Spring 2017 – Past and Future Reflections….

There are countless ways that birthing women have touched my life and provided me with inspiration through my own trials. The end of 2016 and earlier part of this year brought challenges of a lost car and an injury. Both resolved with good endings and affirmed my belief in community and the importance of positive thinking. In the later challenge, an occupational hand therapist encouraged me to let go of fear and reframe injury pain to that of strengthening, healing sensations. Enabling me to persevere through uncomfortable exercises and over time, to notice improvement. My wonderful family and friends from near and far provided needed distraction.

My gratitude also goes out to Aleka Stobo RM (Coast Midwifery), Andreia Situm RM (Babease) and Zahra Khoddamy RM (On-The-Drive-Midwives OTDM) that provided services to my clients in March and April, while I recovered and could only do clerical work. I am pleased to say that I am now enjoying being completely back to work, supporting mums, their significant others and welcoming their babies in my practice and a colleague’s practice that I provided homebirth back-up services.

While I was recuperating, I was able to compile last year’s statistics. In the interest of continued transparency that I begun in an earlier post (August 15, 2016) and because, I intend to honor all experiences, including those that are little known or acknowledged, I share the following:

Midwifery Care North Shore (MCNS) provided 42 women a full course of care in 2016.

Out of these clients –

76% had a vaginal birth with only a midwife and second attendant, 56% of these births occurred in hospital and 20% took place at home.

We had 4 clients wanting a vaginal birth after a caesarian (VBAC), 2 resulted in vaginal birth and 2 had to have a caesarian delivery.

Our assisted birth rate, where a midwife is in a supportive role and an obstetrician is the most responsible provider was approximately 24%. There were 2 vaginal breech births included in this statistic and 9 caesarian sections, 1 that was elective and 8 that occurred in labor.

Regardless of type of birth – 41 babies had skin-to-skin in the first hour of birth,
38 babies were exclusively breastfeeding at their 6-week discharge visit and 3 were mixed feeding with breast milk and formula. Breastfeeding is a dance that most women and babies learn to do well within a couple of weeks. Some women and babies are challenged. In these circumstance, we encourage a woman to define her own breastfeeding success and to enjoy nurturing her baby in whatever manner she can and considers best.Going to a postpartum group and connecting with other women that have had a hard dance can be helpful. One place to go for support is Family Services of the North Shore Postpartum Group that takes place on Thursdays from 10am – 12pm at North Vancouver City Library. There are also drop-in groups run by Vancouver Coastal Health at different locations. One privilege of providing midwifery services is the opportunity to walk with women and their families through unexpected situations in pregnancy, labor and with their babies.

We sadly had a term baby that died with no explanation in utero last year. Our hearts go out to this baby’s parents with continued condolences for their loss of their daughter. Through this family’s experience, we discovered first hand hospital activities, organizations and resources that assist with loss of a child during pregnancy and infancy. These circumstances are particularly tragic for all concerned, due to the rarity, unexpected and unexplained nature of late fetal death. To provide some perspective, according to Statistics Canada, roughly 380,000 women give birth in Canada a year. Approximately 3,000 of these are noted as stillbirths, making the rate less than 1%of all births.

‘Enduring Love’ is a Memorial in Victoria Park, North Vancouver to remember babies ‘born sleeping’ and other children ‘lost from sight’ that live in bereaved parents hearts – North Vancouver Compassionate Friends Group – contact csosnowsky@shaw.ca

Continuing education is part of life. Currently, I am learning about Front End Speech Recognition in preparation for VCH electronic health record platform that is planned to be launched at Lions Gate Hospital the end of the year. I see benefit in communication and improved individual care, when the system has been well implemented and integrated. In the mean time, I trust that women and families will be patient with healthcare providers, as we become familiar with electronic hospital charting.

Waiting for labors to begin and babies to arrive is hard. I find creative outlets that still my mind helpful. Amigurumi, a hobby that began in South Africa a year ago continues to be a source of fun and an expression of affection. My crochet menagerie has expanded to include other critters and crochet ‘peeps’.

Looking forward, my 2017 course-load continues to be 3 to 6 clients a month during months that I am working. I anticipate a busy end of spring and summer, before I once again travel with my husband and dear friends in September and early October. Zahra Khoddamy RM (OTDM) and MCNS office assistant Jazzmin Nagy will be looking after the practice in my absence, with my North Shore colleagues in the background. On my return, I will be pleased to attend women in care that are due the end of October, November, December 2017 and those yet to be taken into care that are due in 2018.

In June 2018, Midwifery Care North Shore will be celebrating 20 years of providing services to North Shore women and others that have been prepared to travel.   Currently, over 900 women and their families have used our services.   We intend to plan a party …