Natural Parenting in a Hospital Setting With a lifelong interest in natural therapies, and having two wonderful homebirths, including a planned breech, it was a bit of a shock to have to cope with the medical world with the birth of her third child. Rachael Forbes shares her story of retaining as much of the Natural Parenting philosophy in the alienating clinical world of Neonatal Intensive Care Unit (NICU) and then the Special Care Nursery (SCN). I squinted through blurry eyes and tried to shake my head to get a clearer view of my little boy encased in a plastic box. I wanted to scream “he shouldnt be in there”; I wanted to reach out to him; I wanted him where he should be… on my chest or, at the very least, on his Daddys chest. It all felt so wrong and so surreal. I was planning a homebirth for my third child, just as I had for my first two pregnancies and births. At 30 weeks I was admitted to hospital for observation, for bleeding due to placenta praevia. When I requested an early discharge I was told by the female intern that, “you and your baby could die” if I were to leave the hospital early. I was so shocked that I couldnt come back with a simple and reasonable explanation – I would get better nutrition and rest at home and, if I bled again, I could very easily come back. As it was, I did bleed off and on until I did actually go into labour at 34 weeks, with heavy bleeding. It was difficult for me emotionally to be at the hospital with my lifelong interest in natural therapies (I learned to massage at nine years old) and possibly there were some negative associations from childhood operations from the age of two. Parents werent allowed to stay at the hospital with their children at the time. Due to the political situation surrounding homebirth in Queensland at the time, instead of having my midwife with me, at the onset of labour I arranged for a friend to meet me at the hospital to provide support and help me negotiate the medical discussions. She helped me to come to consciousness when I fainted. After my blood pressure reading was found to be 70/35 it was decided to call in the head Obstetrician and proceed with an Emergency Caesarian. By this stage I had been hemorrhaging in hospital for nearly three hours and my contractions had weakened considerably. Undergoing emergency surgery in the form of a caesarean wasnt unexpected. I would have preferred a spinal epidural to be conscious throughout the birth and have the familiar company of my husband and friend in theatre. However, as my blood pressure was already so low I could only have a general anaesthetic for the operation. I soon discovered how simple but important requests were not honoured by the hospital staff. I had specifically asked to discover the sex of the baby for myself, but was brought back to consciousness from my general anesthesia with a, “Wake up, you have a little boy”. I felt so angry and devastated by this. This was the first of many situations I couldnt control. Some requests were observed though, such as asking for a “Patient Controlled Analgesic” (PCA). The advantage of this was that I could minimise the amount of analgesics in my system which assisted in a quicker recovery. It seemed that the respect for my natural parenting wishes lay with the sympathies of individual staff members. When Ben was three days old I finally got him out of the incubator for a proper cuddle. I had a great nurse with me that day who suggested I try Ben on the breast. He latched on like a trooper as if he had been doing it for years! This was in stark contrast to the berating I received from a nurse earlier in the day when I touched my son with a very light stroke with my thumb. I had been touching him this way for the previous two days! My frustrations of being within the hospital system ran at a high when I was discharged without any prior discussion. My request to wait one more night until I could see a social worker was refused. I was feeling distressed at having to leave Ben at the hospital and wanted to have some support strategies in place before having to travel back and forth to hospital, expressing milk and somehow trying to hold it together for my other two children. Frustration grew to hostility. Combined with my lack of sleep I began to feel paranoid that some of the medical staff were blocking my contributions to managing Bens care plan. I was expecting the social worker to be of more assistance here, but as she was relief staff she ended up being more of a sounding board. This was of some help though, as she gave me reassurance and I was then able to take a step back from the hostility and paranoia. The next meeting with the Pediatrician went a bit more smoothly. Thanks to my supportive homebirth community I was able to arrange care for Ben during the day while I rested and had lunch and dinner. While in SCN1 he was always being cuddled by someone (skin to skin) unless he had to be under the bili lights. The aforementioned meals were also wholesome, often organic and lovingly supplied by my friends. I was repeatedly told by the paediatricians and nursing staff that Ben would be expected to be in the hospital for “at least four to six weeks”. Thanks to my supportive network and my own determination Ben was discharged from the hospital on day ten. Natural parenting, attached parenting, intuitive parenting… call it what you will, but it helps babies become stronger and healthier much more quickly than if the care is left just to the medicos alone. Even over two and a half years later, there are remnants of the fog still lifting. Physical recovery in some aspects were quick, especially with access to my natural remedies. However, emotionally it has been a very slow process. I remember stating after a year that I felt the fog was clearing… I repeated this statement around two years later! I am still saying this even now with Bens third birthday imminent! Intertwined with the wounded spirits and emotions surrounding Bens arrival earthside has been complications in other areas of my life. I became very numb to emotions for a couple of years in order to be able to cope with day to day life. I also became very busy to distract myself from processing the emotions. Last year I joined a weekend womens circle which helped to remind me to have compassion… for myself as well as others. Later, a series of family events prompted me to seek further help before the end of the year. This is now coming into fruition with the support of a family psychologist. The journey of healing form hurts and pain has been slow to date. However, I feel the bell curve is soon to be in a sharp upwards direction, and have been feeling the most clear and hopeful for many years. Sharing this story still brings up strong emotions for me. My hope in sharing this story is that it will provide some practical ideas for women and their families to retain as many of their ideals as possible in a similar situation. In turn, this may help to reduce some of the stress and emotional trauma that it can entail. Rachael is a regular contributor to the Natural Parenting forums and is happy to be contacted for support and information regarding this article. Email or telephone 07 3349 7360. Some Suggestions to Support Parents with Babies in NICU/SCN Retaining your attachment parenting philosophies in a hospital setting can be challenging. If you feel youre hitting a brick wall and that everything is going against you it may be time to step back and regroup before picking up and trying again. A social worker or counsellor can help you with this. Here is a summary of a few ideas that may help a parent remain attached and focused on the mother-baby dyad. * If requiring surgery, request a PCA (patient controlled analgesic) as this usually helps towards a quicker recovery. * Ask for a comfortable chair whilst in NICU. If recovering from surgery this is imperative! * Request a basic explanation of the monitoring screen if you would like to know what the beeps and figures mean. * Talk to and touch your baby as much as you feel you can. Be aware that some sick and/or premature babies cannot handle stimulation and therefore you may only be able to rest your hand lightly over their buttocks. Ask a friendly member of staff to explain if youre unsure. * Know when to negotiate around hospital policies, and when to back off. Although there are some procedures you would like done differently, it is sometimes difficult to change them. Seek guidance from your social worker. * Do as many of the nappy changes and tube feeds of EBM (expressed breast milk) as possible. This helps to create a sense of ownership and responsibility, rather than letting the staff take over. * Hand or pump express regularly and try and be as comfortable as possible. * Get your baby to the breast at the first possible opportunity. It is worth persisting with this and ask for a copy of their breastfeeding policy. Also seek information from the Australian Breastfeeding Association. They have booklets such as “Breastfeeding and Hospitalisation” and “Breastfeeding After a Caesarean Birth”. * Find out what time the Pediatricians come on their daily rounds and be present. It helps to be dressed up and stand up if possible (ie when youre not feeding) This encourages the medicos to treat you more as an equal’. The head Pediatricians normally only visit weekly. The Head Nurse should be able to provide this information. * Ask questions and insist on being included in all the discussions and decision making regarding your babys care. * Ask for support from the hospitals social worker. You can voice your concerns, debrief and they can also help negotiate with the hospital staff where necessary. * Ask for information regarding kangaroo care. If you feel that the nursing staff are fobbing you off, ask the lactation consultant as they often have the information. Even though most hospitals have policies that advocate kangaroo care, ensure that the staff support your decision to do this. * In Special Care, arrange around the clock skin-to-skin care cuddles for your baby. While youre having a rest or break, organise a friend or relative to keep an eye on and a warm heart near him. * Try and create a private space. Use of a folding screen if necessary. * Request clear notes that no medical procedures are to done without your presence or prior consent. * Also clear notes on no formula or no dummy if those are your wishes. * Be clear on what medical procedures you want to refuse and which ones you consent to. * Encourage friends to help by providing you with really healthy meals and snacks, plus a good supply of good filtered water. This helps aid your physical recovery. * Seek out supplements and alternate therapies (such as aromatherapy) to aid in the healing of your caesarean scar. * As difficult as it is, try and rest as much as possible. Rely on others to get the day to day duties done and concentrate on yourself and your baby.