Having "The Talk" Again and Again

Many of us remember the infamous parental talk about the
"birds and the bees." It was the conversation our moms or dads hoped would help us make informed decisions about having sex and understand the impact of those decisions on our futures. It was not only a rite of passage into adulthood, but one of the preliminary steps in developing a life plan.

But what happened after that talk? Did parents keep talking about sex with their kids as the kids grew up? And who's talking to the adults about sex and its impact on their lives? A life plan is not set in stone as a teen. As an adolescent our goals may have included getting a part-time job, finding a prom date and graduating from high school. As an adult our goals may shift to wanting to purchase our first home, getting that promotion or maybe even starting a family.

Similar to the talk shared between parent and child, we need to keep talking to women and men about making informed decisions about having sex. It's not just talking about birth control and how many children they want to have. We need to talk about healthy relationships, sexuality, sexual transmitted infections and making positive changes.

Contrary to popular belief, family planning counseling is not just something that should take place at the doctor's office. Family planning can be discussed between parents and children and husbands and wives and everyone who could be sexually active. A pastor may need to discuss family planning options with a couple during premarital counseling. Perhaps an outreach worker may find that he or she needs to go over the benefits of birth control methods to a class of young women. All these situations are different, yet family planning counseling is appropriate for each one.

Family planning counseling should be a two-way conversation. As a counselor it is important to ask questions, listen to the response and then provide relevant information based upon that response. For example a community advocate is working with a new mom and discovers she is interested in different family planning options. One of the first questions the advocate may ask is "Do you wish to have any more children?" If the response is yes, the community advocate's next question might be "How long would it be before you would like to have additional children?" Depending on the response the community advocate may then provide information on non-permanent birth control methods such as the pill or the intrauterine device (IUD).

Family planning counseling can be a long or short conversation. It all depends upon the needs of the person at that time. It just needs to keep happening on a regular basis and in many different environments. However, it is important to note that only medical professionals should give medical advice. As mentioned before this doesn't mean that only medical professionals can provide family planning counseling. Non-medical counselors can provide basic information on family planning methods to better prepare a woman for her visit with her healthcare provider. Like the old cliché says, knowledge is power. It is imperative that women feel knowledgeable about their options and comfortable sharing questions with their healthcare provider. The more informed the woman, the more likely she will ask questions that will lead to her finding the best family planning option for her.

Because there is a lot of information on family planning, especially on the internet, it may be difficult to decipher accurate information from not so reliable information. To better assist you, the North Carolina Healthy Start Foundation offers My Health Journal and Taking Care of Me. Both materials have relevant information on wome'’s health and family planning needs. Make having "the talk" easier by ordering these free materials for yourself and to share with others. The North Carolina Healthy Start Foundation works to improve the health of women by providing resources to empower and lead them to making healthy decisions. If you share the same mission, we are here to help.

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Toughest Crib Safety Rules

New federal crib standards recently approved by the U.S. Consumer Product Safety Commission are a step in the right direction in protecting vulnerable babies while they sleep or play in their cribs. This is good news for parents and caregivers. Complying with, and not side-stepping, the new standards may be challenging, but infant sleep safety must not be compromised.

Effective June 28, 2011, all cribs sold in the U.S. must comply with the new safety standards. The standards address major hazards that have, over the years, been fatal. The new safer features include:

• No drop sides on cribs
• Stronger side slats
• Stronger and more durable hardware
• Improved mattress support

The latest standards affect parents and caregivers in several ways. It is now illegal to donate or sell old cribs, even at yard sales. Sales on eBay, Craigslist and other sites will be monitored and it is likely to be several years until the safer cribs will be available secondhand. To get rid of an older crib, the crib should be taken apart and the pieces thrown out at different times so no one can take the parts and rebuild it.

Regulators recommend that all cribs made before the new standards be replaced. Because of the expense of buying a new crib, families can save money in other ways such as buying a fitted crib sheet for the new crib and not the expensive bedding sets with bumper pads and quilts – items which are also hazardous for babies.

Crib safety testing by manufacturers has become more rigorous but unfortunately there is no label identifying the new cribs. Shoppers should not trust labels that say the cribs "meet or exceed federal standards" but should ask if the crib meets "16CFR1219" or "16CFR1220" - the laws for standard and non-standard size cribs.

Transitions are always hard but having safer cribs for babies is long overdue. In no way should the tougher new standards be an excuse to put sleeping babies at greater risk by putting them to sleep on sofas, water beds, fluffy comforters or with other children or adults.

Resources:
U.S. Consumer Product Safety Commission
Information on the new crib standards, crib recalls and a video on infant safe sleep.

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A Safe Home for Help

Women & Substance Abuse

Picture a young 19-year-old pregnant mother of two. Her name is Jodi. She's eight months pregnant, unemployed with 3-year-old twins, a son and daughter. Physically and mentally she is stressed and depressed with little to no support. Jodi has found herself in an unhealthy relationship with her new baby's father who is verbally abusive, drinks heavily each day and gets high with friends at home. Although she's asked him to stop many times, Jodi finds herself drinking alcohol and smoking marijuana from time to time just to cope. She knows she needs to stop and she's worried about her kids and the affects the drugs may have on her unborn child. She doesn't want to lose her kids and wants help but doesn't know where to go or what to do.

Sadly Jodi represents 1 in 12 women across the U.S. who drink alcohol during their pregnancy, according to the Centers for Disease Control and Prevention. The American Pregnancy Association reports that more than 100,000 women each year use illicit drugs while pregnant. What can you do to help women like Jodi when they come to your door?

Lynda Alexander, RICHES member and Program Director for the Robeson Health Care Corporation's CASAWORKS & Maternal Program, is working to reduce this disparity in her community by offering a home to women like Jodi who suffer from substance abuse. CASAWORKS provides a one-year residential treatment program for pregnant and parenting women in Robeson County. The CASAWORKS & Maternal Program has eight furnished apartments for mothers and their children. Mothers seeking treatment must be 18 years of age and have physical custody of at least one child 11 years of age or younger.

Do you have a client suffering from not only substance but mental and physical abuse?

Alexander said the CASAWORKS & Maternal Program offers a holistic approach, counseling women on specific topics such as domestic violence, trauma (sexual, physical and verbal abuse), relationships, women's health issues, nutrition and more. She said their goal is for every woman to make a solid recovery. In addition to counseling each resident receives parenting, financial management and health education classes. "We teach parenting skills to help improve the relationship between mother and child," she said. "Also, when they become employed we help them maintain a job and we strive to ensure both mother and child has preventive healthcare services."

Alexander said the RICHES Choices That Matters Tool Kit and Family Planning flashcards worked perfectly with their Life Skills classes and she is glad to have received training on these materials at the RICHES regional meetings this spring. The tool kit, a portable, easy-to-use flip chart binder includes information and activities on a variety of health topics including relationships, domestic violence and STIs. The tool kit also includes family planning methods flashcards, a ready-to-go teaching tool to help explain and talk about the types of methods, how they work, benefits of planning a family and where to get resources.

She said the Life Skills class, which consisted of four women ranging from ages 24 to 40, really enjoyed the lesson on family planning. "They asked a lot of questions when I got to that section," she said.

Once residents complete the one-year treatment program, Alexander said they work with them on a discharge plan, which may include vocational rehabilitation and public housing services. "Some clients decide to get an apartment locally, some return to their home area, some move on to Mary's Homes in Greensboro or Grace Court in Lumberton," she said.

Alexander said to obtain a list of bed vacancies individuals may email Judith Johnson Jones, Coordinator of the Perinatal Substance Use Project, at jjones@alcoholdrughelp.org. She looks forward to being a resource to the friends of the RICHES network who see women suffering from substance abuse issues. "RICHES is about collaborating and forming partnerships and I look forward to doing that in the future," she said.

RICHES is dedicated to improving the health of women, particularly minorities and those living in low-wealth communities, by creating opportunities for community-based organizations to educate, encourage and support women in adopting healthier lifestyles and behaviors. If you are interested in joining RICHES or would like to obtain a bed availability list for women in your county, please visit www.NCHealthyStart.org for more information.

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Instructions Not Included

Helping Latino Youth Make Informed Decisions About Sex

We know that babies don't come with instructions but there is a lot of information out there to help new parents figure out how to change diapers, how often to feed the baby and when to go to the doctor. And as the baby grows, many parents ask for advice on what to do about a cold, enrolling a child in school or how to get a child to eat better. But when the child becomes an adolescent there is one subject that often silences parents:
S-E-X.

Many parents don’t know how to talk to their children about sex, especially if their parents didn't talk to them about it, as is the case for many Latino parents. Rather than seek advice, they avoid the subject or tell their children sex is bad and leave it at that. Unfortunately, children and youth hear about sex from many other sources and those messages and information are not always the best.

Research shows that teens are less likely to engage in sex if they have had information from their parents. So how can we help Latino parents do that?

The North Carolina Healthy Start Foundation heard in focus groups that Latina mothers were very concerned about their daughters becoming pregnant, but did not know how to talk about this with their daughters. Many mothers expressed not knowing how to start this conversation and felt that they were not experts. In one focus group, a mother said "I don’t know anything about the different kinds of [contraceptive] methods. I have started to pay attention because I see that girls are curious and that is natural. I don’t want her to have a baby while she is still a baby."

The concern about being an expert keeps many parents from even starting a conversation. So we decided that it was important to let Latino parents know that they do not have to be experts. All the parents have to do is talk to their children, ask them questions and listen to what they have to say. The audio guide Conversando con nuestros hijos: consejos de madres latinas sobre la educación sexual (Talking to our children: Latina mothers' advice about sexual education) aims to help parents do just that.

The guide is divided into "how to" topics and the information is delivered by four Latina mothers in North Carolina who overcame their own inhibitions and began addressing this difficult topic with their children. The guide was created from live interviews with the mothers. In those interviews they discuss how hard it was to start the conversation but why they did and provide advice for other Latina mothers. One mother, Melba, recounts how her experience with her first son showed her that she had waited too long to address this topic and started much earlier with her second child. She acknowledges that her upbringing influenced her decision not to allow her oldest son to participate in a sex education class in school ... a decision she later regretted and rectified with her youngest son. The take-home message from all the mothers is simple: cultivate a relationship with your children that allows them to ask you questions and have open,
non-judgmental communication.

This project was conceived with the notion that it is important for Latino parents in North Carolina to relate to the information by hearing from other Latino parents. In addition, two health professionals who work with Latino adolescents, Vanessa Roth from Planned Parenthood of Central North Carolina and Olivia Carless from the Adolescent Pregnancy Prevention Campaign of North Carolina, provide additional information to guide parents on answering difficult questions, finding teachable moments and talking about resources for parents.

The audio guide is available on www.MamaSana.org and includes links to additional information for parents. Parents can listen to each individual chapter. We had a limited number of CDs available and have already distributed more than 400 to Latino parents. We hope you will share this new resource with any Latino parents you know, regardless of the age of their children. It is never too early or too late to start the conversation and help Latino youth make informed decisions.

Resources
Parent-Adolescent Communication about sex in Latino families:
A Guide for Practitioners.

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Behind the Scenes, Working Hard

The North Carolina Healthy Start Foundation is generally a behind-the-scenes organization. We don't provide healthcare services or distribute food. We don't build houses or have hundreds of volunteers. What we do exceptionally well, however, is work with others — from large state agencies to small grassroots community-based agencies. Here are some things you should know about us.

We strive to build the capacity and provide resources that make other organizations more effective at what they do to improve the health of women of childbearing age and young children in North Carolina.

• We have our finger on the pulse of North Carolinians through our qualitative research and focus groups to learn more about the issues and needs of women of childbearing age and their families.
• We make recommendations to the N.C. Division of Public Health about how best to reach these audiences and then implement effective strategies that increase knowledge, impact attitudes and affect behavior change.
• We build the capacity of community-based agencies to address women's health issues by setting up and coordinating the RICHES network of 600+ agencies and providing networking, skill-building and resource sharing opportunities.
• Annually, we distribute more than 2.5 million free educational materials used by health and human services agencies, nonprofits, hospitals, schools, churches, child care facilities, etc. across the state.
• As a service to healthcare providers, our website shows the weekly availability of beds in N.C.'s perinatal substance abuse residential treatment programs for pregnant or parenting women.
• We provide technical assistance and training to hospitals and to community groups to support their implementation of infant safe sleep policies and practices.

Learn more about us and spread the word. To support our efforts and help us extend our reach, we welcome your suggestions. Donate to us through our website or through the State Employees' Combined Campaign (#3760).

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 N.C. Healthy Start Foundation | 1300 St. Mary's Street, Suite 204 | Raleigh, NC 27605 | 919-828-1819
Information@NCHealthyStart.org