It always upsets me to hear the birth and breastfeeding stories of mothers under the supervision of health care professionals who aren’t practicing evidence based care. Rebecca Dekker, PhD, RN, APRN of Evidence Based Birth shares stories of women who were wrongfully induced for suspected big babies and told they were in need of cesarean sections for failure to progress in her online courses. During these classes, I thought back to my prenatal care and birth experience with Willow. Anger never fails to resurge until I put my story into perspective…
Healthy Children Project faculty member Shari O’Brien, RNC, ANLC, IBCLC has worked within maternal child health care for over three decades. She has cared for mothers and babies in settings ranging from a small rural community hospital to a large urban teaching hospital. O’Brien has witnessed maternal shaving, episiotomy, forcep delivery and epidurals all as routine procedures in these facilities.
“I was shocked to watch the physician hack through the perineum when the baby wasn’t even crowning,” O’Brien says. “There wasn’t a lot I could do, but I worked hard to help moms with breastfeeding.”
While birth trauma often negatively influences breastfeeding outcomes, breastfeeding may also be healing to mothers who suffered traumatic births. As a breastfeeding advocate and supporter, O’Brien has influenced the lives of many families..
In the mid 90s, she worked to implement several of Baby-Friendly USA’s Ten Steps to Successful Breastfeeding at a large teaching hospital in Mass. Healthy Children’s Train the Trainer Course allowed her and her colleague to train about half of their maternity staff to better support the breastfeeding dyad. They discarded pacifiers and discontinued giving babies sips of water to test for tracheoesophageal fistula before putting baby to breast. Although skin to skin wasn’t popular, O’Brien says babies were kept with mothers long enough for their first feed.
Despite these efforts, O’Brien tended to a diverse community of patients all with different cultural beliefs about birth, presenting her with unique challenges. Most commonly, mothers believed that “colostrum is no good.”
“Some moms would actually express it out and wait until the mature milk came in,” O’Brien says.
Colostrum is packed with antibodies and the most easily digested food, but O’Brien believes some may be turned off by its yellowish hue. She also theorizes that because many maternity practices encourage scheduled feedings, babies become very hungry. Babies’ distress might be misinterpreted as being caused by the first milk.
Because mothers and babies typically have short hospital stays, O’Brien did not often witness the long term effects of babies deprived of colostrum. She did however care for mothers experiencing severe engorgement.
“All of these things cause moms and babies to be separated,” O’Brien reports. “By the time the mom would show up on the floor, the baby was already in a sleepy state and wouldn’t nurse.”
Of course in this situation, hospital staff generally supplement with formula.
In similar cases, O’Brien says mother preferred not to room in making breastfeeding difficult. After suffering difficult labors and deliveries most often caused by unnecessary intervention, they were too exhausted to tend to their infants.
“It broke my heart when babies were sent down [to the nursery] with no skin to skin, no breastfeeding,” O’Brien says. “They laid in the crib just crying inconsolably.”
A modest attempt to calm the babies, nurses would place the babies on their bellies.
“They would bob their heads as if they were looking for their mother,” O’Brien sighs. “They would scootch up the crib. ‘Maybe there’s a nipple here.’”
When O’Brien was offered an early retirement from the hospital she welcomed the opportunity and began teaching with Healthy Children Project, a dream of hers for nearly a decade.
O’Brien now works educating people about breastfeeding and the important bond it creates, enabling mothers and babies to fall in love.
She recalls the image of baby in mother’s arms as she lovingly gazes down at her infant, stroking his head and calmly picking at his hair.
O’Brien’s wealth of experience, diverse background, dedication to evidence based care and mothers and babies makes her an invaluable resource. She shares her knowledge and inspires The Lactation Counselor Training Course participants to continue to improve maternal child health so that more mothers and babies can be successful at breastfeeding.