Bartlett Regional | House Calls | Fall 2019

During her years working with new families at Bartlett Regional Hospital, Debi Ballam, RN, has seen a lot of changes—and has brought better, more empowering care to the parents and children of Southeast Alaska. Over the course of four decades, Debi taught childbirth preparation courses in her own home; started on-campus pregnancy, childbirth, Just for Dads and breastfeeding classes; initiated parent-child groups and an outpatient breastfeeding clinic; became certified as a lactation consultant; won numerous grants to bring specialized training to her colleagues; and began the years-long effort to certify Bartlett as Baby- Friendly, a breastfeeding advocacy program initiated by the World Health Organization and UNICEF. Today it is common for women to give birth in the same room in which they labor. But, as Debi well remembers, that was not always the case. Through the 1980s, labor happened in regular hospital rooms. Births took place in birthing rooms for low-risk mothers and stark and shiny delivery rooms for higher risk cases. Women stayed in the hospital an average of three days after a vaginal birth and five days after a cesarean section. That gave medical providers time to educate new families on how to care for their newborns. But by the early 1990s, as hospital stays got shorter, the hospital faced a new challenge: A way had to be found to maintain parent education and improve patient safety— without an extended hospital stay. Positive changes Debi wrote a proposal to teach classes for new parents as part of her job. She recalls the administrator at the time, Robert Valliant, as adamant that they be free of charge—and all Bartlett Beginnings classes are still free of charge today. Around the same time, a national movement to help women be more in control of their own birth processes, with fewer medical interventions, began. Bartlett built a birth room, where mothers both labored and gave birth. The room was popular. Another was built and then another. In the mid-1990s, the obstetrics unit became Bartlett Beginnings. Most births occurred in birth rooms where mothers could labor and birth in the same room and have support people with them. With the opening of a new wing in 2007 came rooms furnished to create a more home- like environment. They have beds that look more like those at home, whirlpool tubs to help ease labor pain, and space for generations of family members to witness the birth and welcome the arrival of their grandson or niece. The journey to Baby-Friendly Breast milk is the established best source of nutrition for babies, and breastfeeding has remarkable health benefits for both baby and mother. However, of the 80% of mothers who start breastfeeding their babies, only 1 in 5 continues to exclusively breastfeed for the recommended first six to 12 months. Bartlett provides the support and resources to encourage mothers to breastfeed as recommended for at least the first year of life. At least 25 years ago, Debi was inspired to boost the number of breastfeeding new mothers by training staff to teach and encourage proper breastfeeding techniques through the Baby-Friendly program. “If bigger hospitals could do it, with thousands of patients, why couldn’t we?” thought Debi. She started down the long and winding road to certify Bartlett Beginnings as a Baby-Friendly Hospital. First, Bartlett Beginnings would have to reach a high benchmark for breastfeeding training and practices as endorsed by the Centers for Disease Control and Prevention. Guidelines include a written breastfeeding policy, staff education, helping moms learn how to breastfeed within the first hour after birth, giving infants no food or drink except breast milk, and having babies room in with moms. The offer of free formula samples provided by companies is a thing of the past. In 2014, the Bartlett Beginnings team met the standards to achieve the coveted certification and become one of only two designated Baby-Friendly USA hospitals in Alaska. “Former Bartlett Beginnings Director KarenWhite was very supportive and instrumental in making that happen,” says Debi. Debi is gratified by current data: “In 2019, over 98% of mothers initiated breastfeeding while at Bartlett Beginnings.” Better BEGINNINGS Debi Ballam, RN, reflects on 40 years of breastfeeding advocacy and education for young families OB CARE www.bartletthospital.org 5