Open Arms Luncheon Keynote

By popular request, here's the link to Rachel Abramson's keynote speech, in its entirety, from the Open Arms Luncheon.

Open Arms Perinatal Services Spring Luncheon Keynote

Increasing bonding through biology

Oxytocin - of course we know that hormone as the one that's important during labor & childbirth and breastfeeding. It's also called the "tend and befriend" hormone because it helps bonding and creates good feelings and relaxation. The more of this hormone you have, the more good feelings you have about those around you and with babies, the stronger the bond. That's one of the reasons that mothers breastfeeding report increased bonding - all that oxytocin flowing helps with bonding.

This study that came out last month peaked my interest because it takes a look at the differences between mothers and fathers interacting with their infants and the impact on oxytocin.

Natural variations in maternal and paternal care are associated with systematic changes in oxytocin following parent-infant contact.

It seems men and women have increases in oxytocin at different times, and that these seem to match the typical interactions with babies according to the adult's gender. Women/mothers have a rise in oxytocin when they have high levels of affectionate contact with their babies - giving them lots of snuggly loving! Oxytocin doesn't rise with low levels of affection, it has to be that full-on affection and touch. Men, on the other hand, have their rise in oxytocin with high levels of stimulatory contact - physically engaging with their babies, lifting them in the air, or playing with them while highly engaged.

What's interesting to me is that both moms and dads naturally tend to do the kind of interaction that will increase oxytocin, with the moms snuggling up their babies and the dads being more physically active.

But it also has implications for parents who aren't bonding well or who feel separation from their infants due to depression or extended NICU hospital stays for premature babies - the study suggests that just doing the kinds of activities with your child that increase the parental oxytocin may be helpful in increasing their feelings of bonding with their babies. Allowing for more of these interactions will strengthen bonds of parenting naturally, enhancing the bond with biological responses.

So to strengthen the bonds of parenting, men and women can do different things.

So, men, play with those babies! Women, snuggle them up!

Let the bonding begin!

Community-based doula model

I wanted to share this from our luncheon.

Our speaker was Rachel Abramson, Executive Director of HealthConnect One in Chicago. She spoke about the kinds of results they have seen from community doula programs. The Open Arms Outreach Doula program is modeled after the program in Chicago.

Rachel said:

Let me tell you a bit about the community-based doula model, the foundation for Open Arms’ Outreach Doula program. This evidence-based model has been cited by the Center for American Progress as one of five important national evidence-based home visiting models. It began with a four-year pilot serving low-income African-American and Latina pregnant and parenting teens in Chicago from 1996 – 2000. With 254 mothers in the evaluation, we saw:

* 80% breastfeeding initiation rates, including 65% initiation rates at an agency with practically no breastfeeding in their home visiting program before the doula piece was integrated

* 8.1% c-section rates

* 11.3% epidural rates

* Increased pregnancy spacing for young teens

* Significantly enhanced maternal scores on the NCAST scale to rate videotapes of maternal-infant interaction

* Decrease in preterm births

* Cost savings including $750 per person in c-sections and epidurals not performed, approximately $500 per breastfed baby in savings on formula, and broader savings from shorter hospital stays and less illness among breastfeeding babies.

These outcomes have held up over time and with replication in a variety of underserved communities across the country. We have seen consistent high breastfeeding rates, consistently lower c-section and epidural rates, increased use of birth control, increased practice of skin-to-skin contact after birth, and lower preterm and low birth weight babies. There are now 40 community-based doula replication sites in 14 states, 6 of which are funded through the new HRSA Maternal and Child Health Bureau funding stream. We have rolled out this year a robust and user-friendly data collection system designed to continue the process of evaluating these programs and researching the outcomes and processes of community-based doula program.

These outcomes are so important. The birth outcomes that come from having a doula are outstanding - resulting in healthier moms and babies, lower health care costs and shorter hospital stays.

But the one that really caught my eye is the better parent-child interactions. That is the key - the lasting effect that will go on to improve lives for years to come. When a parent increases the quality of interaction with the child, all sorts of brain development happens, attachment happens, and the entire family is strengthened.