Winter 2012 Newsletter – Family Matters

What's On for Winter

We hope everyone had the chance to pause, relax, and enjoy the holiday season! School is back in session now, and the Family Care Office is excited to see that the campus is busy once again. This winter we are looking forward to bringing the U of T community new and exciting workshops, discussion groups and family events.

During the fall semester, the Family Care Office held many workshops on a range of topics including mindfulness for families, understanding care for elders in a long term home, and infant massage. We also hosted exciting events for the whole family, like the Halloween party and a free family skate at Varsity Arena. If you missed any of the workshops or events during the fall semester, do not fret! Here is a highlight of what's to come:

Choosing Childcare That Works for Your Family – February 29
Can I Have Both? Becoming a Parent While Pursuing Academia – March 6
Elder Care: Heads Up For Healthier Brains – March 29

The Family Care Office will also be offering a new discussion group:

Support Group for Parents of Children with Learning Disabilities – March 15 and April 19

If you have school-aged children, and are wondering about activities to do with them during the March Break, you should definitely check out the FCO's March Break activities! The activities will include, among others, a family yoga session and an art session that is part of the Global Art Project for Peace. Kids, along with their parents, will create a work of art expressing their vision of global peace and then exchange it with children somewhere else in the world.

For March Break camps and activities, look no further than the FCO website! The FCO has compiled a list of community centres and organizations that offer camps and other activities in the GTA. The list is available on our website at March Break Camp 2012.

If you haven't had a chance yet, visit the Family Care Office blog, Intersections: Where Work, School and Family Meet which features fun and informative posts related to family matters. The blog can be found at: http://blogs.studentlife.utoronto.ca/intersections/

You can also find us on Facebook and Twitter.

On behalf of the staff at the FCO I wish you good luck and good learning this semester!

Written by Anoja Muthucumaru (4th year Undergraduate, English)

Do you have healthy boundaries in your relationship?

Have you ever met someone who is stuck in such a bad relationship that you wonder why they don't just leave their partner? Or after dating someone who wasn't good for you for a long time have you ever stopped and wondered why it took you so long to get out of such a draining situation? The truth is it's always easy to judge a relationship when we're not in the middle of it. But sometimes, when we're really in love with someone, it can be hard to see the ways that our relationship is causing us pain, or how we can get help to solve some of these problems.

So how can we recognize if our relationship is healthy or not? After doing some reading on relationships, I decided to examine two different "diagnostic tools" that will help you assess how your relationship is doing.

Reading the book, "Don't be nice, be real" by Kathy Bryson inspired me to recognize that one of the ways to assess the health of your relationships is to look at whether or not your relationship has healthy boundaries. But what do healthy boundaries look like anyway? Sometimes it is easiest to understand boundaries by knowing what NOT having healthy boundaries looks like.

If you find yourself relating very highly to some or all of the items listed above, you may be experiencing some real difficulties in life right now. Perhaps your partner is sick, you're the main caregiver, and you're at the end of your rope. Or maybe your partner lacks coping skills because of a mental health or an addiction issue, and you find yourself suffering at work, losing weight, and struggling financially because of it. Either way, it's time you look into what you can do to help start building the healthy boundaries that you need to be happy. Try talking with your family doctor about support services, or stop by the Family Care Office to talk about what kind of community supports are available to you. You may also want to try contacting counseling services at the University of Toronto, or a community family service centre where you can talk with a social worker or other registered counselor for emotional support. See the resources at the bottom of this article for ideas.

After reading this checklist, you may be very concerned. You may be thinking about times you didn't want to have sex with your partner but you felt pressured or scared not to. You may be thinking about how scared you feel in general in your relationship and how often you do things you don't want to because your partner puts so much pressure on you. If this is the case, it sounds like you could be in an abusive relationship, and it is even more important that you seek help so you can stay safe and happy.

Keep in mind that even if your relationship with your partner is not abusive, you may still benefit very much from examining whether or not your partner and you have established healthy boundaries. Boundaries affect the health of all different kinds of romantic relationships, made up of all different kinds of people. So don't kid yourself – your relationship deserves to be examined regularly to assess whether or not you have appropriate boundaries.

Finally, for another diagnostic tool to assess how you and your partner are doing, drop by the Family Care Office and check out our display "Check the temperature of your relationship".

If you're struggling with some of the issues outlined in this article, please talk with someone about them. The following resources are available to you:

• Family Care Office, University of Toronto,
  214 College Street, Main Floor, Room 103, Koffler Student Services Centre.
  Phone: 416-978-0951
• Counselling and Psychological Services (CAPS), University of Toronto,
  214 College Street, Main Floor, Room 111, Koffler Student Services Centre.
  Phone: 416-978-8070 **Students Only
• Employee & Family Assistance Plan, University of Toronto
  Phone: 1-800-668-9920 **Staff and Faculty Only
• Family Services Toronto, various locations across the GTA.
  Phone: 416-595-9618.

Written By Mary Ann Nafziger, M.S.W. candidate, Social Work

Sources
Bryson, Kelly (2004). Don't be nice, be real. Elite Books, California, USA.

Sleeping Safely with Baby

Sleep. We all need it, but as new parents, we don't always get very much. While the average infant sleeps up to 16 hours per day, they do so lightly and with frequent waking. How this night waking is dealt with will differ from family to family. Some parents find that everyone sleeps better in their own beds, in their own rooms. Others find a bassinette or a crib in the parent's bedroom is the best choice, and still others find they get the most rest when the baby sleeps directly in the bed with them. There is no one right choice for every family.

It's important however to ensure that whichever sleep option you choose, you make the environment as safe for baby as possible.

Clutter-free Sleep Space
Regardless of where a baby sleeps, make sure there are no heavy blankets that could lead to suffocation. The safest option is warm sleeper pajamas so that additional blankets are unnecessary. Also make sure there are no toys in the sleep space for the first six months.

Smoke-free Home
Exposure to cigarette smoke can increase the risk of Sudden Infant Death Syndrome (SIDS). If you or other family members smoke, take it outside.

Back to Sleep
Babies who sleep on their backs have a much lower risk of SIDS. Every time you put your baby to sleep, make sure he or she is face-up.

Do Not Overheat
Make sure that the baby doesn't get too hot. Keep the room at a comfortable temperature, and make sure the baby isn't overdressed.

There are additional safety concerns for parents who choose to share their beds with their babies. The biggest risks are suffocation and entrapment. The Canadian Pediatric Society has acknowledged that while most families will choose to co-sleep with their infants (crib or bassinette in same bedroom), some will choose to bed share.

When done safely, bed sharing can be very beneficial for developing attachment with your baby, can make nighttime breastfeeding less stressful, and can lead to better sleep for some families. Some strategies to make bed sharing as safe as possible include:

• Never leave an infant or toddler alone in an adult bed.
• Use a firm mattress.
• To avoid/reduce the impact of falls, put the mattress directly on the floor.
• Never sleep with a baby on a waterbed or a couch.
• Keep your bed away from the wall, to avoid the baby from getting stuck in the small space between. Also keep the bed away from all other furniture.
• Choose a different sleeping option if you are under the influence of drugs or alcohol, overly tired, or if you take medication that lowers your ability to be alert.
• Avoid having siblings sleep directly beside infants.
  

Another safer bed-sharing option is to set up your child's crib beside your bed in a "side-car" fashion. Removing the side of the crib and securing it to your bed keeps your baby within arms reach of you, while ensuring an independent space without blankets and other suffocation hazards.

Whichever method best suits the needs of your baby and your family is the one that will work best for you. Following these simple strategies will help your baby sleep with fewer risks.

For more information about safe sleep, please consult the Canadian Pediatric Society's Recommendations for safe sleeping environments for infants and children.

Written by: Shannon Salisbury, MT candidate, OISE

Doctors, Midwives & Doulas: What's the difference?

If you are pregnant or planning on becoming pregnant there are a few options available to you for prenatal, labour & delivery, and postnatal care. Many women are unaware of some of the services available to them in Ontario, so this article aims to explore some of these care options including doctors, midwives and doulas.

Doctors

If you would like to use a doctor as your primary health care provider during your pregnancy and delivery you have a few options to explore. All physicians are registered with the College of Physicians and Surgeons of Ontario and have acquired a medical certificate. Some family doctors are able to provide prenatal care and delivery (obstetrics), as a part of their practice. Additionally, an obstetrician (OB) is a doctor that specializes in obstetrics, which is a focus in pregnancy, labour and delivery. Obstetricians have the ability to work with women who are experiencing pregnancies that are deemed high risk or have special needs such as multiple pregnancies, high blood pressure and/or diabetes.

All labours and deliveries provided by doctors take place in hospital settings and are covered by OHIP. Obstetricians and doctors who provide obstetrics are usually only present during the final stages of delivery and periodic checks through labour. Often an obstetric nurse is present throughout the whole labour & delivery process to supplement the services provided by the doctor. Often doctors have a practice with other doctors who, as a team, cover shifts at the labour & delivery ward at the hospital. This means that it may not be your doctor specifically that is present at your delivery but could be another doctor who is in practice with your physician.

If you already have a family doctor that you like, you can inquire as to whether or not they have the ability to provide obstetrics. If they do then you are set, as you already have a working rapport with your physician and they will continue to provide you with care. If they do not have obstetric capabilities than you can ask if they may be willing to provide "shared care" which means they work in partnership with an obstetrician in caring for their pregnant patients. The obstetrician will take over the complete care towards the end of the pregnancy and for the delivery. After the birth the family doctor will resume care for the mother and the new infant.

If you do not currently have a family doctor, and would like to use a family doctor who can provide obstetrics, you can go to the College of Physicians and Surgeons website and use the "Doctor Search" tool to find a doctor in your area.

If you would like to use an obstetrician, you will need a referral from a doctor, as appointments cannot be booked directly. This referral can be provided by a family doctor or a doctor at a clinic or hospital.

Midwives

Midwives are registered health care professionals who act as primary caregivers for women deemed low-risk during their pregnancy, labour and birth. The College of Midwives of Ontario is responsible for protecting the public by licensing/ insuring midwives and developing standards of safe care in Ontario. Midwifery care in Ontario is paid for by the Ministry of Health therefore services are free for all Ontario residents. Only one primary health care provider is covered by OHIP, therefore you must choose between using a midwife OR a doctor to be your primary care provider.

Midwives use a client/women centered approach to care and believe that empowering women through informed decision making leads to the best outcomes for moms and their babies. Using this approach midwives and their clients will work together to create a birth plan that best suits the needs of the mother. Midwives believe women have the right to make informed choices regarding issues such as vaginal birth or cesarean, tests during pregnancy and where to have their baby. Midwives support a range of pain management options including the use of massage, heat and water therapy, as well as epidural anesthesia. It has been a common misconception that midwives will not support the use of pain management medication during delivery, however, most will.

With the services of a midwife, women can choose to either deliver at a hospital or at home. Midwives are typically present throughout most of the labour & delivery process. Ontario midwives have privileges at most hospitals in Ontario, meaning the client will be admitted and discharged from the hospital by their midwife and their midwives will attend to the birth process rather than doctors. Ontario midwives are also trained in safe home birth practices. The benefits of a home delivery often include feeling more relaxed and calm than at the hospital and experiencing a lower likelihood of needing medical interventions, such as a c-section. A disadvantage of a home birth for some women may be that the use of epidural pain management can only been done at a hospital. Some women may also feel safer at the hospital.

Midwives specialize in low risk pregnancy and delivery only, however they are also trained in emergency skills. The mother and baby are closely monitored during the whole labour process and a close eye is kept on any possible complications. Additionally, midwives and midwifery organizations usually work in close partnership with a few doctors. This has proved to be helpful in dealing with women who become more high risk or require medical intervention during their labour and delivery.

Midwives also provide postpartum care to new moms and their babies for six weeks after the birth. Midwives will monitor the health of both mother and baby, providing breastfeeding support and ensuring that the mother is recovering both physically and emotionally. Within the first twenty-four hours after delivery, midwives will provide in-home care visits. Additionally, midwives will continue to provide post-natal/newborn care and breastfeeding support for up to six more appointments. After six weeks you will be released from midwifery care and you will use a family doctor for future care needs.

For more information on finding a midwife in your area, visit the Association of Ontario Midwives.

Doulas

Doulas provide emotional and physical support to women, and their partners, during the childbirth process. They are not licensed medical health professionals and should be viewed as non-clinical support persons throughout the labour and delivery process. This means that doulas do not provide any medical services such as vaginal exams to check dilation, taking blood pressure etc. For many women, especially women experiencing their first pregnancy, the process of childbirth can be anxiety ridden due to uncertainty of what to expect. Doulas help to empower women by providing information about the physiology of birth, making women aware of their options and rights during childbirth, and assisting in creating and carrying out a birth plan. Specific services that each doula provides may vary, however most doulas meet with clients 1-5 times during pregnancy, are present through the whole labour & delivery process and offer 1-5 postnatal/breastfeeding support sessions. Unfortunately, doula services are not covered by OHIP but many offer sliding scale fees. To gain more information and to find a doula services in your area visit www.doulacare.ca.

Written by Carol Anne Austin, M.A., M.Ed. candidate, OISE

Sources
Association of Ontario Midwives (www.aom.on.ca)
College of Physicians and Surgeons (www.cpso.on.ca)
Doula Canadian Association, Registration and Education (C.A.R.E) (www.doulacare.ca)
Planned Parenthood Toronto (www.ppt.on.ca)
Sexuality-and-U (www.sexualityandu.ca)
Toronto Public Health (www.city.toronto.on.ca/health)

 

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