planning, maternal mental health, what we were talking about before and how important that is, common baby struggles around sleeping and eating and crying, and then a big part of it is how to ask for support and where can you find it. So it's gonna be an awesome class. I'm so excited about it. I feel like we've poured our heart into it, so we're ready for it to start.
SPEAKER_06Fantastic. Now it's a virtual class.
SPEAKER_05It will be virtual. So it's the two-session class. Uh, one day focuses on mom, and then the second day focuses on those baby common struggles and your partner and how to have communication with them.
SPEAKER_06Excellent. And is it open to the public? Can anyone join this?
SPEAKER_05It is. Actually, um, there is no other program like it in the state. So um we we're definitely gonna push it out to everyone, including all of our other Hartford Healthcare hospitals.
SPEAKER_06Fantastic. So we want to be sure to spread the word for that. I will post a link in this episode's notes where you can learn more or register to join those two classes. That's exciting.
SPEAKER_05It really is. Thank you.
SPEAKER_06Okay, well, Jen and Mary, this has been just the perfect topic for Mother's Day. Thank you so much for joining us.
SPEAKER_05Thank you for having us. Thank you.
SPEAKER_06Happy Mother's Day to you both.
SPEAKER_05You too.
SPEAKER_06Thank you, Jen and Mary, and all the amazing moms out there. Make sure to share this episode with the moms or moms to be in your life. And don't forget to check the links in this episode notes for those amazing support groups and classes available. And follow more life to be notified every time a new episode drops. Just search Hartford Healthcare on your favorite podcast platform. For Hartford Healthcare, I'm Enron DePierre. Thanks for listening to More Life.
SPEAKER_01I'm ready for my go.