Benefits of a Birth Doula

For centuries, women have given birth with the support and care of other women in an experience that focused on the psychosocial and emotional aspect of this remarkable life event.

Modern day doulas have modified this age-old concept and integrated their unique, non-medical services into many healthcare settings to enhance childbirth services for expectant mothers and their families.

“We provide a woman and her partner with ongoing comfort, encouragement and respect,” says Rean Cross, Doula and Executive Director of the Doula Program at The Scarborough Hospital. “Family support is certainly important, but a third-party person with extensive knowledge and experience in the birthing process can improve the overall satisfaction families have with their childbirth experience.”

Stefanie Atunes, Doula and Chief Operating Officer of Discover Birth Inc., which has partnered with TSH to offer doula services, adds that a doula acts as a bridge between the medical aspect of childbirth and the emotional journey that families experience as they transition into parenthood.

Rean and Stefanie share some benefits of including a doula in your childbirth experience:

1. Doulas are present throughout the entire process. When a woman goes into labour, her family contacts the doula on-call who provides 24/7 support from beginning to end. There are 18 doulas currently enrolled in the program at TSH, and they work on-call rather than in shifts so they are able to remain with the family for the duration of the birth.

2. Doulas provide support to both woman and partner. There is a misconception that doulas should only be involved in the birthing process if a woman has no other supports. In reality, doulas can help a woman’s partner be more effective in their support strategies, which leads to a better experience for everyone.

3. Doulas are experienced childbirth professionals. Historically women gave birth with the help of an extended family member such as a grandmother, mother or older sister who gained experience by being involved in many births throughout their lives. In modern times, people don’t witness many births, and so doulas provide that same level of comfort and a reassuring presence to guide the mother through her labour and delivery.

4. Doulas provide care that helps to reduce complications. The non-medical care provided by doulas includes relaxation, positioning and other techniques to focus on the health and well-being of the mother, which allows the medical team to better administer clinical care and safely deliver the baby. This interprofessional team approach can lead to reduced complications, cesareans and interventions.

5. Doulas continue to provide care after the baby is born. Families who need or want comfort measures after the baby is born benefit from the expertise of a doula who can answer questions such as how to manage visitors, or help the family to understand and appreciate the amazing event they just experienced. They also offer breastfeeding and diaper changing tips. The additional care following a birth has been shown to decrease the incidence of post-partum depression.

6. Doulas are available last minute. There is always a doula on-call at TSH. Generally, doulas become involved in the birth process in the last trimester, but if a woman arrives at the Emergency Department in labour and asks for a doula, the nurses can refer to the on-call schedule and arrange for a doula to attend the birth.

7. Doulas at TSH are affordable. Cost to include a doula in your birth at TSH is determined on a sliding scale, based on your ability to pay. This is to ensure that everyone in our community has an equal opportunity to access this remarkable service.

Stefanie and Rean add that doulas will be volunteering their services and assisting with births at TSH throughout the month of May to recognize International Doula Month. Staff, physicians and the community are welcome to visit the hospital and learn more about the role of doulas in the childbirth process and how they can benefit from a doula’s unique expertise.

Spring is here. Play safe!

Spring fever is the only kind of fever we like to catch. And with summer just around the corner, it’s time to get outside and get active. This is the time of year when neighbourhoods come back to life and playgrounds are full of energetic kids running and jumping.

Your kids are probably itching to get to the park, start their soccer season or get out on their bikes for the first time in months. You might want to refresh yourself on some tips to keep your kids safe as they gear up for their summer sports.

Identify and deal with concussions

Concussions are becoming more common in kids’ sporting activities. Concussions do not always result in a loss of consciousness, and recovery for children can take much longer than for adults.

“Common signs of a concussion are headache, dizziness, sensitivity to light or sound, and confusion or difficulty concentrating,” explains Dr. Peter Azzopardi, Chief of Paediatric Medicine at The Scarborough Hospital. “They can be caused by a direct blow to the head, neck or face, or by a blow somewhere else on the body that sends force to the head.”

The Canadian Paediatric Society recommends children or teens with a concussion should:

• Seek medical attention at the time of injury.
• Rest until all symptoms are gone.
• Avoid sports, exercise or participation in any recreational activities.
• Limit activities like reading, texting, watching television, computer work and electronic games.
• Be cleared by a physician before returning to school or sports.

Wear the right protective gear

A key to keeping your kids safe is providing them with the right protective gear for the activity they are doing. Here are a few things to consider:

Helmets – these are the most common, and probably the most important, protective gear your child will wear. It’s important to choose the right helmet for the activity. There are different helmets for baseball, football, biking and skateboarding, and you shouldn’t substitute one for another. Ensure they fit properly and always do up the chin strap or else it will fall off when your child needs it most.

Shoes – Similar to helmets, there are different shoes for football, baseball, softball, and soccer. They have rubber soles or metal cleats designed specifically for a certain activity.

Other protection – Some sports require eye protection, mouthguards, pads, wrist, elbow, and knee guards and protective cups (for boys only).

If you’re unsure about what protective equipment your child needs, you can talk to the coach or an expert at a sporting goods store.

Get out there and enjoy spring safely!

Signs of an abusive relationship

Today is the National Day of Remembrance and Action on Violence Against Women in Canada. Today, we honour the 14 female engineering students whose lives were cut short at École Polytchnique de Montreal.  The tragic events of December 6, 1989 are a stark reminder that women are at risk of violence because they are women.

Violence against women continues to be a serious issue in Canada. Violence has a strong impact on the health status of female victims, and often, it’s difficult for women to even recognize they are in an abusive relationship.

“We are working with a number of agencies including the Toronto Police, Victim Services and shelters to promote the concept that as friends, families and neighbours, we all need to be involved in providing support and safety to women and children at risk of violence,” explains Shirley Broekstra, Manager, Sexual Assault/Domestic Violence Care Centre at The Scarborough Hospital.

Recognizing the signs of an abusive relationship can be as subtle as a partner keeping you from seeing friends or family, or as obvious as physical harm. Shirley adds that other signs that you might be in an abusive relationship can be determined if your partner:

• Has a bad and unpredictable temper.
• Hurts you or threatens to hurt or kill you.
• Threatens to take your children away or harm them.
• Threatens to commit suicide if you leave.
• Forces you to have sex.
• Destroys your belongings.
• Acts excessively jealous and possessive.
• Controls where you go and what you do.
• Limits your access to money, the phone or the car.
• Constantly checks up on you.

If you are in an abusive relationship or have been assaulted, contact the Sexual Assault and Domestic Violence Care Centre at The Scarborough Hospital at 416-495-2555 or http://www.sacc.to.

Four reasons to quit smoking before surgery

Here’s another good reason to quit smoking, especially if you have surgery planned. Did you know that 52 per cent of smokers experience post-operative problems and are more at risk of infections and complications?

“Part of my job as an anesthesiologist is to ensure patients are in the best possible condition before surgery, and I feel it’s an uphill battle with smokers,” explains Anesthesiologist Dr. John Oyston, of The Scarborough Hospital. “I am tired of seeing patients cough and sputter in the recovery room and not do well during surgery.”

Dr. Oyston developed a ‘stop smoking for safer surgery’ plan to assist patients. He offers the following tips:

1. It may be easier to quit smoking when you are having surgery because you are away from normal routines. While in hospital, you can get help to quit smoking from medical professionals, and the risk of withdrawal symptoms is less while in hospital;
2. Choose a ‘quit day’ at least four weeks before surgery, and stop smoking on that day;
3. If you have less than four weeks to prepare, you have at least eight hours to get rid of the carbon monoxide in your body. Since you are often told not to eat or drink eight hours before surgery, do the same with smoking;
4. The risk to your heart is reduced by even a few hours of non-smoking, but it takes your lungs several weeks to improve after you stop smoking.

And remember: smoking is not allowed anywhere on the property at The Scarborough Hospital, and that includes staff, volunteers and patients.

Blood conservation tips for elective surgery

If you are planning elective surgery in the next few months, you should be prepared, including considering blood conservation methods.

“Depending on the type of surgery, your hemoglobin and the length of time before surgery, there are blood conservation strategies available,” explains Laura McKenzie-Kerr, RN, and Blood Conservation Nurse for The Scarborough Hospital. “These include a variety of iron medications either by mouth or intravenously, medications that can stimulate your production of red blood cells, and in certain situations, donating your own blood in preparation for surgery.”

Laura offers the following points to remember when planning for elective surgery:

1. Know your hemoglobin. Hemoglobin carries oxygen or energy to your blood cells. A simple blood test (that does not require fasting) will provide you with your hemoglobin level.
2. If you are diabetic, take certain high blood pressure medications and a thyroid medication; studies have shown your hemoglobin will be below normal.
3. The higher your hemoglobin going into any surgery, the better off you will feel and recover after your surgery.
4. Normal hemoglobin ranges are different between females and males: female   ranges from 120 to 160 g/L and male from 140 to180 g/L.
5. The expected blood loss varies from each surgical procedure.
6. Low postoperative hemoglobin will affect your recovery after the surgery. If your hemoglobin is too low, your surgeon may recommend a blood transfusion after/during the surgery.
7. Canadian Blood Services relies on volunteer donors to supply blood to Canadian hospitals. As our population ages and develops more health issues, and are taking more medications, this will affect the blood donor pool which may lead to blood shortages.

Blood donors DO save lives

There are 1,440 minutes in every day. For each of these minutes, Canadian Blood Services says someone in Canada is in need of blood. Most individuals who are between the ages of 17 and 61 and in good health can give blood.

Those who do not donate blood often complain they are too busy, or they have a fear of needles or of contracting a disease through blood donation, or wrongly believe they are ineligible to donate blood. Unfortunately, the lives of those who undergo basic, routine or emergency medical procedures are constantly at risk if Canada’s blood supply becomes limited.

Laura McKenzie-Kerr, RN, Blood Conservation Nurse for The Scarborough Hospital, explains the main reasons why we should donate blood regularly.

1. Donating blood offers all donors a mini-health checkup. Your blood goes through an extensive screening process, which includes lab testing, hemoglobin (iron) testing, and a blood pressure check. These tests can reveal health anomalies you didn’t know you had.
2. Donating blood saves lives. A person undergoing cancer treatment can need up to eight units of blood per week; a liver transplant can need up to 100 units, a car accident or gunshot wound up to 50 units, and a fractured hip/joint replacement can need two to five units.
3. Different blood products can be stored for different amounts of time. Donated red cells can be stored for 42 days, plasma for 12 months and platelets for only five days. The shelf life of blood and blood products means that new donations are constantly needed.
4. Donating blood can help your friends and family members. Canadian Blood Services reports 52 per cent of Canadians or their family members have needed blood or blood products after a medical procedure.
5. With the population of Canada aging, a need for more blood and blood products will increase. Becoming a frequent “lifetime” donor will help to meet this need.

To book an appointment to donate blood in Canada or to find out more information, call 1-888-2-DONATE or visit www.blood.ca

Give the gift of life

Talking about organ donation can be a difficult but necessary discussion to have with your loved ones. If one person consents to organ and tissue donation, their donation can save up to eight lives and enhance 75 additional lives. Speaking to your loved ones about organ donation can positively impact the lives of others in the future.

At this time, there are around 1,500 people on the wait list for a vital organ. If you are 16 years of age or older and living in Ontario, you can register to donate your organs and/or tissues upon your death. The oldest tissue donor was 102 years old and the oldest organ donor was 90 years old.

Making the choice to donate your organs can shock or frighten your family members, but it can also provide relief and comfort during a tragic situation. Half of Canadians are unaware whether or not their loved ones wanted their tissues and organs donated.

This week (April 17 to 24) is Organ Donor Awareness Week, and Shahista Walli, Trillium Gift of Life Coordinator at The Scarborough Hospital, explains what you should discuss with your family:

1. Research organ donation and see if it’s right for you. If you do have any questions about the organ donation process, speak to your family doctor.
2. Find a comfortable location where you and your family can discuss sensitive issues. Make the conversation as natural as possible and be open to the initial emotions your family members may feel.
3. Explain the organ donation process to your family. Organ donation does not interfere with your funeral arrangements—it’s a completely confidential act that no one will know about.
4. Think about which person in your life would be called to make the final decision to donate your organs. Discuss your wishes with them and help them to understand why you have made this decision.
5. Your choice to donate your organs may have inspired others to do the same. Provide your family members with the information you have learned on your journey to this decision.

Find out more about organ and tissue donation, and download a Gift of Life consent form, from the Trillium Gift of Life website.

Seven signs of Tuberculosis

One-third of the world’s population is infected with tuberculosis (TB), and efforts are underway to stop the spread of this airborne disease through education and treatment. March 24 is World Tuberculosis Day, and health officials around the globe are reminding people about TB risks, symptoms and treatment options.

“Tuberculosis germs are usually spread when a person with active TB disease symptoms coughs or sneezes,” says Teresa McCormack, a registered nurse in the Occupational Health Department at The Scarborough Hospital. “If another person breathes in those germs, they could get a TB infection. Most people exposed to TB in this way won’t get sick, but there is a risk of developing full-blown TB disease.”

Simply put, a TB infection is when you have TB germs in your body, but they do not grow and do not make you sick. When someone has TB disease, however, the germs keep growing and evolve into the symptoms outlined below.

McCormack says a simple skin test on your arm at your doctor’s office is the best way to test for TB infection. If you do test positive, your doctor might recommend preventive treatment with Isoniazid to keep the infection from progressing to TB disease. The infection can be cured, though it may take six to nine months to kill the TB germs.

Tubeculosis disease requires confirmation by a chest x-ray. Those diagnosed with the disease could be quarantined for a period of two or three weeks while being treated.

Tuberculosis is considered more of a risk for people with previous TB infections, those who are HIV-positive, diabetics, alcoholics or intravenous drug users.

Signs of TB may include:

1. Excessive coughing (for more than three weeks)
2. Coughing up blood or mucus
3. Chest pain when you cough or breathe
4. Weight loss
5. Loss of appetite
6. Sweating at night
7. Fever

If you suspect you might have been exposed to TB, or are exhibiting the symptoms above, contact your family physician.