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Babies, instructions, and reassurancesnurses at the Family Place teach new parents

By Cindy O. HermanFor the Daily item

LEWISBURG — “Everybody was awesome,” said Kristi Bachman, Selinsgrove, of the staff at The Family Place in Evangelical Community Hospital as she and her husband, Brady, prepared to take their newborn son home. “We’d just like to take them all home with us today.”The nurses at The Family Place hear that a lot from parents eager to start their new roles yet uncertain about the challenges ahead. But almost as good as having a nurse in the house, parents leave the hospital with significant baby care instruction, as well as the welcome assurance that they can call The Family Place with questions or concerns at any time, 24/7. It’s all part of the hospital’s commitment to help patients to be the best parents possible.

AnticipationsFrom the first prenatal visit, women are welcomed into The Family Place’s Perinatal Education Program (PEP), which starts with newsletters mailed to the home loaded with what-to-expect information.“We want to let new moms and dads be prepared, and to know things are normal,” said Kelly Everitt, RN, BSN, lactation consultant and patient educator. “Birth is normal.”Parents can choose from low-cost classes, including:• Prepared Childbirth• Newborn Care• Breastfeeding• Hello Baby (for siblings)• Teen Class• Childbirth Refresher (for second-time parents)To allay fears, parents visit The Family Place about five weeks before the due date. Patients can preregister, facilitating the admissions process on the big day, and receive individualized tours of The Family Place.

ActionWith the joyous arrival of a baby comes a need to learn

new skills, something The Family Place nurses love to teach.“There’s a lot of hands-on teaching here,” Everitt said. “We say, ‘We show, you do’ before you go home.”Nurses spend one-on-one time demonstrating bathing, diapering, swaddling, etc., and then allow new moms to try their hand at the tasks. Instructional videos are offered on mom and baby care, breastfeeding tips, and other topics. Three are mandated by the state:• Car Seat Safety• Sudden Infant Death Syndrome (SIDS)

• Shaken Baby SyndromeAs the lactation consultant, Everitt guides new mothers through their first breastfeeding experience.“The most common question they have is, ‘Is the baby getting enough to eat?’” Everitt said. “People have to see something to believe it, and when you’re nursing, you can’t measure (the amount).”By explaining that a baby’s tummy on the first day of life is about the size of a marble, she helps mothers understand how quickly the baby’s hunger can be satisfied, and how quickly it can return.“Breastfeeding babies need to eat more frequently around the clock,” she said, “because breast milk is so much more easily digested (than formula).”

Everitt encourages questions and has gladly helped moms who have been breastfeeding through the entire first year of their baby’s life.“They can call any time,” she said.A series of screenings checks for an extensive list of conditions, including hearing problems, congenital heart defects, and jaundice. The TDAP (whooping cough) vaccine is offered free of charge to moms and support persons living in the household. Everitt explained that whooping cough vaccinations, once thought to last a lifetime, have

been found to wear off, and whooping cough in a baby can be serious.“Babies can’t catch their breath,” she said. “They have died from it. Anyone handling a newborn baby should have the vaccine.”

Post expectationsParents can take their newborn home armed with instructions as well as with “Post Expectations,” The Family Place’s booklet that covers everything from bathing, cord care, and newborn jaundice to calming tips, circumcision care, even balancing the needs of older children or including dad in the baby’s care.“It’s called The Family Place because we want to include the whole family,” Everitt said.

When it’s time to go home, Everitt reassures new moms that they’re doing their best.“I tell them the first two weeks are survival,” she said with a smile. “It doesn’t matter how or when things get done. You just do what you can to take care of yourself and your baby.”At a post-partum visit about three days after discharge, mom and baby are checked for overall health, and moms have a golden chance to ask more

questions. And as always, Everitt, reassured, “They can call 24/7 here.”Everitt’s final bit of advice to new moms comes from her 28 years at the hospital as well as her own experience as a mother.“Enjoy every moment,” she said with a wise smile. “It goes fast. It goes way too fast.”Cindy O. Herman lives in Snyder County. Contact her at cindyoherman@gmail.com or on Twitter @CindyOHerman.

“they’ve done a great job making sure we’re comfortable,” said Kristi Bachman, of Selinsgrove, about the nurses at the Family Place in Evangelical Community hospital in Lewisburg. From left, Kelly Everitt, lactation consultant and perinatal patient educator, Brady and Kristi Bachman, and 2-day-old austin Bachman, in the crib.

two-day-old austin Bachman sleeps soundly in his mother’s room before making his first trip home with his parents, Brady and Kristi Bachman, of Selinsgrove.

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Gynecologists help patients throughout their livesindividualized care for a spectrum of health services

LEWISBURG — Patients are sometimes surprised at the spectrum of gynecological health services for women as they age from teens to middle age to menopause.“A woman should start seeing a gynecologist when she has a need to discuss any female health issues,” said Dr. Helen Lambe, a board-certified gynecologist at OB/GYN of Evangelical, with offices in Lewisburg and Northumberland.The newest guidelines suggest women should start having Pap smears at age 21 and stop at 65. Regardless of age, internal exams should be done annually.“I think the important thing for women to know is that we would like them to come for an annual exam,” Dr. Lambe said, “and we will individualize their care.”Individualized care is vital throughout a woman’s life for conditions as varied as heavy bleeding, birth control options, breast health, genetic testing, bone health, and pelvic organ prolapse. Abnormally heavy periods can be helped with hormonal options such as birth control pills, progesterone pills, progesterone injections, and progesterone-releasing intrauterine devices (IUD’s), which Dr. Lambe said are an under-utilized but effective treatment approved for both birth control and heavy periods. “Placing the device involves a five-minute office procedure,” she said. “Progesterone does not cause blood clots or blood pressure elevation so is safer than estrogen for every woman. It is safe for women over age 35 who smoke.”An endometrial ablation, a 15-minute, outpatient procedure, is “90 percent successful in treating heavy periods for women who have completed childbearing,” Dr. Lambe said. “It saves 75 percent of women from having a hysterectomy from heavy bleeding.”When bleeding or pain are unresponsive to the above methods, total laparoscopic hysterectomy can be considered.

But where a traditional hysterectomy used to require a large incision, a three-to-four-day hospital stay, and six weeks of recovery, it is now typically done in same-day surgery with a two-to-four-week recovery

period.Women today can choose from among birth control options that include birth control pills or injections, IUD, Nexplanon (implant in upper arm), NuvaRing (vaginal ring), and

tubal sterilization. Gynecologists can discuss the benefits unique to each option to find the one that best matches a woman’s lifestyle and health needs.“We help a patient decide which is best for her,” Dr. Lambe said. “Everything is individualized.”Two promising newer health screens for women are digital mammography and genetic testing. Saying that the precision of digital mammography is akin to comparing digital photos to Polaroids, Dr. Lambe also pointed out that computer programs now aid radiologists in analyzing the images, further increasing accuracy.Cutting-edge genetic testing considers a patient’s risk for cancer by studying her relatives for “clusters” of certain cancers:• Breast• Ovarian• Uterine• Colon• Melanoma• Pancreatic“Instead of just testing for breast and ovarian cancers, there is now Myriad myRisk™ testing, where the risk for all these diseases is assessed,” Dr. Lambe said. This information can guide the type and frequency of screenings a patient receives, possibly even

preventing diseases.“You can’t change your genes,” Dr. Lambe said, “but knowing about them can help you make an informed decision. This is the ultimate in individualized care.”To maintain healthy bones as a woman ages, the DXA bone density scan painlessly and without radiation provides doctors with an image of the lower spine and hip bones.“Osteoporosis is reversible,” Dr. Lambe said. “You literally can get the bones strong again.”Aging is hard on pelvic organs as well as bones. Pelvic organ prolapse can be remedied with a pessary, a silicone device that holds the organs up, providing comfort and preventing the need for surgery.“I’ve had women that have had pessaries for years and years, and do great with them,” Dr. Lambe said.Gynecologists help patients throughout their lives, something Dr. Lambe values.“It’s my patients; that’s what I enjoy,” she said. “When I can make a difference in a patient’s life … it may just be reassuring her that her symptoms are normal, or helping her work

Continued on Page 15

By Cindy O. HermanFor the Daily item

“Osteoporosis is reversible,” says Dr. helen Lambe. “you literally can get the bones strong again.”

Dr. helen Lambe shows a colposcope, which can be used for closer examination of signs of disease.

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“you can’t change your genes,” says Dr. helen Lambe, “but know-ing about them can help you make an informed decision. this is the ultimate in individualized care.”

Progesterone-releasing intrauterine devices (iUD’s) are an under-utilized but effective treatment approved for both birth control and heavy periods, says Dr. helen Lambe, a board-certified gynecologist at OB/gyn of Evangelical, with offices in Lewisburg and northum-berland.

Gynecologists help patients throughout their livesContinued from Page 13

through a problem.” She smiled. “If I can help a patient and make her feel better, that makes it all

worthwhile.”Cindy O. Herman lives in Snyder County. Contact her at cindyoherman@gmail.com or on Twitter @CindyOHerman.

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LEWISBURG — Mothers today are intrigued with the idea of natural birth while being mindful of the value of medical care for unexpected complications. Midwives, certified professionals who assist women in childbirth, can provide mothers and their newborns with the best of both worlds.“I chose this field because I felt that the moms needed a little more of the hands-on labor management,” said Bonnie Galloway, CNM, MSN, at OB/GYN of Evangelical. “I had an affinity for OB in nursing school,” said Amie Kennedy, CNM, MSN. As a nurse she came to feel like she had “set the stage” for women in labor with effects like dim lights and soothing music. “I wanted to maintain that atmosphere of calmness as much as possible. I wanted the focus to be on the family.”In a normal, healthy pregnancy, midwives work closely with physicians in a hospital setting to do just that, focus on the new mother, her baby, and the people in her life.“Midwifery is a sub-specialty

of obstetrics,” Galloway said. “We focus on the normalcy of pregnancy rather than what can go wrong in pregnancy.”“We have a good relationship with the doctors at OB/GYN of Evangelical,” Kennedy said, explaining that obstetricians back her up on any concerns.“Our physicians are excellent at trusting our assessment skills,” Galloway agreed. “When I say it’s time, they are there right away.”The four midwives at OB/GYN of Evangelical take turns being on call, so patients are encouraged to meet with each of them at least once during pre-natal care. Focusing on childbirth education allows patients to make informed decisions throughout the birthing process.“Some women want an epidural as soon as possible, and we support that,” Kennedy said, adding that she values each woman’s own pain assessment. “At the same time, you hope you’ve developed a sense of trust over time so you can suggest things.”Midwives try to stay with a patient throughout labor and birth, unless the patient prefers more alone time. “So it’s that individual care,” Kennedy

said. A midwife gets to know her patient, encouraging her when progress seems slow and engaging fathers and other support persons in the birthing process. “I think dads with hands-on experience, they get a better perception of what incredible effort it takes to have a baby,” Holloway said.Once the baby is born, midwives encourage skin-to-skin contact, also called “kangaroo care,” in which the naked baby nestles under a blanket on the mother or father’s skin. This helps stabilize a baby’s body temperature, regulates heart and breathing rates, shortens the time it takes to deliver the placenta, helps start breastfeeding, and lowers levels of stress hormones (Journal of Midwifery & Women’s Health).“It shows how important touch is, and that leads back to midwifery,” Galloway said. “We are really hands-on as opposed to hands-off.”Throughout the birth, midwives from OB/GYN of Evangelical collaborate with doctors as well

as the nurses and staff from The Family Place, Evangelical’s obstetrics unit. “I feel like it’s all a team kind of effort,” Kennedy said. “We make the woman the priority, what’s best for her.” She recalled calming a woman undergoing a Cesarean section. “She thanked me afterward for just holding her hand and keeping her grounded. We’re there for our patients. We go through things with them. We cry with them. We just try to be a support.”After a difficult first birth, one of Galloway’s patients was understandably scared during her second birth. Knowing the woman’s history guided Galloway’s handling of the situation, which ended with a healthy delivery.“I really felt I was in a good spot to give her that reassurance that would be received well,” Galloway said. “She had a good rapport with the midwives and knew that we were going to take good care of her.”Another birth seemed to be going fine, with most indications pointing to normal, but some

tiny clues pricked Galloway’s “sixth sense,” resulting in her hurrying the delivery — rare for midwives. As it turned out, the umbilical cord had been wrapped very tightly around the baby’s neck. The baby was fine, but would have been in danger if the delivery had gone on longer.“I was really happy that I listened to my gut,” Galloway said.Beyond pregnancy and childbirth, midwives provide a continuum of care, including birth control, pre-conceptual counseling, menopause, and beyond. But there is no denying the bond of sharing in the birth of a new life.Echoing the feeling of many mothers for their midwives, Kayla Boyer, of Beavertown, said she was delighted that Galloway was on call when Boyer gave birth to her son, Gannyn, in February. “I saw her through most of my pregnancy,” Boyer said. “I just love her.”Cindy O. Herman lives in Snyder County. Contact her at cindyoherman@gmail.com or on Twitter @CindyOHerman.

Continued on Page 17

By Cindy O. HermanFor the Daily item

The power of touchhands-on deliveries with midwives

“i just love her,” says Kayla Boyer, of Beavertown, about certified nurse midwife Bonnie galloway, CnM, MSn, at OB/gyn of Evangelical, as the two gaze at Boyer’s son, gannyn, born in February.

Understanding the letters:CnM — Certified nurse Midwife, a person with a degree in nursing plus a post-graduate certification in midwiferyCM — Certified Midwife, does not hold a nursing degree but may have a de-gree in other areasLay Midwife — Education is hands on, in a home environmentMSn — Master of Science in nursingCMs and CnMs are members of the american College of nurse Midwives (aCnM). all midwives at the Family Place are CnMs.

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Gynecologists help patients throughout their livesContinued from Page 15

Dr. helen Lambe demonstrates the procedure for a progesterone-releasing intrauterine device (iUD).

The power of touchhands-on deliveries with midwives

Kayla Boyer, of Beavertown, was delighted to find that certified nurse midwife Bonnie galloway, CnM, MSn, at OB/gyn of Evangelical, was on call when Boyer’s son, gannyn, was born in February.

Continued from Page 16

“We focus on the normalcy of pregnancy,” says certified nurse midwife Bonnie galloway, CnM, MSn, left, with amie Kennedy, CnM, MSn, from OB/gyn of Evangelical.

gannyn Boyer, of Beavertown, son of Kayla Boyer, sleeps contentedly after his mother’s postpartum checkup with certi-fied nurse midwife Bonnie gal-loway, CnM, MSn.