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New Insights, Common Issues


Jane Svensson, IJBPE Editorial Board Member from Sydney, writes about the recent Childbirth and Parent Educators of Australia (CAPEA) conference

 

One question I am frequently asked when training Antenatal Educators is, ‘What if I have a same sex partner in my program? Does the partner go with the men when we do group activities or stay with the women?’ This very question was answered at the Childbirth and Parent Educators of Australia conference that I attended recently in Adelaide – the answer being, ‘Let the partner decide for herself’. Taken one step further, the presenter was then asked, ‘Well, what if we have a number of same sex couples birthing at our hospital? Should we have specific antenatal programs for them?’ The answer was, ‘No, don’t; let’s not marginalise these couples even further. They have often been through adversary to come out so let’s embrace them and welcome them into any of our regular programs’.

 

Increasingly in Australia, as elsewhere, Educators are welcoming a diverse range of ‘partners’ to their programs, so we really do need to reflect on the learning activities we use - especially when many sessions now have split gender time so the ‘boys have time to themselves’. At this national conference for Childbirth and Parenting Educators, we were challenged to think about whether female partners experience the same issues as do male partners when it comes to even simple things such as delegation of household tasks and allocation of family income. Surely they do, so let the female partner decide which group she wants to go to – expectant Mums or expectant partners.

 

Next, the sobering statistic of six babies dying every day in Australia at or close to term resonated through the room at the conference with delegates being reminded that fetal movement changes are a significant predictor of fetal wellbeing - decreased strength and vigor of fetal movements and interestingly, an incidence of hiccups greater than 5 minutes daily. Death is more likely at night-time. Importantly, maternal intuition must be acknowledged as it has been shown that 60% of women have a ‘gut instinct’ that something is wrong. Supine sleeping in pregnancy is to be discouraged.

 

Another topic of interest at the conference (and indeed at another seminar I attended) was that of the human microbiome and the potential practice of ‘seeding’ babies born by elective caesarean section. Mode of birth is now recognised as determining later health with babies born via caesarean section being colonised by skin bacteria rather than gut bacteria. So what can we do – ensure skin to skin in theatre; encourage exclusive breastfeeding for longer than 6 months; help the mother to express breastmilk if the infant is separated from her and colonise the baby with swabs of vaginal flora. The last recommendation arises from very early work and is not currently widely practiced. We don’t know the long-term implications of seeding because surely this is a different situation from when the baby births through the vagina? A further question raised for us to consider was how antibiotics given in labour, such as those given to group B strep positive mothers, affect the microbiome. They certainly disrupt the microbiome as does feeding infant formula to a baby. Some formulas are now loaded with pre-biotics, but what is their long-term effect? It will be interesting to see how this research progresses in future years.

 

My final learning from the conference was that the Australian Institute of Family Studies has found that the percentage of time that children spend with their father only across a week is 11%, whereas with their mother only, it is 46%. The implication for antenatal education is that partners have a key role in the forming of relationships but that many dads need guidance and both partners need to know how to support each other to achieve a close relationship with their new baby.

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