Improving Regina’s Birth Experience – Survey Results!
As many of you may know, I am an active supporter of improving Maternal Mental Health across the province and am currently working on a few different projects that will help increase awareness for PPD/ANXIETY but also, help families that are affected receive prompt and effective support in order to regain their overall health. With that said, I recently created a survey titled “Improving Regina’s Birth Experience” and received an overwhelmingly positive response, which included 147 mothers who were willing to share their opinion in hopes to identify some basic, practical changes we can work on to improve how we support our new mothers during birth and into the postpartum period, which will ultimately improve Maternal Mental Health.
I currently sit on the RQHR Maternal Mental Health Committee, and this past Friday we met to review the ongoing initiatives and goals we have set up across the province. I was able to share the survey with the team and it created a very positive dialog at the table. So, I wanted to share some of the keys results from the survey with all of you as well as, how and what I presented to the committee just to keep you in the loop with what my goals are with Family First in this department. Below you will find some of the key findings you submitted and what a bit of the conversation looked like!
So first off let’s break down the key findings. I didn’t include everything at the meeting although they did receive a copy of the survey itself. I wanted to focus on the practical improvements we could be making that would benefit the new mother.
Question 1- Arriving on the unit
1. Over all welcomed on the unit which is a positive!
Question 2- Care during Labour
1. Were you asked if you had a birth plan? 45.31% said NO. Room for improvement.
2. Comment: Not being able to squat or choose birth position. What is currently being done or what can be done to improve the choice of birth positions?
3. DISCUSSION: I reminded the committee that the research is showing that most woman report a positive birth experience when they feel their voice or birth wishes are LISTENED to, not if their plan unfolds exactly like they had planned. With that said, I think if we could get the nursing staff to consistently asking in a supportive manner when a couple arrives on L&B if they have a birth plan, that would absolutely validate and encourage the couple in such a way that they automatically feel the medical staff is aware and supportive of their wishes. A simple question could go a long way in setting the tone of the relationship. As per birth positions… yes this is important and I did discuss it, although I think there are other committees throughout the RQHR that could make better use of this info.
Question 3 Pain Management
1. 34.43% said that they were NOT given multiple options for pain relief.
2. Comment: Felt the use of drugs to augment/speed up her birth was technically her choice but at the same time, she felt rushed and that there wasn’t much option. She says her nurse was awesome but, there was an underlying feeling of the unit being very full and that her delivery needed to happen sooner than later.
3. DISCUSION: What can be communicated with the nurses on how to handle the extreme demand without having moms feel like just another number? Not much for immediate resolution on this one which is completely understandable and we are at the starting line.
Question 5- Breastfeeding after birth
1. 40.35% said NO, they did not receive assistance with breastfeeding immediately after delivery.
2. DISCUSSION: They found this one quite surprising as sometimes they hear that nurses are pushing breastfeeding on new mothers more so than not offering help. I discussed my experience as a labour doula and how once the baby is born, there tends to be more priority set on clean up and getting the room together rather than taking the time to help the mothers begin to nurse. At the same time I don’t think it’s due to lack of caring but more of a practicality that they have over 4000 births a year and are way to full. But once again a little goes a long way and maybe there is room for having this discussion with the nursing staff. Lots of times there tends to be 3 nurses in the room but they may all be discussing the same thing where as one should be paying more undivided attention to the mom, even if it a short time. Quality vs quantity. They have started a new FCC program where they do have a dedicated nurse to help moms, especially during recovery from C-section, to have skin to skin and begin breastfeeding. So far a very positive feedback and are hoping to expand.
Question 6- Breastfeeding basics review
1. 47.37% said they were not told about the basics of breastfeeding including proper latch, supply and demand and what to expect in general. ROOM FOR IMPROVEMENT!
2. DISCUSSION: This one is directed more towards the nursing team on Mother/Baby. From my experience and was also mentioned often in the comments, that Mother baby unit felt rushed and mothers were not getting adequate supports. A simple review of the breastfeeding basics is essential! Not feeling comfortable with infant feeding can be extremely overwhelming and can be a major contributor to postpartum anxiety once the mother is home. If we can improve on breastfeeding education and begin routinely reviewing the basics and what to expect over all with new moms, we can help elevate the stress a new mom experiences as she begins to breastfeed.
Question 7- Milk Supply/ Formula
1. 18.75% said they were told to supplement with formula because there milk hasn’t “COME IN”
2. DISCUSSION: This seems like a really high number when research is showing that new moms who cannot physically breastfeed due to medical reasons is less than 10%. Nurses should really not be suggesting formula at any point and that patient should immediately have access to an IBCLC if problems arise. Infant feeding overall needs to be held at a higher priority. If there was any other problem with anew bon they would immediately be referred outward, same should apply here.
Question 8- Overall breastfeeding experience
1. 37.94% said they disagreed or strongly disagreed that the hands on support was gentle and mother led.
2. Comment: Quote “ All but one nurse would come in and grab my daughter by the back of the head, grab me by the breast and smooch the two of us together” “ It was so unhelpful and degrading”
3. Comment: Different advice from different nurses. No consistency with breastfeeding education.
4. Comment: Tongue ties not being checked for and diagnosed.
5. DISCUSSION: Once again the theme here is increased breastfeeding education for the nurses and increase access to IBCLC’s
Question 9- Overall experience/ Mental Health
1. 38.67% said they did not feel there overall hospital experience left them feeling positive in their mental health and confident as a new mother, ready to bring their new baby home.
2. This number is much higher than it should be but, if we are able to work on some of the goals outlined above I’m hopeful that this number would decrease significantly.
So thanks again to everyone who filled out the survey. This is just one helpful step in the right direction of improving Saskatchewan Maternal Mental Health! I am working hard and will be out an about in the community over the coming months talking about all things DOULA but a strong component of the work I will be doing is educating my clients and the general public about the realities of PPD/Anxiety, how to reduce their risk factors and of course providing information on the resources we have available when help is needed. There are a few things coming down the pipeline that aren’t quite ready to launch yet so, you will have to keep an eye out on the Facebook page for details as they come up! In the meantime if you or someone you know is expecting a new baby and would like to be better prepared for the postpartum period or is currently going through PPD and needs some extra help figuring out a game plan, please don’t hesitate to contact me at firstname.lastname@example.org and I would be more than happy to help in any way I can!