Counseling of Parents Around the Birth of a Baby
Evan Charney MD1
1 Department of Pediatrics, Sinai Hospital of Baltimore, Baltimore, MD 21215
One of the pediatrician's most pleasant tasks is counseling families around the birth of a child. It is a joy if the baby is healthy, more difficult (though even more important) if there is an abnormality. In this article, the physician's postpartum role with the full-term, basically healthy infant will be discussed; although the comments apply to the preterm or ill child as well, in those instances a good deal more is involved, and is outside the scope of this presentation.
Of necessity, a discussion of this kind is subjective, reflecting the biases and experience of the author. There is very little recorded knowledge on this topic, and physicians have evolved a variety of approaches that probably work equally well. The point here is for the health provider to keep certain issues in mind; how they are dealt with will vary with the personality of physician and patient, and with the practice pattern of the community. In fact, if the postpartum visit is the first contact with a new family—a common phenomenon—its major purpose is for family and physician to get to know each other's "style." The pediatrician wants to know what kind of parents he will be dealing with—are they basically a stable couple, confident of their abilities, or do they seem less secure? Is there a supportive relationship? Are they married? Is the mother very organized, with written lists of questions prepared, or does she seem more casual, with few questions? Who does the talking in the interview? The parents, in turn, are watching to see whether the physician is brusque or relaxed, authoritarian in his manner or more nondirective.
