Winnipeg Free Press

Winnipeg Free Press (Newspaper) - August 06, 2013, Winnipeg, Manitoba C M Y K PAGE A11 A FTER a difficult birth, I was alone with twin infants for six hours. One was in a sling, the other nearby. The days ( in fact, the first two years) were a blur. I collapsed on the couch wearing a calm baby while the other one slept. When I awoke, startled by one of the babies' cries, 15 minutes had passed. That was my only chance to sit down for the day. After that, my husband and I decided that nobody should be alone with our twins for more than three hours. Everyone needs to sit down sometimes or use the washroom. New moms may need breaks the most, but they get the least. Giving birth is life- altering. Modern medicine has improved things dramatically. Now, when you give birth, you and your infant are likely to survive. This hasn't always been true. There are still women who die in childbirth and babies who don't make it. Our society, however, forgets how scary this experience can be. Many deal with childbirth without family and community support. Newcomers to Manitoba cannot always expect help when a baby is born. Although parental- leave policies exist, there are situations when the mom's partner cannot take time off - leaving her alone to recuperate and care for a newborn - and possibly older children. At best, a woman has a short, easy labour and birth and a healthy, fullterm newborn. Even so, recovery and newborn care can be hard. Somewhere between one- fifth and one- third of all babies are born by caesarean. These surgeries are sometimes planned, but many are emergencies. Then, a mom is recovering from major abdominal surgery while also managing a newborn that may have special needs as a result of the caesarean. The public health nurse was my lifeline to the health- care system. My obstetrician was quick to encourage me to return to my family doctor after an emergency caesarean - too quick, as I had to return to the hospital for more surgery due to complications. While I was pregnant, my family doctor left his practice. The practice's other doctor had a full roster and no intention of taking me on. I was left without a doctor when I needed one most. It took six months to find a new doctor, even with the advocacy of the public health nurse. I juggled my twins' health issues along with my own. Recovery was slow. New to Canada, we leaned on local friends and house guests, but lacked basics that many people take for granted. What should we do for new moms? Here are a few suggestions to start the discussion. . Put resources behind better patient care: Fund more midwives in the province and more support for women to choose their birth plans and be respected for their choices. I felt pressured to be induced, to be constantly monitored and to take drugs I didn't want. In the end, my birth experience was botched, requiring a second surgery to correct a dangerous mistake. Some people find their babies' births meaningful - I found it traumatic. . Doctors should notify their patients directly when they leave their practices so new moms know to find new doctors when it matters - right after giving birth. . The province must help new moms and infants. At present, the Family Centre of Winnipeg helps some families with special needs but is unable to keep up with demand. Public health nurses are great but cannot meet some moms' needs. A potential system might be based on the model of the postpartum doula. She's a knowledgeable person who comes into the home to help with nursing support, baby care, laundry, meals and basic cleaning. Our postpartum doula was a lifesaver. She helped us a few days a week until our twins were five months old. We couldn't have managed without her. . Every family affiliated with a place of worship should be able to draw on organized support from that community. Every church, temple, mosque and synagogue should have a " helping- hand" committee alerted to the community's pregnant women and their due dates. That committee should help with whatever the family feels comfortable - with soup or hands to hold a baby or two. We wish we'd had such an organized endeavour. Friends offered us assistance, but it was hard to organize it to be helpful on one to three hours of sleep at a time. . Manitoba must get a better childcare system in place. We, like others, have been on countless wait lists with no hope of a good placement. One of our preferred daycare options told us we were 156th after 18 months on the waiting list. This is a recipe for disaster. If the province is serious about generating revenue, they must find a way to help women get back to work promptly after maternity leave. If there is adequate licensed child care available, women return to work. The province taxes that income, providing provincial revenue. Licensing more childcare providers makes jobs and tax revenue available. There is no downside to providing an improved childcare infrastructure in Manitoba, especially for children younger than three. . If you know a neighbour or friend is giving birth, see if you can help out. Suggest a visit, bring a meal or walk the dog. Consider reaching out, as an individual, to help others. These visits are signs of support from the community to a new mom. . New motherhood is not all cute baby skin, good smells and roses. It's hard work, mind- numbingly boring and isolating. Many moms enjoy every moment with their newborns, but many of us don't. Please don't make perfectly competent new moms feel bad by offering unneeded advice about what worked for you as you got rest and support, felt like a million bucks and were joyous 24 hours a day. Some of us miss our careers and our old lives and need help coping with this transition. Don't make new moms feel bad if they can't enjoy this. Many people never do. Some just get through it. This is in memory of those who don't make it. We can't know what goes on in the minds of moms who can't manage. But many of us struggled and imagined the worst. Please reach out to help new moms. Joanne Seiff is the author of Knit Green and Fiber Gathering. She lives in Winnipeg and has twin two- year- olds. www. joanneseiff. com New mothers need supports JOANNE SEIFF A RLINGTON, Va. - A cute little bungalow where crazy dreams once grew poses at the apex of a quiet cul- de- sac. There is an open house today on Evergreen Street, and the 65- year- old grey- brick Cape Cod with the dormer windows and the plunging ravine in the backyard looks like a steal. Where else can you find a renovated four- bedroom this close to Washington for only $ 949,900? Inside, there is no trace of the former occupants, a Pentagon family whose dad rose to the rank of rear admiral in the United States Navy and whose tenure in Arlington was only one stop during a peripatetic career that took him from Georgia to Pearl Harbor to Florida to Virginia to Korea to New Mexico to California and to Vietnam to help start a war. Along the way, George S. Morrison and his wife Clara had three children, one of them a boy they named James Douglas. Now, in the bungalow the family once called home, there is an upright piano in the immaculate front room and books about dinosaurs and da Vinci on an antique �tag�re. One bedroom has been turned into a museum of expensive American Girl dolls and their period- piece accoutrements, and another has a Bengal tiger painted on the wall. Looking down Evergreen from the upper storey, I picture a young Jim Morrison scanning the same bland prospect and thinking - as he later would prophesy in song - " no one here gets out alive." That would have been in the 1950s, when the future Lizard King of psychedelic rock and front man of the Doors was following his bemedalled father from port to port, little knowing that, by 1971, when he was only 27, he would be celebrated, wealthy, world- travelled, wasted and dead, his brief, bright fire already lit and snuffed, to be entombed beside Moli�re and Modigliani, Delacroix and Chopin at the Cimiti�re de P�re- Lachaise in Paris. When I come back down to the living room, there is a woman on the verge of tears. " I lived in this house from 1956 to 1959, just after the Morrisons left," Adrie Sardonia Custer is saying. Her father, she tells me, was an air force intelligence officer during the Vietnam era. It's her first time back inside in 50 years. " My dad died last year at the age of 93," she sighs, " and in this house I see him everywhere." " Did Admiral Morrison pay him 950,000 for it?" I ask, trying to brighten the mood. " My parents would turn over in their graves," Custer replies. The tidy Cape Cod on Evergreen Street is not officially designated as a National Historic Site of Rock ' n' Roll. ( Neither is the house on Vernon Place in Melbourne, Fla., where Jim Morrison was born; in fact, during the recent implosion of Sunshine State real estate, its listed value actually fell from $ 225,000 to $ 78,000.) This isn't even the only house the Morrisons lived in during Jim's elementary- school and, later, his high school years in Arlington. Half a mile away, on North 28th Street, is a brick ranch whose current owner, a woman named Rhonda Baron, claimed a couple of years ago she had seen Morrison's ghost stretched out on her bed. " It was like a haze. It was like you could look through it," Baron avowed. Back on Evergreen, van loads of families far too young to remember the Doors are flocking to the open house. Flitting to their sides is a 48- year- old realtor named David Lloyd , who can barely hide his excitement behind a polished spiel and yellow balloons. " As an adolescent," Lloyd says, " our gang idolized Jim Morrison and the Doors, and we all tried to be like him. But try as I might, I failed to achieve the full Lizard King." This underachievement may have saved Lloyd's life. " What we strive for as adolescents is not the same as what we strive for in adulthood," the agent sagely notes. But for Jim Morrison - and for Janis Joplin, Jimi Hendrix, Kurt Cobain, Amy Winehouse and Cory Monteith, whose death is announced on the same day as the open house on Evergreen Street - true adulthood, with its domestic responsibilities and quotidian rewards, never came. On a blistering day at a fountainhead of rock, I venture out into the yard to gaze at the admiral's rear. There is a hot tub here now, expensive hardscaping, and a steep, landscaped hill down which, on snowy afternoons, a doomed young poet might have sledded 60 years ago. In my head is a lonely song of a deep- blue dream. And back in the little house on Evergreen, Adrie Custer is smiling again and saying, " I always tell people that Jim Morrison and I shared a bedroom. Just not at the same time." Allen Abel is a Brooklyn- born Canadian journalist based in Washington, D. C. Winnipeg Free Press Tuesday, August 6, 2013 A 11 POLL �� TODAY'S QUESTION Should the CMHR agree to use the term ' genocide' to describe Canada's past treatment of aboriginals? �� Vote online at winnipegfreepress. com �� PREVIOUS QUESTION What are your plans for the long weekend? TOTAL RESPONSES 4,524 Winnipeg Free Press est 1872 / Winnipeg Tribune est 1890 VOL 141 NO 260 2013 Winnipeg Free Press, a division of FP Canadian Newspapers Limited Partnership. Published seven days a week at 1355 Mountain Avenue, Winnipeg, Manitoba R2X 3B6, PH: 204- 697- 7000 BOB COX / Publisher PAUL SAMYN / Editor JULIE CARL / Deputy Editor Doors founder slept here ALLEN ABEL T HUNDER BAY - Physicians are the secondlargest component of provincial government health spending in Canada, averaging about 20 per cent of overall health- care budgets and constituting one of the fastestgrowing public health- sector costs of recent years. This is despite the fact Canada has relatively few physicians compared with many other developed countries. According to 2013 Organization for Economic Co- operation and Development health statistics, at 2.4 practising doctors per 1,000 people, Canada ranks 28th of 34 OECD countries. These countries range from a high of Greece, with 6.1 practising doctors per 1,000 people, to Chile's low of 1.6. Canada is just behind the United States at 2.5 and ahead of Japan, Mexico and Poland - all tied at 2.2. Recent Canadian growth in physician ranks has some pundits alarmed. In a new study for Health Policy , however, I demonstrate it is not growing physician numbers we need to worry so much about. The greater strain on our health budgets will come not from more doctors, but from more doctors earning more while working less. Estimated determinants of provincial government health spending show physician numbers alone are indeed a positive driver of health- care spending after controlling for other factors. From 1975 to 2009, the increases in physician numbers accounted for a range of about three to 13 per cent of the increase in average real per- capita total provincial government health expenditures, ranging from a low of two to eight per cent for Manitoba to a high of five to 18 per cent for Quebec. These results support the conventional wisdom that expansion in the number of billing physicians is itself a driver of health- system spending. Yet physician numbers contribute less to spending increases than do increasing fees and service volumes. Indeed, a Canadian Institute for Health Information study on health cost drivers found new technology, utilization and price inflation at the top of the list, along with population growth and aging. We also need to recognize that many of our doctors are working fewer hours than in generations past. One study found 27.7 per cent of Canadian family doctors reduced their work hours between 2005 and 2007, and 33.9 per cent of them planned further reductions in their weekly work hours between 2007 and 2009. Only 8.1 per cent planned to increase their weekly working hours. Another study found younger and middle- aged family physicians carried smaller workloads than their same- age peers a decade earlier. Older physicians, many approaching retirement, are carrying a heavier workload relative to younger physicians. These payments to physicians for their services, according to CIHI, continue to grow, rising six per cent in 2010- 11 after increases of 9.7 per cent in 2008- 09 and 7.9 per cent in 2009- 10. While total physician numbers are growing, the workloads for many physicians appear to have declined, but their compensation has not. Doctors do work long hours, and it is understandable they may desire a better work- life balance. In an era of tight public budgets, however, having more physicians doing less and costing more may be seen as a luxury. This sentiment was undoubtedly a driver behind Ontario's recent decision to tackle physician fees, especially given that physicians in Ontario account for about onequarter of the government's health spending - the highest share in the country. The recent increases in physician numbers from ramped- up medical school enrolment may not be the biggest cause for concern when it comes to future health- care spending. Rather, the drivers of public health- care spending are a complex interaction between physician numbers, physician decision- making, physician workload, diagnostic and drug technologies, population growth, aging, the cost and deployment of human resources, provincial health- system institutions and the role of demand- side economic variables such as incomes and patient preferences. So what can be done? Future cost control in health spending will need to either restrain growth in service volumes and utilization - an unpopular move with the public - or it will need to tackle fees much more directly - an unpopular move with health- care providers. One thing is certain: The recent trend toward doing less for more is not a sustainable option. Livio Di Matteo is an adviser with EvidenceNetwork. ca and professor of economics at Lakehead University. His recent study, Physician Numbers As a Driver of Provincial Government Health Spending in Canadian Health Policy, appeared in Health Policy. - Troymedia. com LIVIO DI MATTEO Doctors are working less for more Heading to the lake 14% Starting my summer vacation 4% Attending a festival 5% Hanging around the city 52% I have to work 25% Jim Morrison A_ 11_ Aug- 06- 13_ FP_ 01. indd A11 8/ 5/ 13 11: 43: 18 PM ;