Spring 2006 Spring 2006

FOUND ATION

FONDATION DU

St. Mary’s Hospital Foundation

As one of the largest birthing centres on theIsland of Montreal, with over 3,700 babies bornhere every year, St. Mary’s Hospital Center takesour commitment to compassionate patient-care toa whole new level for our smallest constituents!Through the exceptional generosity of our keysupporters, St. Mary’sredesigned and reno-vated the BirthingCentre, and business isbooming. Just ask littleMylène, pictured here,only hours after claim-ing the auspicious titleof first baby born inthe New BirthingCenter, on April 26th at 10:19 p.m.

The New Birthing Centre is equipped with themost cutting-edge apparatus, to ensure an optimalenvironment for mothers and the safest welcomepossible for the babies. Thirteen birthing roomsreflect the theme of the four seasons, all of whichare equipped with a private shower with jet-massage. Satellite medical stations make itpossible for the medical personnel to follow andprovide for the patients without ever leaving theroom.And since giving birth is not an experiencewhose impact is restricted to a woman and herbaby, great pains were taken to create an environ-ment where the whole familycan be accommodated.Spouses are welcome andencouraged to spend thenight, and a sleeper sofa isprovided for that purpose.

The revamped deliverysuites will completely revolu-tionize the experience ofgiving birth – as much for themother as for her family andthe medical professionals

attending her, allowing moms to labour, deliverand recover all within the same spacious,beautifully decorated suite. Serene décor isaccented by all the amenities necessary to create arestful atmosphere: a recliner chair, armoire,bassinet. With comfort and safety as priorities,onlythe most technologically advanced birthing beds,monitoring and emergency equipment are used inthe state-of-the-art birthing rooms – all of whichcan be packed away when not in use to maximizespace.

The massive renovations that turned the out-dated facilities into a warm and welcomingenvironment were made possible through theoutpouring of support that provided the necessary$2.6 million. The key contributors, all of whomhave a very personal relationship with the BirthingCentre, include The J.W. McConnell FamilyFoundation,The Stanley & Josefina Clarke Family,The Eric T.Webster Foundation,The Auxiliary of St.Mary’s Hospital Center, The Shannon Family, andThe W.H.Wilson Family.

Joan Shannon attended a receptionhonouring the donors who brought theBirthing Centre to life,and she had,arguably,one of the most entertaining stories to tellabout how the Birthing Centre hadimpacted her life. As a young nurse, Joan(who is the aunt of the Foundation

Chairman, CraigShannon), wasassigned to assistbirthing mothersat St. Mary’s manyyears ago. Sherecalls that one ofthe mothers, NanShannon, had a very suc-cessful experience, giv-ing birth to her first son,Craig. When her husbandarrived to inquire after

his wife (this was back in the days when men werenot permitted to witness the birth!), Joan politelydirected him to the room. However, when theexact same man presented himself to Joan asecond time, and again asked to be directed to theroom of Nan Shannon, Joan wasn’t sure if sheshould take his second inquiry as a joke, or ifperhaps the man was not “all there.” There are twohappy conclusions to this story. The firstconclusion is that the gentleman enquiring “asecond time” for Nan Shannon was actually BillShannon, the identical twin of Nan’s husband, Jack.And the second conclusion is that Joan was sorelieved to learn that the man’s mind was intactthat she married him! The Shannons have since“graced” the halls of our Birthing Centre on many,MANY occasions, and it was more than fitting thatSt. Mary’s Hospital Foundation had theopportunity to honour their major contributiontoward the renovated facilities by naming aBirthing Room after them.

Joan Shannon is pictured here (2nd from theleft) in front of the Shannon Family Birthing Room,

accompanied by just a SAMPLING of thebounteous Shannon crew, including (you maywant to have a seat . . . ), Craig Shannon at the farleft (Foundation Chairman), then to the right ofJoan is Anna, Janet, Jim, Mark, Debbie (Trudeau),Gary, Judy and Bill.

Oh BABY,WHAT A BIRTHING CENTRE! ST. MARY’S HOSPITAL CENTER

BECOMES BABY FRIENDLYAnyone who has ever given birth at St. Mary’s might find it hard to believe that St. Mary’s would be considered anything

less than “baby friendly.” But this term actually denotes a very specific status awarded by the World Health Organization(WHO) and UNICEF. The Baby Friendly™ Initiative (BFI) is an international ten step program established in 1992 by WorldHealth Organization (WHO) and UNICEF to promote, support and protect breastfeeding worldwide in hospitals and in thecommunity. As the National authority for the WHO / UNICEF Baby Friendly™ Hospital Initiative (BFHI) in Canada, theBreastfeeding Committee for Canada (BCC) has the goal of implementation of the BFI across the country over the next threeyears. Although approximately 15,000 facilities (hospitals and healthcare units) have been awarded BFI status, only six healthcentres in Canada are qualified for this prestigious status as of November 2005.

Small wonder that the statistics for Canadian women who breastfeed are proportionately meagre. Even though 1994statistics show that the average national rate of breastfeeding is about 73%, about 40% of mothers who breastfed reporteddoing so for less than three months. In 1982, 17% and 41% of mothers who breastfed stopped at two and four monthsrespectively. As well, regional tendencies very much skew that number,since British Columbians have a pronounced tendencyto embrace breastfeeding at the provincial rate of 89%. However, a curious trend, referred to by Stats Canada as “the east towest gradient,” shows a gradual but marked decline in breastfeeding as you move from the west to the east of Canada, whereonly 53% of mothers choose to nurse. This trend has been evident since the 1960’s.

To guide institutions through the rigorous steps required to attain BFI status, the Canadian Practice Outcomes Indicatorsfor Hospitals outlines Ten Steps for what constitutes evidence of good practice, which have now been adopted by St. Mary’sHospital Center:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.2. Train all health care staff in skills necessary to implement this policy.3. Inform all pregnant women about the benefits and management of breastfeeding.4. Help mothers initiate breastfeeding within a half-hour of birth.5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.6. Give newborn infants no food or drink other than breastmilk, unless medically indicated.7. Practice rooming-in: allow mothers and infants to remain together 24 hours a day.8. Encourage breastfeeding on demand.9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

The principles governing these practices are focused on the well-being of absolutely everyone who is involved inwelcoming each tiny life into the world. The benefits to everyone involved are quite impressive:

For the woman and her child

• Consistent care, information and advice. Staff in maternity and pediatric units have a written policy, which they understandand follow.

• Consistent and skilled help with breastfeeding. Staff are required to be able to support women who wish to breastfeed.• Early initiation of breastfeeding. Babies are not unnecessarily removed from mothers at birth, thereby encouraging the

instinctive seeking and suckling behaviours. When mother and baby need to be separated the mother is helped withexpressing her milk and the expressed milk is given to the baby.

• Mother’s milk is valued. No food or drink other than breastmilk is given.• Breastfeeding is valued.Artificial nipples and soothers are avoided.• Empowerment.The woman has authority for her own resource, breastfeeding.

For those who care for mothers and babies

• Increased knowledge, as evidence for the Global Hospital Assessment Criteria becomes better understood.• Increased skills. Staff are committed to the support of breastfeeding mothers and their babies, even the difficult ones.• Increased professional competence, as practices are investigated and challenged, and changes are made.• A new respect for the woman, the baby, and their ability to breastfeed when given appropriate support.The midwife/nurse

is “with woman”, rather than providing nursing management of a disease.• As the care becomes “woman-centred” rather than “task centred”, all staff respect the woman’s need for consistent advice and empowerment, thereby increasing

cooperation and collaboration between different staff members.

For the maternity units:

• A high standard that is measured by the unit and confirmed by a Baby-Friendly™ team representingprofessional and lay assessors.

• A Global Hospital Assessment Criteria, recognised and respected by professionals and consumers.• Valuable in marketing the services provided.• Considerable monetary savings.

For the family

• Health and development of infant.• Health of mother.• Cost saving, immediate and long term, breastfeeding is the “Best Investment” a family can make.

For the community

• Flow-on from family.• Environmental considerations. No waste products.

The Breastfeeding Committee for Canada emphasizes that the process of changing attitudes andpractice is important, not “passing” or “failing” the assessment.

The Baby-Friendly Initiative is being embraced by St. Mary’s in an effort to turn around some of the more gloomy facts and figures related to Breastfeeding in thisprovince. According to a study done in 1996-1997, Quebec had the lowest rate of breastfeeding of all the Canadian provinces. In fact, in 1999, 79% of mothers givingbirth at St. Mary’s preferred to supplement their infants’ diets with formula rather than offer them breast milk. Happily, with the BFI already firmly in place at St. Mary’s,the tide is taking a decided turn:as of last year,91% of mothers at least initiate breastfeeding with their babies,and only 30% of mothers were supplementing their babies’diets with formula.

In addition to promoting and supporting breastfeeding mothers, the BFI outlines strict rules about the marketing of breastmilk substitutes (ie., formula). Goneare the days when formula companies are permitted advertising anywhere near the birthing centre. No more free samples of formula offered along with any kind of“care package” to the new mothers. In fact, not even the health care workers who deal with the mothers are allowed to accept gifts or personal samples from theformula companies.

All of this is a radical departure from what was par for the course for birthing mothers even five years ago. And Florence Jean, Program Manager for the MaternalChild Care Unit since 2001, acknowledges that the changes being implemented here will require no less than “a change of culture” – as much for the team of 230+medical professionals who comprise the Maternal Child Care Unit as for the mothers who give birth to the over 3,700 babies here at St. Mary’s every year.

Today, St.Mary’s Hospital Center provides birthing mothers access to 14 licensed Lactation Consultants, and three more in training. The education of our MaternalChild care personnel is rigorous and very dedicated toward our goal of responding more efficiently to the needs of birthing mothers by becoming Baby-Friendly, andtowards that end, we are proud to announce the opening of a Breastfeeding Clinic since January 2005. In 2007, St. Mary’s Hospital Center will take its place as theseventh Baby-Friendly institution in Canada, and the only English-speaking birthing centre in Quebec with this prestigious distinction to its name.

For as long as there have been women labouring to bring babies into the world, therehave been other women by their side assisting them. Whether sister,mother, friend,nurse,or doctor -- the presence of a second woman in the delivery of a child is more usual thanthe contrary. In the time before doctors presided over childbirth -- in fact, even beforethere were doctors -- this crucial role was usually played by a midwife.

“Midwife” literally means “with woman.” In French, the term “Sage-femme” connotesthe exceptional wisdom of a woman necessary to see another woman through what maybe the most challenging time in her life. The role of a midwife is as varied and complexas the mystery and miracle of childbirth itself. Her involvement may begin even beforeconception, offering advice to improve opportunities for conception, and to prepare themother’s body for an optimal environment for conception. Throughout the pregnancy, theMidwife will work in tandem with the mother to whatever degree the parents requireinformation, counseling or support. It is a very comprehensive role that does not beginand end with the actual childbirth, and Midwives typically follow the woman and childafter the birth, to ensure that the woman’s health is recovering as it should, and that thebaby’s progress is in keeping with developmental expectations. The care is decidedly“woman-centred” and relationship-focused,” and the Midwife typically becomes a regularpresence in the home and family of the expectant mother, as she strives to ensure thatevery single aspect of this baby’s entry into the world is attended to with detailed care.

Canada has been very slow to jump on the Midwifery bandwagon, as the lastindustrialized country to undertake the legal recognition of midwifery. In Scandinavia, theNetherlands, New Zealand and other countries, all prenatal, intrapartum and postpartumcare for at least 70% of expectant women is provided solely by midwives.As a result, thesecountries have experienced much lower obstetrical intervention rates than those ofCanada, despite the fact that their maternal and prenatal mortality rates are equal to and,in some cases, better than those of Canada. It wasn’t until the mid-1990’s that theprovinces of Ontario and Quebec first regulated midwifery services as a recognizedprofession, and even then, only in response to the increasing demands made by women

and midwives.The resurgence of Midwifery completes the 360-degree turn back to this ancient practice that progressivelydisappeared in this country in the 20th century as hospital

births became standard practice. Many factors postponed thedevelopment of midwifery in Canada, the most prominent being thelack of training programs, the first of which only surfaced inOntario in 1993. Midwifery has been regulated in Quebec fornearly a decade, now, but has only recently witnessed anintegration into the contemporary healthcare system.

What many people do not realize is that securing thesupport of a midwife is not mutually exclusive to theinvolvement of an obstetrician or family doctor. Thepractice of midwifery is respected and supported bythe medical profession, and the services offered by a

registered midwife can prove verycomplimentary to those offered by yourobstetrician. In 2002, St. Mary’s HospitalCenter was one of the first Montrealhospitals to apply to the Minister of Healthand Social Services for the integration ofMidwives in our Birthing Centre. As one ofthe largest birthing centres on theMontreal Island, the integration ofMidwives is a natural progression of thisHospital’s unfailing commitment tocompassionate, patient-centred care.

The advantages to accessing the services of a Midwife are impressive: midwifery careis associated with greatly decreased rates of medical interventions during labour, such asinduction of labour, episiotomy and cesarean section, anesthesia and IV fluid use, andmoderate decreases in narcotics use,use of forceps,electronic fetal monitoring (EFM) andamniotomies, vacuum extraction, with a greatly increased rate of spontaneous vaginalbirths.The advantages in terms of healthcare costs are undeniable, according to the 1997final report of Evaluation des projets-pilotes de la pratique des sages- femmes au Quebecwhich cites a savings of approximately $780 per mother who received pregnancy, labourand birth, and postpartum care from midwives, when compared with the cost of similarcare received from physicians at hospitals. But the most compelling argument for callingupon the assistance of a midwife at any or all stages of your pregnancy/childbirth is thevery personalized and focused care that midwives offer. The level of satisfactionexperienced by a woman who integrates the services of a Midwife, either in tandem withor independent of contemporary obstetrical care, is entirely unequalled by that of awoman who chooses to do without.

The number of practicing registered midwives in Quebec is now around seventy-seven.

In March of this year, St. Mary’s Maternal-Child Program began integrating students ofthe Midwife Baccalaureate Program from Université du Québec à Trois-Rivières.

THE ANCIENT ART OF MIDWIFERY

Inside This Issue

The New Birthing Centreis equipped with

the most cutting-edge apparatus

The exceptional wisdomof a woman

SUCKING UPTO THE BOSS

Everything you (may not) wantto know about breastfeeding

THE ANCIENT ARTOF MIDWIFERY

Oh BABY,WHAT A

BIRTHING CENTRE!

Published by:ST. MARY’S HOSPITAL FOUNDATIONEditor: Paulanne Jushkevich, M.A., CFRE3830 Lacombe AvenueMontreal (Québec) H3T 1M5Tel.: (514) 734-2694Fax: (514) 734-2655E-mail: fondation.stmary@ssss.gouv.qc.ca

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