Mother and Baby Support: A Long Time Coming

It’s been a long time coming, but finally the North Island is to get a unit geared toward helping new mothers who face post-natal depression or distress.

Health Minister Tony Ryall announced today an $18.2 million commitment to providing both acute in-patient beds as well as residential beds where the mother and baby can remain together, and Martin Johnston in the Herald did some good reporting on the news in today’s paper.

Lynda Williams, the coordinator of the Maternity Services Consumer Council, told me this commitment is something she and myriad consumer, health and even official organisations have been championing for many many years. She heartily welcomed the news, with a caution: “It’s not enough,” she said, “but let’s start with what we’ve been waiting 20 years for.” Williams emphasises that the new services must be set up in consultation with the consumer groups that have been fighting for it. “We have some clear ideas about how this needs to be done. Preferably it would be better to have a stand-alone unit with other support groups and services around it.”

Despite numerous well-attended meetings, support from experts, lobbying and campaigning, she suspects a crucial impetus for the move were the reports of the Perinatal and Maternal Mortality Review Committees, which in recent years have shown suicide to be the No. 1 cause of maternal death in New Zealand.

As a (this links to a PDF) recent article in O & G Magazine (the magazine of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) points out, these maternal reviews were only reinstated six years ago, and they show that in the five years to 2010, there were 57 maternal deaths, with the three leading causes listed as suicide (13), pre-existing medical condition (11) and amniotic fluid embolism (9).

The figures and the O&G article also show that overall Māori and Pacific mothers are more likely than NZ European mothers to die in pregnancy or in the first six weeks postpartum. 

The O&G piece notes that there were four deaths by suicide not included in the review figures because they took place more than 42 days (the cut-off to be counted) – though less than a year – after the women gave birth. Those 13 maternal deaths by suicide that were counted break down a bit further like this: 7 occurred during pregnancy and 6 postpartum or post-termination of pregnancy. (O&G reported that: "Eleven of the 13 deaths from suicide were by violent means.")

As well as the proposed new and much-needed mother and baby services for the North Island (there’s already a unit in the South Island), the figures clearly point to the need for support and options for all aspects of reproductive and maternal health care.

Rugby World Cup grieving

So you know when you're in the place you go to have your hair cut, and two of the women who work there (both recent migrants to Aotearoa from parts of the world which do not play rugby) spend the time they are washing your hair talking about disappointing French back-play?

Or you get a status update (yes, I do check occasionally, my poor neglected Facebook friends) from the stroppiest of your sports-hating feminist mates about how much they are looking forward to the final?

I'm not going to bore those who hate rugby with why I love sport. I'm certainly never going to excuse the cultural supports to violence which rugby provides.

But I think this tournament has allowed many people living here to enjoy identifying with all the rugby-playing countries they are affiliated to through whakapapa. My Newtown street is covered in Manu Samoa and Tongan flags, I have friends with Irish and Welsh flags flying proudly, and of course the Silver Fern is everywhere. Given how full of hate flag waving can be, our ability, as a country, to hold these complex belongings is something to be deeply proud of. I remember living in Lewisham, London, during one football Euro Champs, Turkey beating England, and the Turkish laundromat around the corner being trashed beyond repair because clearly being both Turkish and English was impossible.

This tournament, on a very personal level, has also allowed me to grieve for my sports-mad mother, who died in July, in beautiful ways. My first sports memory, aged seven, is my Mum jumping on top of our sofa, screaming "Batty, Batty" at the top of her voice while rhythmically clapping her hand to her thigh, during a famous All Blacks victory over the British Lions at Athletic Park. Mum lived without full motor control of her left hand side, in constant pain - watching her move atypically like that started my love affair with sport.

Every game I've watched this Rugby World Cup, I've thought of Mum. Missed her explaining the history of every anthem before the game, because nationhood fascinated her. Missed her excitement at wonderful play, and her teasing my father about his one-eyed Cantabrian pride. She would have loved all the upsets - Tonga beating France, Ireland beating Australia, and perhaps most of all, Canada, her country of birth, beating Tonga.

This Rugby World Cup has been a route in to grieving with my father. He is bereft, in so much agony I just want to hold him until it's gone. He is living on automatic pilot, as best he can, while he tries to imagine and live life without the person he loved for more than 43 years. The best times Dad and I have had over the last couple of months have been watching rugby games "Mum would have loved that." The space of the games has allowed my emotionally reserved father to talk about the gap where Mum used to be without being more open than he can manage.

I'm sure it's not what the International Rugby Board had in mind, but it's made this RWC poignant and special for me.

Guest Post: Dealing with Infertility: a How to Guide for friends and family

Many thanks to Foggy in Nelson for this contribution, on the eve of Mothers' Day.  Wanting to write this has driven FiN to set up her own eponymous blog, (the below is crossposted) which I'll be adding to the blogroll shortly. 

 

I’ve thought long and hard about whether to pen this post but after 12 hours of feeling churned up about the issue I have decided that getting it all out on paper (the laptop version) will help with the processing of my feelings, and maybe serve as an educational and useful tool for a few people out there.

 

Fertility, or lack of it, is an awkward issue. It can destroy friendships, relationships, and the self esteem of those involved because of the sheer hugeness of it all, combined with the insidious silence that is often associated with all things to do with female reproduction.

 

I have known since age 23 that I have a fertility ‘issue’, having been diagnosed with Polycystic Ovary Syndrome (PCOS) following years of irregular periods, strange weight gain, body hair and oily skin. I read up on PCOS, took the information to my GP, who ordered the necessary blood tests and internal uterus / ovary scan (fun – not) and confirmed my thoughts. I have PCOS, which means that my ovulation is out of whack. It doesn’t make pregnancy impossible, but it certainly can make it more challenging. I’m fully aware that I may have to go through the horrors of hormone treatment, medication and IVF, and that there is still no guarantee of a child at the end of it all.

 

It’s always been in the back of my mind, but it wasn’t until my marriage to S in 2009 at age 29 that the reality started to really weigh on my mind. S and I visited our GP, whose advice was to ‘get cracking’, which we promptly have done but to no avail yet.

 

One of the total arseholes about having PCOS is the irregular periods, meaning that 5-6 times a year I have ‘hope’; my period hasn’t arrived for 8 weeks and we immediately think ‘ooh, could it maybe have happened naturally’. Then comes the purchase of a pregnancy test with the heartbreaking single blue line as a result.

 

This doesn’t just affect me, it affects S deeply too. The only times I have seen him cry during our marriage is when he admits how painful our conception issues are for him. It must be doubly difficult for him; having to comfort me and the (irrational but real) guilt I face, while also feeling heartbroken himself.

 

I sometimes wonder if people are aware that we are not childless by choice, particularly given my commitment to my career (whatever my career will morph into!) and passion for feminism, choice and women’s rights. The reality is that until re-connecting with S I wasn’t desperate for children (although I did have a plan to have them one day), but once we had started dating again I have been burdened with an overwhelming desire to make a small creature that is part me, part S. I love the idea of having children who look like him, maybe have his personality, or mine, or their own! Yes, I can rationalise that it’s probably hormones talking, but that doesn’t take the pain away.

 

The reason this has all come to a head is the pain of having to endure another round of “mum’s are the best”, “being a mum has completed me” nonsense that comes up during the commercialised marketing opportunity that is Mother’s Day. Don’t get me wrong, I have no problem celebrating mothers (mine is amazing), but I DO have a problem with the sheer hype about Mother’s Day that has the opposite effect of a celebration on many people; those who have lost children, those who can’t have them, those who are trying and trying to have them, those who have lost Mother’s, those who have become estranged from their Mother’s, those who were adopted and desperate to find their birth Mother, those who had their children taken from them when it was socially unacceptable to have a baby out of wedlock.

 

I am grateful that my Mother has always seen Mother’s Day as a commercialised waste of time, and has instead encouraged us to do nice things for her on a regular basis. She would rather us attend her PhD graduation, make her regular cups of teas and have long phone chats, instead of making a big fuss of her on a random day that has been designed to generate $$ for companies.

 

I make the comparison with Valentine’s Day. I’d rather S made me cups of coffee when I’m working on an essay, gets up in the morning with me when I have to get to the airport early and buys me flowers / chocolate / wine / ice cream occasionally. It would suck to be in a relationship when it was only celebrated once a year. I would likewise encourage those who go overboard on Valentine’s Day to also think about the effect of their celebrations on others. Since struggling with our infertility issues I have become acutely aware that shoving my happy relationship in other people’s faces could actually be really hurtful for those who are going through a breakup, separated from a loved one, bereaved, or single and lonely.

 

This isn’t to say we shouldn’t celebrate the happiness in our lives. But we should also do so sensitively and also keep a look out for our friends and families who have tough burdens to bear and think about their needs.

 

One further point before I leave you with some ‘do’s and don’ts’ for supporting a friend or family member who has infertility issues. Being a mum is not “the best”. People who say that are unintentionally ostracising and demeaning the work and lives of those who are not mothers. Just because we’re not mums doesn’t mean we can’t be “the best”. It doesn’t make us less loving, less caring, less hard working, less smart, less connected to people, or less valuable. We do other things that matter: we advocate for people, we work as cleaners, doctors, teachers, bus drivers and politicians. I am no less a fully-fledged adult woman because I haven’t popped out a sprog yet.

 

Do:

• Involve us in the lives of your children. Just because we don’t have them doesn’t mean we don’t like yours. Invite us to birthday parties, baptisms, school assemblies etc. When you leave us out but invite your friends who do have children you only ostracise us further.
• Do allow us to say ‘no’ though if it is a bit too hard.
• Ask us about our work and actually put some genuine interest into it.
• Organise a girls’ night, get a babysitter, and keep children out of the conversation.
• Remember that we childless ones can have sleepless nights, stress, and sickness too.

 

Don’t:

• Pity us. Treat us as human beings with full lives, because we don’t need children to have a full and interesting life.
• Expect us to get super excited when you get pregnant / have a child.
• Give advice on how to get pregnant, or promise that we will get pregnant one day. How could you possibly promise that?
• Tell me a story about someone that I’ve never met with PCOS who got pregnant after trying for years. How could that possibly help me?
• Forget about your childless friends after you’ve had a baby. We’re still here!
• Stick endless posts up on Facebook about your children’s nappies, teeth, sleeping routines etc. No offence, but no one really cares.*

 

 

 

* Ok, so that may be a little harsh, I don't mind hearing about children occasionally but when it's all I ever see it's quite a put-off and makes me assume that you have nothing else to talk about. For me, seeing your posts about kids all day is the other side to you putting up with constant political posts from me.

Guest post: Middle/upper class privilege gone crazy

Many thanks to Giarne for this restrained response to an outrageous column in today's Herald.

Shelley Bridgeman’s opinion piece in the NZ Herald today “Not all families are equal” really got my blood boiling!

I must preface this with some information about me. I’m 33 weeks pregnant with our first child. I have no direct experience with breastfeeding nor parenting. My comments are based on discussions with friends and family and all the new things I’m hearing at antenatal classes and from our midwife.

Bridgeman’s article is a prime example of middle/upper class privilege gone crazy.

I’ve had many a debate with friends around the pressures of pregnancy – to breastfeed or not to breastfeed; how long to breastfeed for; how much weight they put on during pregnancy; how fast they lost it afterwards; how many stretch marks they had; how they feel about those stretch marks that are left; whether they are comfortable whipping their breast out in public; raising the ‘perfect’ child; dealing with colic, disability; whether to have a drug free birth or interventions that might be wanted/needed. Just the start of the list I’d say.

I want information about many of these topics, but I don’t want anything rammed down my throat. I have a great deal of respect for Plunket, the World Health Organisation and the Parents Centre; I also have an enormous amount of respect and time for the experiences of my friends and family.

Bridgeman is pushing her experiences down our throats in this article. She makes revolting, patronising comments about how other families raise their children and it is obvious that she is most disparaging of lower socio-economic families and mothers in developing nations. How hypocritical that she says "not all families are created equal" and then in the next breathe extols her way as the only way to go.

WHO's recommendations about breastfeeding are about the best start you can give children, the milk that comes from women is a very nourishing, complete food and I would suggest from the women I know that not breastfeeding has more to do with issues they might have (infection, pain, latching problems etc) rather than some upper class notion that they will need breast surgery afterwards or can't find good quality water in which to mix formula.

The author’s focus on the superficial issues with breastfeeding shows that Bridgeman and her peers need just as much advice as the lower class and developing nations – just maybe they need advice about body acceptance, the way advertisers manipulate our environment and they desperately need some assistance being empathetic to others’ lives.

She states:

I have reliable anecdotal evidence that there exists a small and privileged sector of society for whom the act of breast-feeding leads to the acquisition of breast implants a few years later. WHO's recommendations, while a godsend for women in developing countries, aren't doing their counterparts in Remuera and Herne Bay any favours by inadvertently leading some of them to undergo major surgical intervention in order to remedy their dissatisfaction in their post-feeding breasts.

She continues to say “Once the risks and costs of surgery are factored in, bottle feeding would seem a no-brainer for this particular subset of women.” So, her needs come first and she feels validated by other peers saying that they too have put themselves before their children. I’m not sure she read WHO’s 10 facts on breastfeeding in much depth. Colostrum contains antibodies that help protect infants from common childhood illnesses, later in life it is shown the breastfed babies have lower blood pressure, lower rates of overweight, obesity and type-2 diabetes; and for the mother it reduces the risks of breast and ovarian cancer, helps a return to pre-pregnancy weight faster, and lowers obesity rates.

It’s not stacking up as a no-brainer for me yet when breast surgery costs thousands of dollars and has a heck of a lot of risks. It seems to me after my little bit of research that we could be saving thousands, if not hundreds of thousands of dollars in health care costs over a child’s lifetime if they get at least a little breast milk. Plus, there are benefits for the mother, one of them is even superficial about getting back to a pre-pregnancy weight.

I won’t really get into the ‘flat head syndrome’ – I’ve heard many theories – that babies spend too much time in car seats (as many of them now clip into pram bases); that sometimes they just come out with some flat bits on their head ... oh hang on, do I really care if my baby has a flat piece or two on its head but its healthy and happy? No I don’t! If that’s all the Bridgeman family has to worry about then aren’t they lucky!

Bridgeman decided that we all needed to hear the superficial reasons why she didn’t breastfeed when she could have taken the opportunity to give some information from some experts and her friends and family about how they navigated the amount of information about how to care for their infant.

exactly what it was supposed to do...

a quick post to direct you to a rare piece that has something positive to say about single mums and beneficiaries:

The two-dollar heroes bagging her out make me sick. You roll in here with your lynch ropes and your nail-studded clubs screaming for vengeance against some woman you think dudded you out of your hard-earned. Two words. Bull and shit. You paid about one tenth of 1 per cent of bugger all to keep her children fed when she couldn't find work.

[...]

If a woman like Sandra Reynolds needs a hand up via the welfare system when she's at her lowest point, I'm happier to see my tax dollars spent on her than I am on the middle-class welfare you've probably got your hands out for. Your baby bonuses. Your family tax benefits. Your private school subsidies. Your superannuation tax breaks. Your private health insurance rebates. Your first-home owner schemes. Shall we go on?

The attack on Reynolds reminded me of a Henry Kissinger quip about academic in-fighting. The fighting is vicious because the stakes are so low. There are so many other, worthier, targets than a single mum who used the long, dark teatime of unemployment to fashion herself a slightly alternative income stream. News flash: that's what welfare does. It helps people until they can help themselves. It didn't fail in the Reynolds case. It wasn't rorted. It did exactly what it was supposed to do, and now she'll pay it all back and then some when the ATO [Australian Tax Office] does its sums at the end of financial year.

please do go read the whole thing. and the comments are worth a read as well. hat tipped to my very cool facebook friends.

Should this woman have gone to prison?

A report of a mother's sentencing this week has been haunting me. The first thing to note is that the woman, a recent immigrant from Fiji, aged 29, had suffered long-term domestic violence. In other words, her husband regularly beat her up. She was also suffering from a "major depressive episode" and was not copng with her youngest child, a toddler, so Child Youth and Family removed him and his older sister. However, they then put him back with her. They later admitted that this was a mistake, due to the case being handled by "an inexperienced social worker and an overloaded supervisor" and failure to complete "final checks".

After the child had been home for two days, his mother left him alone in a deep bath and he drowned. The judge accepted that "she had no intention of killing her son". But this week she was sentenced to two years and ten months in prison. Her five-year-old daughter, who had been sexually assaulted by a 13-year-old boy while she was in CYF care, was being looked after by her father. (It was not clear whether this was the same man who had inflicted the "domestic violence", or a different man.)

I can't see that sending this woman to prison for two years and ten months was the right and just thing to do. She should obviously have been getting help, not simply so she could cope as a parent, but for her own sake. But the only solution was to remove the children - which I would have thought wasn't calculated to make her feel any better about herself. Nor was it safe to leave them with her on her own - as the little boy's death so tragically proved. I do understand how difficult it must be for CYF to cope with such cases, but somehow it seems that it was no one's job to look after her, and everything else stemmed from that.