Category: Post Pregnancy

Babies Have Back-to-School Needs, Too

by, Summer Hunt

This time of year from late July into August, many moms are preoccupied with back-to-school shopping for all the basics: pencils, paper, glue and the like, as well as products like paper towels, hand soap and facial tissue. Just as these items are important for school-age kids, babies and toddlers have “back-to-childcare (and preschool)” needs, too—and diapers top that list.

Did you know that babies and toddlers can’t attend childcare without an adequate supply of extra diapers? It may not seem like much, but for the 1 in 3 families who don’t have enough diapers to keep their babies clean, dry and healthy, buying extras typically breaks the bank. Without enough diapers, parents are forced to choose between work—and a paycheck—and taking care of baby.

The Harsh Realities of Poverty
Diapers cost $70-$80 per month, per baby, and parents can’t use food stamps for diapers—in fact, there is zero direct government assistance for diapers. Low-income families can’t afford to buy diapers in bulk, and many do not have access to big-box discount stores or online shopping. This means families hurting the most financially are hit hardest when it comes to buying essential care items like diapers. In fact, the poorest 20% of Americans spend nearly 14% of their income (after taxes) on diapers, according to the National Diaper Bank Network (citing 2014 government data)—that’s $1 out of every $7 of their average $11,253 income spent on diapers, or $1,575 a year on average.

Parents just want to do right by their children. We spoke with four moms last year who talked about their experiences with diaper need. These families are doing their best to keep their babies happy and healthy, even if that means going without or making tough decisions about paying other bills. And with 5.3 million babies in America living in low-income families, these moms are not alone in their struggles.

Nurses on the Front Lines
AWHONN is proud of all the work our nurses to do to take care of moms and babies, especially those in the most vulnerable populations. Our Healthy Mom&Baby Diaper Drive gives nurses the recognition they deserve when they go beyond patient care and collect items like diapers, wipes, clothes, car seats for their tiniest patients.

Across the country, at section and chapter meetings, through community baby showers and diaper drives, when donating diapers to diaper banks and women’s shelters, and in their own hospitals and clinics, nurses are on the front lines every day combatting diaper need for their patients.

Let Us Share Your Efforts!
What are YOU doing in your area to make sure that babies are clean, dry and healthy? Are you:

  • Giving out diapers at community and education events?
  • Participating in a diaper drive event with your local faith community or civic group?
  • Sharing diapers with families in need in any other way?

Tell us your stories at AWHONN.org/diaperdrive, or contact our Diaper Drive consultants Jade Miles and Heather Quaile. Our consultants can also help you increase your efforts or start something new and make sure that your current successes are counted in our final totals. You can also visit DiaperDrive.org to make a dollar donation that will be used to purchase diapers at wholesale for diaper banks across the country. Are you an advocate for cloth diapering? There are several diaper banks that accept cloth diapers, and you could even initiate a cloth diaper drive in your community!

As families everywhere get ready to head back to school, why not toss an extra pack of diapers into your cart to donate to your local bank? Or, head over to DiaperDrive.org while surfing the Internet for prime deals on books and binders and donate $20 dollars to diaper a baby for two weeks. You’ll ensure a brighter future and a better bottom line for babies everywhere—and that’s a guaranteed A-plus in our books.

Nurses Make Change Possible for Babies_1

Summer HuntSummer Hunt
Summer Hunt is the editorial coordinator for publications at AWHONN

Five Easy Steps to Save Lives and Promote Healthy Families

by, Donna Weeks

It’s staggering to think that 54 to 93 percent of maternal deaths related to postpartum hemorrhage (PPH) could be avoided.

So what can we do on our units to reduce the number of women with complications, or even death, from an obstetrical hemorrhage?

I have taken part in many discussions about high tech simulation and drills, and we are always asking ourselves:

  • How can we have effective drills without a simulation lab and simulation models?
  • Can low tech simulation play a beneficial role in decreasing obstetrical hemorrhage?

I recently took part in a pilot program that the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)  trialed on postpartum hemorrhage risk assessments, evidence-based oxytocin orders, and hemorrhage drills and debriefing based upon a variety of settings.

Here are a few ideas that I have implemented without utilizing a simulation lab. These easy suggestions may help every obstetrical unit  raise awareness of obstetrical hemorrhage and contribute to decreased maternal morbidity and mortality.

First, have a mock code on your unit using your own crash cart.  You may be surprised to find out how many nurses are uncomfortable with finding key items in your crash cart.  Use a pillow to simulate a gravid uterus and have one nurse demonstrate left uterine displacement while other nurses deliver compressions and ventilations.  Additional nurses may find supplies, IVs, and medications in the code cart.

Second, devise a scavenger hunt and ask your staff to find the closest location of items needed during an obstetrical hemorrhage.  In many units the OB techs check the hemorrhage cart and the nurses may be less familiar with the items on the cart.  They may be leaving the room to get supplies and medications that are already on the cart.  In a true emergency this will use up valuable time.

Third, consider efficiencies. Do you have your medications locked in a Pyxis or Omnicell?  Do nurses have to remove the uterotonics one at a time? Due to the awareness raised by our hospital’s participation in AWHONNs postpartum hemorrhage project,  the day after our medication administration system was installed our pharmacy was notified that we needed a postpartum hemorrhage kit.  Now with one selection we retrieve ergonovine maleate (methergine), misoprostol (cytotec), carboprost (hemabate) and oxytocin (pitocin).

Fourth, how do you drill? What about drills in an empty patient room?  Have a drill in a patient room with nothing more than a mannequin.  Change the scenarios and include the less common situations.  With a type and screen being completed on most admitted labor and delivery patients it is not common to be ordering uncrossedmatched blood.  I use a scenario that includes a woman presenting to L&D with an obvious hemorrhage. This scenario presents the opportunity to review how and when to retrieve uncrossmatched blood.  What is your procedure?  Is there special paperwork or forms?  During one drill we strongly stressed the time element including how quickly we could generate a medical record number and how much time would be lost if an OB tech was sent for the blood. In our institution uncrossmatched blood may only be released to a physician or nurse.  Take the scenario further and include your massive transfusion protocol.  Review when and how to initiate the protocol.

Lastly, practice quantification of blood loss until it becomes routine.  Use scales, work sheets, and a variety of scenarios to keep staff informed and interested.  These can be presented by a charge nurse on any shift without preplanning.  It is just one more way to keep obstetrical hemorrhage on the forefront of everyone’s mind.  The more awareness we raise the better chance we have of early recognition and intervention. The goal is to have a healthy mother and healthy family.

DonnaDonna is a Perinatal Clinical Specialist at JFK Medical Center in NJ.  She has always loved OB nursing and also enjoys teaching.  She is currently an adjunct instructor at Kaplan University and Walden University.  She was the Hospital Lead for AWHONN’s PPH Project.

 

 

Citations

Berg, C. J., Harper, M. A., Atkinson, S. M., Bell, E. A., Brown, H. L., Hage, M. L., . . . Callaghan, W. M. (2005). Preventability of pregnancy-related deaths: Results of a statewide review. Obstetrics & Gynecology, 106, 1228–1234.doi:10.1097/01.AOG.0000187894.71913.e8

California Department of Public Health. (2011). The California pregnancy-associated mortality review. Report from 2002 and 2003 maternal death reviews. Sacramento, CA: Author. Retrieved from http://www.cdph.ca.gov/data/statistics/Documents/MO-CA-PAMR-MaternalDeathReview-2002-03.pdf

Della Torre, M., Kilpatrick, S. J., Hibbard, J. U., Simonson, L., Scott, S., Koch, A., . . . Geller, S. E. (2011). Assessing preventability for obstetric hemorrhage. American Journal of Perinatology, 28(10), 753-760.doi:10.1055/s-0031-1280856

Resources

Get free postpartum hemorrhage resources from AWHONN.

Learn more about AWHONN’s Postpartum Hemorrhage Project

For more in-depth info and to learn more about how to reduce clinician errors associated with obstetric hemorrhage mortality and morbidity, join AWHONN’s newest implementation community on Postpartum Hemorrhage.

Cora’s Law

by, Elizabeth McIntire

In northern Indiana in November of 2009, Cora McCormick was born–a full term apparently normal newborn. Her parents were thrilled at the birth of their first child. Her mother had experienced a perfectly normal pregnancy, labor and delivery. Cora took well to nursing and the new family went home from the hospital 48 hours after Cora’s birth.  Cora, her dad and mom Kristine spent three wonderful days together– until tragedy struck.

Kristine was nursing Cora when suddenly her baby girl turned blue/gray in her arms and stopped breathing. They rushed their newborn daughter to the hospital but nothing could be done. Cora died at five days of life. Cora’s cause of death was congenital heart disease.

Shortly after Cora died, her mother took up a crusade to make congenital heart defect screening in Indiana required as an addition to current newborn screening.

Due to Kristine’s efforts, in January 2012 “Cora’s Law” was passed by the Indiana legislature and required hospitals to screen newborns for critical congenital heart defects.

This is where I got involved. Prior to the law going into effect, perinatal providers throughout the state needed to become aware of the law and how it impacted newborn screening. I was responsible for developing an education program for these providers. As we were gearing up for implementing this law, I had the good fortune to meet Kristine McCormick, witness her advocacy for this screening and witness a mom who’s own heart was broken turn her grief into something truly amazing. I knew that if we could use Cora’s newborn picture—that of a completely healthy looking cubby cheeked baby girl, it would make an impact as we talked to physicians and nurses about the importance of the screening and new law.

Baby Cora

Baby Cora

Kristine gave me permission to use Cora’s picture in our educational presentations and in a postcard I helped develop with the screening algorithm on it. Fast forward to February 1st, 2012, one month to the day after Cora’s law went into effect. On that day a baby boy, Gabriel, was born in southern Indiana. He too looked perfectly normal—like Cora. However, before he went home he underwent the screening that Cora’s mom advocated for. The screen was abnormal. The staff at the hospital repeated the screening and again, he failed. With the screening algorithm at hand, they knew what to do and he was transferred to a quaternary center for management. He was diagnose with a critical heart defect and underwent emergency surgery to correct the issue. He did well postoperatively and was able to return home with his family.

Several months after surgery, Gabriel came back to Indianapolis for a routine postop checkup. It occurred to me that Kristine needed to meet Gabriel’s mom and Gabriel’s mom needed to meet Kristine. I wanted these two women to come together—both bound by motherhood, tragedy and victory. They needed to meet, to heal, hug each other, and share Cora’s baby picture, laugh and cry.

Mother to mother—each of them understanding that Cora Mae McCormick was the reason they were there, the reason Gabriel was wiggling in a blanket in Kristine’s arms. I watched as the local news channel filmed the event and next to me was one of the neonatologists who helped with the statewide teaching efforts. I leaned over and told him—“this is what it’s all about. This is why we do what we do”. It was and still is one of the most profound moments in my nursing career.

Click here for additional information on Cora’s Law. You can also find information on the Cora’s Story Facebook page.

To find out more about pulse oximetry screening, visit: http://www.childrensnational.org/PulseOx/ 

 

McIntire_Elizabeth_2015%5b1%5dElizabeth McIntire, WHNP,WHNP-C, EFM-C
Elizabeth is the Director Maternity & Newborn Health at 
IU Health Riley. Elizabeth started her career in obstetrical nursing and has never looked back. Besides her family, her passions are high risk obstetrics, perinatal safety, and high reliability, challenging the process and modeling the way.

What Children with FASD Want You to Know

by, Marilyn Pierce-Bulger, ANP

Jason is a 13 year old boy who knows he is different but he does not understand why.  He blames himself for the difficulty he has had in school and with social relationships over the years. He thinks he is not trying hard enough or is not smart enough.  His teachers and parents view him as willful, rather, than ‘unable’ due to his hidden disability. Continue reading →

Standardizing Postpartum Oxytocin Administration

13 Comments

by, Jennifer Doyle, MSN, WHNP-BC
Director, AWHONN Executive Board
APN, Women’s Service Line
Summa Health
Akron City Hospital
Akron, OH

Photo: Jennifer Doyle assessing and caring for fellow colleague Amy Burkett, MD, FACOG.

Somewhere in a Labor and Delivery unit, a woman gives birth.  A family is born. A nurse remains at the bedside.  A sentinel, who assesses, plans, and intervenes.  The nurse is equipped with knowledge and skills to holistically care for mom and baby.  The nurse’s primary focus is to promote bonding and breastfeeding. However, despite a safe birth, risk remains.  Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality.  It is often preventable.

As a labor and delivery staff nurse, there were countless occasions when I held vigil at the side of my patients after they gave birth.  I was prepared with an array of resources to treat PPH. In part, this included uterine massage, oxytocin, methylergometrine, carboprost, and misoprostol.   As a nurse caring for a woman in the immediate postpartum period, my goal was to assess maternal bleeding and avoid PPH, or treat early if it occurred.  I would often stand at the bedside, pondering how much oxytocin I should administer to this new mother, and for how long. Continue reading →

Top 10 Posts of 2015

When we launched AWHONN Connections in May of this year, we could not have imagined the response that we would have received from our members, nurses, parents and members of the media.

In less than a year our blog has received over 232,000 visits, from 167 countries and had 4 blogs republished on the Huffington Post! As the year comes to a close we want to say a HUGE Thank You to our readers and our bloggers.

Here’s Our 2015 Top Ten Round Up! Continue reading →

Top 5 US Airport Mother’s Lounges & Nursing Stations

The holidays are in full swing and that means a lot of busy moms on the go! Traveling during the holidays can be stressful and traveling with little ones can add more stress. Finding a private and/or quiet place to nurse or feed your baby in a busy airport can be like finding a needle in a haystack, luckily we’ve done some research for you, here’s a look at the Top 5 US Airport Mother’s Lounges/Lactation Rooms. Continue reading →

6 Tips For Postpartum Care for Mom “The Patient”

1 Comment

by, Kristen Wesley “The Mom”

Kristen and IslaThere is a moment after labor when you realize that not only is your sweet little baby a patient, but that you are too. At least for me, that was something that hadn’t really registered. On the day that my little baby girl Isla was born I very quickly began to understand we would both need a ton of care in the hospital and at home.

You would think from all the books I read, articles I scoured, and the numerous second hand accounts from friends I received, it would have sunk in. But it just didn’t. It literally never occurred to me that I’d be a patient too during and after labor and birth. Continue reading →

Take A Walk In My Postpartum Shoes (Part 2)

Dani_2See the first part of Danni’s Story posted September 1

by, Danni Star

After overcoming my PPD, I gave birth to another daughter and thought I knew what to look out for and was thankful not to experience the same intensity of symptoms again. What I didn’t realize is that PPD comes in so many different forms.

I went to lunch with a good friend after my second child was born. I don’t know why but I unloaded how I had been seeing my anxiety rise again, how bad it had gotten, my intrusive thoughts and how I literally kept thinking of worst case scenarios.

She urged me to go see a maternal mental health doctor. I took my time but the following week my anxiety was at an all-time high and I could feel myself falling apart so I called the doctor and she said she would squeeze me in that week.

A few days later I was in her office sweating profusely, heart racing so bad I felt like it was going to explode out of my chest and I couldn’t sit still. She asked a million questions and I answered them extremely honest. I told her that I felt anxious all the time, like a walking ball of nervous energy. That even at work when I am in my zone I still feel so out of place.

I told her that my biggest fears are losing my children, Slim, my husband, and Claire, my best friend.  I have literally dreamed all of their funerals repetitively- I don’t know maybe as a coping mechanism.

As I am saying these things, I still think she is going to tell me I just have anxiety and that we will get through it. I keep referring to “when I had Postpartum Depression.” I keep referencing how it felt then.

And then the bomb drops. She tells me that I am suffering from PPD. I instantly start bawling. No I am NOT, I had that before and this is different, I don’t want that. I can’t have that; it almost killed me and ruined my life and my marriage. I go to work, I laugh, I function…how is that possible?

She explains to me that all I know of PPD is the most severe, that I am experiencing moderate PPD. I feel hurt, angry, and mad at myself for not realizing, after all I have been here before. I think back to all of the things that I just described to her and I realize she’s right, if any of my friends would have told me what I told her I would have known instantly, so why didn’t I realize it about myself?

Instead, just like before, I will beat this. I will attend support groups, I will try my hardest not to only function normally at work. I will follow the doctor’s treatment plans and I will talk it out. I am scared, this is my biggest fear realized but I am going to be ok.
I WILL TO BE OK! My nemesis has returned but my fighting spirit will be its kryptonite.

Postpartum depression is my truth. An ugly truth that I just so happened to conquer and you can too. You are worthy so be open, learn what is going on and don’t be afraid to ask for help!

Danni Starr HeadshotDanni Starr
Danni Starr works daily as co-host of the nationally syndicated “The Kane Show.” Danni fell in love with radio at 19 and 11 years later, she still considers it her first true love. As a Mother and wife Danni is the “Den Mom” to the show & offers open, honest, opinions and advice.

 

GET SUPPORT

Postpartum Support International: 1-800-994-4773 or postpartum.net
National Postpartum Depression Hotline: 1-800-PPD-MOMS

REFERENCES AND LEARN MORE AT

AWHONN’s Mood and Anxiety Disorders in Pregnant and Postpartum Women Position Statement

http://www.health4mom.org/postpartum-depression/

Nurses’ Critical Role in Preventing Infant Sleep-Related Deaths: A Call to Action

2 Comments

by, Sharon C. Hitchcock

Did you know most infant sleep-related deaths are considered preventable? This is good news worth sharing! Because most babies are born in a hospital or birthing center, nurses are uniquely positioned to interact with virtually every new parent. This means nurses play a critical role in helping prevent these deaths. We know that parents trust us (we are the most trusted profession!), watch us, and listen to us. We have a responsibility to make sure we give parents safe sleep recommendations along with the evidence behind them. We have a responsibility to problem-solve with parents about accomplishing safe sleep situations, all while simultaneously respecting their right to decide what is best for their family. The bad news is too many babies are still dying. October is SIDS Awareness month and a perfect time for nurses to spread the good news and advocate for our smallest patients! Continue reading →