Post by sarahck on Oct 2, 2017 13:55:22 GMT -5
Have you ever once gotten to all the content in a Session 4? Postpartum contraception, interpersonal relationships/parenting/safety, and preterm labor, oh my! And a partridge in a pear tree....
I love the openers in the facilitators’ guides –
I have one more opener suggestion - since we talked about stress reduction and self-care at the last session, I like to go around the circle and have everyone say something they’ve done to take care of themselves since our last session.
And THEN it’s time for the big-bad postpartum contraception discussion. It can take hours! Here are some options:
WHEW. And that’s all just for contraception. Now we have parenting and relationship safety to tackle.
1. I LOVE the “Dear Centering” activity that is in the Facilitators’ Guide. Here are the questions that we use for them:
2. Some of our providers like the agree/disagree cards as a way to discuss domestic violence. They’re nice and neutral and nonthreatening, which is nice given the topic.
3. As I said earlier, I like to do the family question in popcorn form too - have them write "One thing I like about the way I was raised that I want to continue with my family is..." and "One thing about the way I was raised that I want to do differently with my family is..." This usually starts a lovely discussion about strengths and learning from our past.
WHEW again. And you STILL have to discuss preterm labor! We don’t really use any structured activities for that, just ask the group the classic Centering question: “When should I worry?” about preterm birth, naming all the warning signs. And you can refer to the March of Dimes page in the Moms’ Notebooks about late term brain development.
Wear your running shoes to try and get through all that in one session! Good luck!
I love the openers in the facilitators’ guides –
- Share good advice you’re hear about diet or exercise - I’d suggest one change to this - instead of having patients share good pieces of advice they’ve heard, have them share something they’ve actually done to improve their exercise and nutrition lately. I think that a lot of us get advice that we never follow up on because we don’t think it’s feasible or interesting to us. (For example, my partner has lost a lot of weight by eating raw almonds and 1 egg for breakfast. Me, I’ll take the double chin and muffin top rather than face that every morning.)
- Naming one thing you’d like to continue or change from the way you were raised (it’s an SAS in the patient notebooks). We often do this with popcorn due to the sometimes sensitive nature of the question, but I think it could work as an opener too.
I have one more opener suggestion - since we talked about stress reduction and self-care at the last session, I like to go around the circle and have everyone say something they’ve done to take care of themselves since our last session.
And THEN it’s time for the big-bad postpartum contraception discussion. It can take hours! Here are some options:
- I like the activity in the Facilitators’ Guides about having patients stand on the card of the contraception method that they want to use after the pregnancy, or that they have questions about. We usually don’t have time to do the activity of having them stand on what they used before they got pregnant, because see first sentence in this post. I suggest sticking with asking patients what they LIKE about this method. If you get “into the weeds” on all the side effects, then I’ve found the discussion can turn very negative and only focus on why everyone hates birth control. (Note: of course you have to have the discussion with patients about potential side effects before you prescribe a method of birth control; I just think there’s not enough time to go over all the benefits and side effects fairly with the limited time that you have considering all the options there are. I think that the purpose of this discussion can be to get information out there about options so that patients can follow up with their provider about which method they’re interested in selecting and can further discuss side effects at that point.)
- BUT BEFORE you do that activity, I suggest starting with goals. Hand everyone a piece of paper during mat time, ask everyone to write out a goal they have for themselves for the next 1 and 5 years of their lives. I tell them, “It can’t be ‘parenting,’ because we know you’re pregnant and assume that’s a given. But what are 2 other goals that you have for the next 1 and 5 years for yourself?” During circle up time, go around the circle and have everyone share their goals. Then I say something like,
“I noticed everyone has some great goals for themselves, but nobody had ‘having another baby’ as one of their goals [note – if someone did say that you can say ‘except for ___’]. So if you don’t want to have another baby, you’re going to need a tool to stop that from happening. Luckily, we have all these options that you can use, and we’ll talk about them and see if we can find the right one for you.”
The reason I like to do this is because it frames the PURPOSE behind our encouragement of postpartum contraception. And remind them that there are things that may make it worth the side effects/ risks of contraception. In my experience, this has made the discussion about contraception a little more positive. - When “male condom” comes up, I like to do the condom line-up game. Aaaand I make them actually do the steps with a condom and this little buddy. I highly recommend this game – we love it.
- I also like to use the STD stuffies (note, I also had to buy the HIV, Hep B, and trichomonas stuffies in addition to the ones that come in that box). I toss them out to the group and have them stand up if this statement applies to the STD they have:
Stand up if: you are transmitted by sexual intercourse of any type
Answer: All
Stand up if: you’re the most common STD in America
Answer: chlamydia
Stand up if: you’re the most common STD among teens in the US
Answer: HPV [note – this may change as kids that got the vaccine are growing up!]
Stand up if: there’s a vaccine to prevent it
Answer: HPV, Hep B
Stand up if: you sometimes have no symptoms at all
Answer: potentially everyone
Stand up if: you can cause preterm labor if present during pregnancy
Answer: chlamydia, gonorrhea, trich
Stand up if: you can cause infections in your baby
Answer: chlamydia, gonorrhea, Hep B, herpes, HIV, syphilis
Go to one side of the room if you cause discharge, the other side of the room if you cause bumps/sores/lesions
Answer: Discharge - syphilis, gonorrhea, trich
Bumps - HPV, syphilis, herpes
Go to one side of the room- treatable (but not curable), the other side if you’re curable
Answer: Treatable – HIV, Herpes, HPV, Hep B, HPV
Curable – syphilis, gonorrhea, chlamydia, trich
Go to one side of the room if you’re caused by exchange of fluids, the other side if you are caused by skin-to-skin transmission
Answer: fluids – Hep B, HIV, syphilis, gonorrhea, chlamydia
Skin-to-skin – herpes, HPV
Go to one side of the room if condoms offer protection against them, the other side if condoms offer limited or no prevention
Answer: condoms yes – Hep B, HIV, syphilis, gonorrhea, chlamydia
Condoms not so much – herpes, HPV (maybe syphilis?)
1. I LOVE the “Dear Centering” activity that is in the Facilitators’ Guide. Here are the questions that we use for them:
- My partner and I just can’t talk about our sexual relationship. What should I do?
- My partner doesn’t want to use condoms to protect me from STDs. I don’t think he’s cheating, but I want to protect myself and my baby. What should I do?
- How would I know if I have an STD?
- How would I know if I have HIV or AIDS?
- My partner doesn’t like it when I say “no” if I’m not in the mood for sex. What should I do?
- What should I do if I think my friend is being abused by their partner?
- My partner yells at me a lot, and I don’t like it. What can I do to get them to stop?
- Sometimes I’m afraid of my partner. What can I do?
2. Some of our providers like the agree/disagree cards as a way to discuss domestic violence. They’re nice and neutral and nonthreatening, which is nice given the topic.
3. As I said earlier, I like to do the family question in popcorn form too - have them write "One thing I like about the way I was raised that I want to continue with my family is..." and "One thing about the way I was raised that I want to do differently with my family is..." This usually starts a lovely discussion about strengths and learning from our past.
WHEW again. And you STILL have to discuss preterm labor! We don’t really use any structured activities for that, just ask the group the classic Centering question: “When should I worry?” about preterm birth, naming all the warning signs. And you can refer to the March of Dimes page in the Moms’ Notebooks about late term brain development.
Wear your running shoes to try and get through all that in one session! Good luck!