Part I these themes and questions are derived from the digital stories. You can use these questions to guide your discussions with new parents around these sensitive issues.



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Digital Story Discussion Guide





PART I

These themes and questions are derived from the digital stories. You can use these questions to guide your discussions with new parents around these sensitive issues. Each question references the story in parentheses so you will know where the question originated.



The Transition into New Parenthood:

Helping Parents Cope with Expectations



QUESTION: What were your expectations when your new baby arrived? Did you feel that those expectations were met? Did you feel that there was a disconnect between your expectations and reality? (Douglas’ Story)
QUESTION: Are there feelings that you have that are unique as a dad? Do you feel included/left out? (Douglas’ Story)

The Transition into New Parenthood:

Early Care and Nurturing



QUESTION: Many women think that bonding will happen immediately; this isn’t always the case/doesn’t always happen. What were your experiences like? (Korotoumou’s Story)


Provider Client Relationships:

Providing Comprehensive Care & Support

QUESTION: Do you feel that you have enough supports from family or friends to help with the transition to becoming a new parent? (Ava’s Story)


Provider Client Relationships:

Cultural and Logistical Barriers to Family Planning

QUESTION: Especially after having a baby, many women have questions about birth control. There are a lot of misconceptions because it can be confusing. What are your feelings about birth control and I can help you with answering any concerns or questions? (Jane’s & Carollee’s Story)

QUESTION: Are you familiar with the term birth spacing and how it relates to your health? (Jane’s & Carollee’s Story)

Healthy Relationship:

Family and Intimate Partner Violence




QUESTION: Because violence is so common in many people’s lives, I’ve begun to ask all my patients about it routinely. Are you in a relationship with a person who physically hurts or threatens you? (Yari’s story- Question adapted from the Family Violence Prevention Fund)

Well-Being:

Substance Abuse



QUESTION: Were your parents or any close friends or family members involved with

a substance abuse issue? (Wanda’s Story- Question Adapted from Massachusetts health Quality Partners)




PART II
Support group specific

This section of the discussion guide is intended for support groups or any kind of group for postpartum parents. These questions are written with the assumption that the digital story has just been played for the group. After the story has been shown, below are some examples of questions to start the conversation.




Douglas’ Story

(Paternal Expectations)

As we just saw in Douglas’ story, he imagined playing with his new baby and teaching him new things. However, Douglas was not able to play with his baby like he thought. This challenge saddened him and he felt stressed about what to do and what would happen. Many new parents have expectations about what it will be like to be a new parent, but when the time finally arrives, things are different than they expected.




    • Was there anything that you expected before your baby was born that didn’t end up happening?
    • What feelings did you experience with this?


    • In Douglas’s case, he and his wife received services from Early Intervention. What are other ways to cope or access services that could help with the unexpected challenges and surprises that may come with a new infant?

    • With the stresses of a new baby has this put a strain on your relationship with your partner?




Ava’s Story

(Building relationships b/t providers

and patients & prematurity)

Ava’s provider wondered who was taking care of mom and dad after experiencing Ava’s traumatic preterm birth and 4 month stay in the NICU. Ava’s birth was so traumatic that the parents were emotionally strained and someone needed to address their emotional well-being too.




    • Can you identify family members who could help you 1) make dinner, 2) take a break, 3) go on a date?

    • What do you think would have helped Ava’s parents cope with their difficult challenges with Ava in the NICU? What do you do to help cope with your challenged as a new parent[or as a parent who had a preterm infant]?

    • When things are difficult and at times overwhelming it is often difficult to discuss or express your feelings. Are there people in your life you can talk to about your feelings? Would you like to hear some strategies about how to discuss difficult topics with your provider, family, and/or friends?



Jane’s Story

(Provider assumptions about family planning/ birth control)


Many women do or don’t use birth control for a number of reasons. For Jane, she felt confused about birth control and was afraid of it.




    • What are your feelings about birth control?

    • Can you relate to Jane’s concerns?

    • Can I answer any questions about it for you?


Korotoumou’s Story

(Bonding & attachment and maternal depression)

Megan (the provider) talked about the importance of listening to Korotoumou and hearing what she wasn’t saying. Its often hard to talk about feelings with providers, especially around doubts around bonding or challenges with motherhood (what some expect to just naturally happen).




  • Why do you think it was important for Korotoumou to share her feelings with her provider, family and friends?

  • Do you feel comfortable talking to your provider about sensitive topics?

  • Can you relate to the feelings Korotoumou experienced after her son’s birth?

  • Korotoumou delivered her son, Adama, by cesarean section. She expressed that this was not how women are supposed to deliver, women are supposed to push their babies out. If you delivered by cesarean, what feelings did you experience about your delivery and thinking about it afterward?

  • Korotoumou felt that Adama wasn’t hers; she didn’t feel the immediate bond with him as she thought she should. Bonding with your infant doesn’t always happen right away, it sometimes takes time. What was your experience with bonding with your baby? How did that make you feel?


Yari’s Story


(Family violence & healthy relationships)

Yari’s family had a history of domestic violence. Yari said in her story that she thought domestic violence was normal, and if a partner was nice to you that meant he was weak. Eventually Yari found a healthy relationship and has learned that she did not deserve to be treated that way.


  • Has something similar to what happened to Yari happened to you?

  • As Yari discussed in her story, building trust takes time. Who are the people

in your life that you can rely on and trust?

  • What supports did you wish you had during this time?

  • There are many community-based resources, such as group and individual counseling, for women who have experienced domestic violence. Do you have any questions about the different kinds of resources available to you in your community?


Carollee’s Story

(Family planning & birth control)

Carollee struggled with intimate questions about her pregnancy; she was unsure if she wanted to keep her fourth child.




  • Have you ever experienced feelings like Carollee’s when you knew you were pregnant?

  • Do you feel that you were in control about when you felt ready to become pregnant?

  • Do you feel it is difficult to find the most appropriate birth control for you?

  • Do you have questions about the myths and facts about different birth control methods?


Wanda’s Story

(Substance abuse)

Wanda’s story is about her struggles with addiction as a parent and her path to recovery.




  • What was surprising to you about Wanda’s story?

  • Wanda’s decision to receive help for her addiction was her path to recovery. What kind of support would she, or someone in the same situation, need to stick with this recovery path?
  • Wanda had feelings of shame, guilt, and being overwhelmed with her life and her situation. Has anyone here had similar experiences?


  • Wanda made the decision to ask for help. Asking for help is difficult. How do you think she felt? Do you have questions about who to ask for help if you have similar feelings?

  • What do you think helped Wanda to get into and maintain her recovery?

  • What was the relationship between Wanda being a parent and Wanda’s recovery?





Resource Guide





For community-based resources in your area go to www.mass.gov/dph/newparents


ONLINE RESOURCES & WEBSITES


  • Family Support Resources/ Groups/ Home visiting

    • Beginnings Guides- www.beginningsguides.net

    • Jewish Family & Children’s Service (JF&CS), Center for Early Relationship Support : www.jfcsboston.org

    • Parents Helping Parents- www.parentshelpingparents.org (support groups)

    • The Maternal and Child Health Library at Georgetown Univeristy http://mchlibrary.info/guides/homevisiting.html (home visiting brief)




  • Women’s Mental Health/Depression Resources:

  • A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in her Childbearing years. http://rutanonacs.com

  • HRSA Depression Booklet: http://www.mchb.hrsa.gov/pregnancyandbeyond/depression
  • HRSA Office of Women: Bright Futures for Women’s Health and Wellness Emotional Wellness Tools free online at: http://www.hrsa.gov/womenshealth


  • Institute of Medicine and the National Academy of Sciences. The purpose of the conference on interventions for parental depression: www.bocyf.org/parental_depression.html

  • SAMHSA Booklet on women’s mental health http://mentalhealth.samhsa.gov/publications/allpubs/OWH09/default.aspx

  • University of Illinois: Chicago Perinatal Mental Health Project:

http://www.psych.uic.edu/research/perinatalmentalhealth

  • Washington State website: http://www.wcpcan.wa.gov/ppd/home.htm

  • Postpartum Depression International: www.postpartum.net

  • Mass General Women’s Mental Health: http://womensmentalhealth.org

  • Postpartum Stress Center: www.postpartumstress.com

  • Postpartum Education for Parents: www.sbpep.org

  • Postpartum Depression website: http://www.mededppd.org

  • The Family Mental Health Institute: www.ppdhope.org

  • Perinatal Depression Awareness Campaign: www.perinatalweb.org



  • Maternal and Child Health

  • WIC: http://touchingheartstouchingminds.com/index.php

  • MCH Library: http://www.mchlibrary.info/BFWHW.html

  • Lactation & Medications: http://neonatal.ttuhsc.edu/lact/index.html

  • Zero to Three: http://www.zerotothree.org




  • Additional Resources:

  • Illinois WIC Training Center (IWTC): http://www.chtc.org/dl/dl.htm

  • (teleconferences)

  • Zero to Three Policy Center: http://www.zerotothree.org/policy

  • Blogs

- http://wellpostpartum.com

- www.postpartumprogress.typepad.com




FACT SHEETS:


  • Home visiting as an intervention in infant mental health. (2006). The Harris Institute for Infant Mental Health Training, Florida State University Center for Prevention and Early Intervention Policy. http://www.cpeip.fsu.edu/resources.cfm




  • Infant and early childhood mental health: Promoting healthy social and emotional development. (May 18, 2004). Zero to Three Policy Center. http://www.zerotothree.org/policy




  • Information for physicians on prescription products to treat perinatal depression. (2007). The Board of Trustees of the University of Illinois, UIC Perinatal Mental Health Project. http://www.psych.uic.edu/research/perinatalmentalhealth/healthcare_provider.htm




  • McLearn, K., Minkovitz, C., Strobino, D., Marks, E., & Hou, W. (May 2006). Maternal depressive symptoms at 2 to 4 months post partum and early parenting practices.

In the Literature. The Commonwealth Fund.




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