Dixie Weber, MS, RN is Family to Family Support Network’s National Advisor of Healthcare Programs providing UFP Program oversight, expertise, and guidance which allows UFP to achieve and maintain clinical and operational program excellence.

Dixie’s background includes 17 years of specializing in Maternal-Child Healthcare and she has held numerous leadership and programmatic positions within the specialty. Her Masters in Nursing Leadership and post- graduate certificate in Adult Learning Theory show a commitment to expertise in training and supporting nurses. She is also highly experienced in this space, having taught hands-on clinical care at the university level and creating and implementing trainings on a variety of maternal and child health issues including substance use during pregnancy, outreach and perinatal education for female prisoners, and a perinatal patient education and discharge app for smartphones, amongst others.

Dixie’s expertise ensures that all of UFP’s work supports nurses well on an individual level while considering the ways those individual nursing knowledge needs can be strategically systematized to function hospital-wide in a meaningful and sustainable way.

Dixie has been awarded the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) 2020 Distinguished Professional Service Award. This award is AWHONN’s highest honor and is given to nurses whose accomplishments in the specialties of women’s health, obstetric and neonatal nursing. Recommended and celebrated by U.S. Senator Mike Crapo of Idaho, Dixie was recognized as a 2017 Angels in Adoption® Award winner for her work as an adoption advocate in the state of Idaho.

In this episode we interview Dixie Weber and Rebecca Vahle from Family to Family Support Network about safe havens. We compare and contrast safe havens, baby boxes, and infant abandonment and the three policies that every hospital should have. We also discuss important communication tips when speaking with a pregnant person in crisis and questions to ask when someone is considering or utilizing a safe haven.

1. In our previously recorded episode about adoption you talked to us about your non-profit, but for our listeners who have not checked out episode 41, can you briefly share with us what the mission and goal of your non-profit is?
2. Can you share with us what is a “safe haven” and why were they created?
3. Now that we have entered this post-roe era, how does the role of safe havens change?
4. There is a lot of rhetoric coming out of Indiana about Baby Boxes. Can you share with us what is a Baby Box and how is it similar or different from a safe haven?
5. There may be a lot of folks who are listening and may be saying to themselves, well a baby box or a safe haven is better than a dumpster baby. Can you unpack why this line of thinking may be problematic?
6. What do you feel is a better alternative to safe havens and or baby boxes?
7. What policies or procedures should clinicians work to implement at their facility or in their community for a pregnant person in crisis?
8. For our listeners who may be contemplating utilizing a safe haven or baby box or are having conversations with a person in crisis, what would you want them to know or how should we communicate with that person?
9. Where can our listeners go to learn more about safe havens and what safe haven laws may be looking like in their state?
10. What is the one thing you would want our listeners to take away from today’s conversation?

Family to Family Support Network

Utilizing Shared Decision Making Tools to Assist Expected Patients and Clients in the Post Roe Era Training

Adopt Match

Adopt Change

safe haven

Nicole: [00:00:00] Hi everybody and welcome to the Women-Centered Health Podcast. Today we’re speaking with Rebecca Vahle, executive Director of Family to Family Support Network, and Dixie Weber, national Advisor for Healthcare Programs for Family to Family, as well as the system service line director.

For the Women and Children Service Line, family to Family Support Network is a pro-education nonprofit that provides training for healthcare professionals in unique family sensitive care, and recently has been amplifying the need for education regarding Safe Havens. You may have heard these names before, as we have previously recorded with Rebecca about adoption, and we did a recording on neutral and compassionate care with both Dixie and Rebecca.

But before we start our interview, we wanna thank all of you for listening and let you know that you can earn CE and get key takeaways, resources, and transcripts by visiting our website, women-centered health.com. Also, Stephanie and I put this podcast together in our free time and often use our personal funds.

So please consider supporting us. You can support us by [00:01:00] subscribing and giving us a five star rating on iTunes or wherever you are listening to us. If you are able to offer a financial donation, visit our website and click the support us tab. All right, let’s meet our guests.

Stephanie: So, hi Rebecca and Dixie. It’s so great to talk to you both again. And thanks for being on for Rebecca the third time and Dixie the second. So, could you first give our listeners a little bit of detail about your background? I’ll have Rebecca start.

Rebecca: Sure. So I’m Rebecca Vahle and my background is education. I’m not a nurse, but my own personal background as an adoptive mom brought me into this space, realizing there was not standardized care for women considering adoption or families pursuing adoption. And so I’ve been in this space of training healthcare professionals in unique families, such as those pursuing adoption for almost 20 years now.

I worked at Parker Venice Hospital, just south of Denver, and created [00:02:00] an adoption support program that was hospital based. Ended up being the first and only program in the nation that really focused on expectant moms and those pursuing adoption. And ultimately quit my job there to start this nonprofit to share the model of respectful, neutral, compassionate care for all families with, our family to family support network.

And Dixie’s been in the trenches with me for a really long time. So, Dixie, I’ll let you introduce yourself.

Dixie: Hi, thanks for having me. I’m Dixie Weber. I’m currently the service line director at Peace Health, which is a large health system in the states of Oregon, Washington, and Alaska. So I cover all of women’s and children’s healthcare for those three states for our health system. And gosh, I have been teaching and volunteering and working for the Family to Family Support network for almost 14 years.

Rebecca and I laugh about this, but I’ve been teaching since my youngest was born alongside Rebecca, and we have just seen what a phenomenal effect it is for both our clinicians and our nurses when you start teaching [00:03:00] about neutral compassionate care. And that’s really how to remove your own personal biases and beliefs and processes away from the bedside of the patient.

I’ve been a nurse, well over 20 years, and my background really is women’s and children’s healthcare and that. Specialty. And so I’m so excited to be here with you guys. This is a topic obviously near and dear to my heart because this is what I do in my full-time world as well as my private world teaching and, and coaching and helping healthcare systems and nurses and doctors really understand what it looks like to take care of patients.

Rebecca and I have been doing webinars across the country, especially on the topics of, you know, the post Roe v. Wade. What does it mean for healthcare workers? What does it mean for families and for women that are carrying pregnancies and birthing people? And, and so we’re super excited to be here today with you.

Stephanie: Yeah, and we’re very excited to hear what you all have to share. And I just wanna add that neutral and compassionate [00:04:00] care episode. I don’t know what number that is off the top of my head, but Nicole and I, that’s like one of our, I would say top five like essentials, for communication. So if you have not listened to that one, please do so, because I think every clinician everywhere, really every human should listen to it,

 Okay, so the other question we always like to ask you is what informs your perspective? So in other words, why do you do what you do and what is most valuable to you? And I’ll start with the Dixie this time.

Dixie: Thanks for asking the question. You know, one of the reasons why this work is so important is, is I have seen firsthand at the bedside, both as the caregiver as well as those that are leading caregiving teams. What happens when you have nurses and doctors that are not educated on how to remove their own personal thoughts and [00:05:00] biases, or they don’t know what to do when they’re confronted with a scenario that’s outside of what they have learned traditionally.

So both nursing schools as well as middle school schools today teach on a model of a mom, dad, baby triad, meaning that’s the model that they’re taught on. But that’s not really what our families look like today, right? Our families come in all different shapes and sizes, and so unfortunately, a lot of our nursing teams, as well as our physician teams are at the bedside without all the tools that they need to be successful when they come up.

You know, across a family that may have a different dynamic, that may have a different history that’s different than what they have seen before or what they have been trained on, and that can derail and create a lot of. In care. And so this work is incredibly important to me because we create with healthcare teams, you know, cohesive care pathways that make sense, that remove all that extra noise from the bedside by helping teams recognize that [00:06:00] you can have a care pathway for someone that’s making an adoption plan for somebody that’s coming through with an as surrogacy plan for someone that’s coming through that maybe has an unplanned pregnancy that doesn’t have a parenting plan in place.

And so we’re at the bedside helping them understand what are their options. You know, they can choose someone else to parent or if they don’t have a parenting plan, what. What a parenting plan look like. But you know, clinicians need to understand what language should they use in order to not, , put their own personal biases into that scenario.

So it’s really creating boundaries and expectations and behavior and clear policy practice and procedure to help those bedside staff members provide good, good care to our patients, , and not interrupt the care that is needs to happen in order to have best practice.

Stephanie: So just in hot topics right now, I was wondering if you two saw that video that was going around on TikTok and the nurses got fired about [00:07:00] sharing their ick moment. Have you, do either of you, have you seen that

Rebecca: Yes.

Dixie: seen yet, but I see Rebecca’s face.

Stephanie: Yeah. I just, I also thought of you when I saw that. So basically it’s just this video TikTok video where these nurses at this hospital in Atlanta are. Kind of saying their ick moment with patients. Like, oh, when the baby’s baby daddy comes out and asks for a paternity test right away, or when the mom comes in for induction and wants to eat and have a shower before, you know, like just kind of complaining about really normal human necessities.

And so they were fired. But it just also going into all this, this bias kind of things, those are I think, very explicit biases. And, but it was like shared as in this is funny and it totally acceptable to share.

Rebecca: Yeah. And I thought it was painful just cause I did see the video, but I [00:08:00] think knowing what nurses deal with every single day and all like their workload and I, I mean it broke my heart cause I thought, oh gosh, this is like the last thing we need is the expectation. That this is what’s going on at the nurses station, right.

you know, with all that’s happening in healthcare, that four nurses would be set forward and said, you know, look, this is, this is what’s going on. And knowing there are just so many nurses out there that. I can see the playful side of nurses. Cause I think that’s part of their survival, judgment call.

Hmm. Yeah, that was a rough one. Like why that would ever be. Okay. But it also just broke my heart. Cause I thought, oh my gosh, that is gonna have people go in. One of the things you asked, why we’re passionate about this, one of the things I, I am always concerned with is that confirmation bias. Like I’m gonna come in and be looking for something.

When we talk [00:09:00] about the unique families we have, we, we are battling these caricatures. Like, this is what a mom considering adoption looks like. This is what the nurse looks like, this is what the leadership looks like. This is what a transgender birthing patient will be like. This is a same sex couple, they’re this caricature.

And I think we’re constantly battling that because automatically when we meet people, , we go back to what we know, what we’ve seen, what we’ve heard on podcasts, what we’ve read in, in, on all the, you know, blogs that we read. And it makes it really difficult to find any consistency in care, right? Because we all have these different experiences, which is one of the reasons that we talk so much about what’s in your suitcase, right?

Because we talk about those biases you carry with you. What do you carry with you to the bedside? How do you interact with that person? What gets activated in you when you’re interacting with that person? Because their husband reminds you, of your ex, you know? And [00:10:00] acknowledging those things that get in the way of patient care and, and calling those things forward and saying it’s not wrong to have thoughts, feelings, beliefs, morals, et cetera.

What is wrong is when it gets in the way of patient care, and that’s when we don’t have consistency of care, because we always kind of joke the shift change happens. Dun, dun, dah, you know? And all of a sudden you go from a nurse that was really supportive. Of your birth plan, your, dynamics of your relationship, et cetera.

And then they have a shift to a change, to a different nurse that can come in with a completely different suitcase. And now we have a huge struggle, because that patient is like, well, wait a minute. I felt safe. My expectations felt like they were getting met. And now because of thoughts, feelings, morals, beliefs, now I’m not sure that I am those things.

I’m not sure that I’m safe anymore. And, and the, the behavior tends to escalate when we don’t feel we’re [00:11:00] safe and our expectations aren’t being met. And then it’s a cycle, right? . So, I mean, all those pieces play into the dynamics that are going on in healthcare right now. The complexities of it. Social media I think is so.

Difficult because of that fact, because we’re all taking in different information. We’re all taking in different attitudes, different beliefs, and there’s a place for us to put out our opinion and thoughts and feelings all over the place. And we do it to everybody. Like it’s just like, blah, blah, blah. What do you think?

What’s your bumper sticker? What’s your yard sign? And then to go into healthcare without saying, oh, all that stuff you did outside of healthcare, you can’t do that at the bedside . And we’ve had nurses say, flat out, no one has ever told me that I cannot give my opinion about care. And we’re like, well, today’s the day like , you can’t.

So I mean, that brings to light such a, a key point. And I’m, I’m really glad that you brought that up, Stephanie, because it [00:12:00] really makes you realize that now that’s in all these people’s suitcases, that event that went viral is in the suitcases of nurses for how they understood that leadership. And then all the patients that saw that , they’re gonna walk in with that in their suitcase now.

Dixie: I think it’s a really important point also to recognize that if you don’t have in your workplace clear expectations around what is acceptable to say and not acceptable to say, because there isn’t clarity around what’s accurate language, and that’s the big piece of the puzzle. You can’t just go in and say to someone, you can’t say that without telling them what you should say.

So for example, we oftentimes say we no longer say that women give up babies, or we oftentimes say, well, you can’t call someone. For example, we still hear nurses say things like drug babies. Like that’s not an acceptable term [00:13:00] to refer to a child, right? Like that’s not acceptable. What you need to say is, is that we have a patient that has had exposure to a substance in utero, like those are acceptable terms that a professional would use in order to describe a situation, but you have to give them an accurate language and say when you document or when you’re speaking about a patient, my expectation is that you will use this language.

And then when they don’t, You can say, we had a conversation about it. We shared as a team that we were gonna accurately speak about our clinical scenarios and about our patients in a clinical way, not in slang, not in our everyday feelings. Not like Rebecca said, like our yard sign might say we’re gonna accurately and professionally speak about it, but we’ve also talked about how do you do that and what are accurate terminology to be able to say substance abuse versus substance use disorder is a great example.

We no longer say substance abuse or substance abuser. That’s not [00:14:00] accurate and it’s not appropriate. We would say someone who struggles with substance use disorder. And so those type of flip the switch and flip the script terms are the way to hold staff accountable and teammates. And so I, I think about what you’re talking about with the video and say, gosh, we just lost four clinicians when we have a huge nursing shortage.

And I’m like, man, in my world, I’m like, could we have intervened early? Could we have intervened with these staff members? And said, let’s talk about why this was so inappropriate and let’s talk about what should have happened. And so that’s where it breaks my heart in those scenarios, but also breaks my heart for the patients.

Cuz I agree with Rebecca. The impression is then those patients won’t come into healthcare, right? And they will give birth an alternative healthcare settings like at home.

Stephanie: Yes. Yeah. Thank you for going down that rabbit hole with me guys. I just, yeah, we, that we had saw that this week and, and then since you were our guest, I just had to ask what you thought [00:15:00] about that. So Rebecca, I kind of skipped you, but did you have anything else to add to our favorite question about what informs your perspective or why do you do what?

Rebecca: Well, I’d love Dixie’s answer. This is why I work with her. It’s like what she said. Ditto. I would say maybe on the emotional side, and you can hear that in my. even response like, oh gosh, this is a mess and I wanna help everyone and like, help this to be handled correctly, like Dixie said. And can we get in there early and, and get upstream for some of the issues that we see happening?

I think the time that I spent with moms going through adoptions and families going through adoptions, I just, how often we meet people and say, I wish I would’ve met them sooner. Would the outcomes have been different? Could we have connected with them? And I think that really drives. . My hope and my passion about the work is that there’s so much that can be done [00:16:00] upstream to proactively address so many of the crises we see downstream in healthcare.

And, I know I’m kind of Pollyanna about that and people are like, oh, that’s so cute. She thinks we can do that. But I’ve seen at work and so I’ve seen the conversations with, with moms that, that got information and said to me, well, Rebecca, I didn’t know I’ll make a different decision because you gave me all the information.

And I think the suitcase and the, and the yard signs and the bumper stickers, it makes it really hard to give information without manipulating information. And I think women are super, super smart . I think that if we give them the information and we’re not trying to manipulate it and keep stuff off the choice buffet, cuz we don’t want them to pick certain options for themselves.

I they. . It’s just, there’s no point in doing any of that cuz people are very smart, they know what’s on the choice buffet. And when we start talking about safe haven and the Roe decision and the long-term effects of unplanned pregnancy, there’s just no [00:17:00] simple answer. And I really think my passion comes from wanting to get upstream and empower women, empower birthing people to really be able to look at their options and say, I had all the information and I’m at peace with my decision.

 Not on the other side. Say I got manipulated, I got tricked and my heart’s shattered and I can’t go back. Cuz a lot of the stuff we do, you just can’t go back.

Stephanie: Yeah, I love that.

Great responses as, as

Nicole: yes, women are smart and resourceful.

Rebecca: We’ll figure

it’s pretty

Nicole: figure. Okay, so like we said, today we’re gonna talk about Safe Haven. So let’s jump in. I think you probably touched on this, so super briefly. In our previously recorded episode about adoption, you talked about, your nonprofit. But for our listeners who have not checked out episode 41, and again, I think you kinda touched on this a little bit, can you briefly share with us what the mission and goal of your nonprofit is?

Rebecca: Sure. Family to Family Support Network. We train in unique family sensitive care. Our ultimate goal is to have [00:18:00] unique family programming in hospitals across the country. So we go in, we train all the staff in respectful, neutral, compassionate care. Dixie comes alongside taskforce groups and they work on everything from policy, procedure, workflow, education to hardwire the respectful, neutral, compassionate care to get away from that idea that it’s person dependent, depending on, oh, which nurse you have, this is the kind of care you get.

And so it really hardwires it. And then we do a community collaborative piece where we go out into that hospital’s community and find out what resources are available for unique family patient population. So started with adoption and we expanded into those involved in surrogacy arrangements. Then we found, well wait a minute, we had nurses in Idaho that stepped forward and said, what about the incarcerated patients?

Can we meet them early and plan their delivery and have a warm handoff back to the prisons or jails? And then it was, what about substance use disorder? What about the L G B T Q I A population? What about trauma aware [00:19:00] care? Could we put some standardized care or education around that? What if we were to look at implicit bias in their racial disparities?

So unique family programming has really exploded, but it’s just about getting consistent, respectful, neutral, compassionate care at the bedside for all families. How’s that for an

speech?

Stephanie: I love it. All right, let’s talk about safe havens now. So really, can you tell us what that term is and why Safe Havens were created?

Dixie: Yeah, so Safe haven really began, I’ll give you a little bit of history. So began in Texas around 1999, and it was really intended to provide a safe and confidential way to relinquish an infant. So if a parent, typically the mother was not able to care for an infant. It was a way in which for that person to be able to relinquish an infant without prosecution.

And so instead of an infant being abandoned in an unsafe situation, that [00:20:00] person could relinquish an infant to a safe situation such as a fire department, a police department, a hospital. So there’s some specified places in which you can relinquish or handover. So that’s what that relinquishment term means, and it really varies per state.

So each individual state will have a age frame for how old that infant can be at the. At the time that they can be relinquished. So it goes zero to one year with North Dakota being the oldest, but you know, some of them are 72 hours, some of them are 96 hours, some of them are multiple days, and then some of them are 30 days, 60 days.

It just really depends. So each state has the ability to determine for their state, what is the age of relinquishment. Also, the ability to determine who can be relinquished. So who. You relinquish to, is it a hospital, is it a fire station, is it a police department? Some states you can relinquish to daycares.

Some states you can use the nine one one system and call nine one and they [00:21:00] will come and pick up your infants. So it’s really important to understand, especially for healthcare agencies and some of those places that may be receiving an infant for them to understand what is their law. What we find when we teach across the country is that most places, even those that are supposed to re be able to receive infants in safe haven, don’t know and understand safe haven and the policy.

 And the goal is, is that you can relinquish that infant without any persecution. The other piece of the puzzle that makes it a little bit hard is, is you know, understanding and gathering information about that infant. So you can ask and should ask, as much information as you can about that infant, like how old is that infant?

In some places you’ll want to ask, identification information. In some places you can’t ask identification information. And so it’s really dependent upon the state. And so clear policies and procedures by those that will be receiving those babies is really important. What we have seen over the last year is [00:22:00] this kind of, push for baby boxes.

And I know we’re gonna talk about that a little bit, but that is the ultimate, hands off approach. We would like to see a much more upstream approach. Safe Haven should be a last resort approach. There are so many touchpoints along the way for that woman or that birthing person that we have an opportunity to intervene and talk to them about their parenting plan and how they’re feeling about being a parent.

And can we assist with that, process prior to them really needing to go through and utilize Safe Haven that I think we lack the opportunity and we don’t take advantage of that opportunity to, to use those touchpoints. But Safe Haven is really an end resort. And I’m gonna hand it over to Rebecca cuz she has some really good thought processes around like what safe haven and when Safe Haven should be used.

Rebecca: I think a lot about safe haven, which is just weird. It’s, as I mentioned since my [00:23:00] passion is about getting upstream, you can imagine that when people talk about encouraging safe haven or, you know, I know that that Judge Barrett made the comment that this, this avoids us having, being forced to parent because they can just do safe haven.

And I really believe any safe haven utilization is a failed woman period. Like if, if she has utilized a baby box or safe haven, she’s been failed. We have, we have missed an opportunity to connect with her. And, I think , it, it’s the ultimate failing of the system. If someone has, the only opportunity they have is to abandon their child.

we know that there’s a need for safe haven. We know people often will push back. When I make that comment, they’ll say, what? You want ’em in a dumpster? And I’m like, okay, . Whoa, whoa, whoa. No . I don’t want them in a dumpster. And that is what Safe Haven was originally about. It was about. You know, postpartum psychosis where mom is going to either put this [00:24:00] baby in a dumpster, drown this baby, or, or hand this baby over to someone else.

But the expectation that someone can be, mentally coherent enough to understand all the laws, where they can go, what the age has to be, all those things tell us that there can be a conversation with that person , that is not someone that’s necessarily heading to a dumpster. And I just get really concerned when we make the assumption that if we fund a lot of education around safe haven, a lot of education around baby boxes, I, I think that it will build that option and that option should be a last resort.

And I get concerned when I see states like Indiana. I, I think we’ve talked about that off air before, that they’ve poured, you know, a million dollars into baby boxes. Well, you pour the money in. , then people use them and people celebrate. They’ve been used and they say, [00:25:00] look at how many babies didn’t go in dumpsters.

So they build more. Like, that’s my concern is that if, if this is highlighted as the best option, then we’re completely disregarding the needs of the child, disregarding the needs of that mother and disregarding the needs of the family that will receive that child. If, uh, there’s a safe haven baby that’s ultimately placed for adoption.

Nicole: Yeah, there’s a lot to unpack there and we will certainly get more into the baby boxes shortly here. But before we do that, now that we’ve entered this post-roe era, how does the role of Safe Havens change?

Dixie: Well, I think what we see on the hospital side is the lack of clarity around the difference between safe haven and what we call on the hospital side, infant abandonment. And so that’s a really hard time term to kind of. Like feel, cuz there’s a lot of feelings around those terms of infant abandonment.

But on the hospital side, we do have women in [00:26:00] birthing persons who are in the hospital and they are very clear and they’re like, I cannot take this child home. And so if they need to be discharged and they cannot take this child home, what we see today is hospitals on the inpatient side saying, well this is a safe haven baby.

And that’s just not a true statement. Safe Haven is only to be used outside of the hospital setting so that patient is not admitted to the hospital. Safe haven is after someone has left the hospital. And so on the hospital side, what we actually see is an a need for an infrastructure that says we completely understand if you are not in a place to parent and you feel like you can’t take your child home, you can discharge today and go home without your child, but your child does not have to go into the Child protective services and immediately into foster care, which is today the first phone call that’s made in a hospital.

Cuz we feel like that’s the only phone call we can make. Cause we don’t know what else to do. We have to teach and educate our healthcare teams to be able to say, you know, you can choose someone to parent and your [00:27:00] child could go home with a family of your choice if you would like that to happen. And.

People don’t even know that’s an option, and healthcare doesn’t even know to offer that as an option. And so it’s much like any situation that you have in healthcare where we’re not even offering options and choice because we don’t even know that that is an option or a choice. And so we’re withholding important information from our patients today.

So that’s number one. We have to be able to educate and offer information. And sometimes that information is not offered because we don’t even know. Like if they say Yes, I would like to do that, we’re like, well shoot. Now what? Because I don’t know what to do after they say yes. So the other piece of the puzzle is to make sure that there are ethical resources available to every healthcare team and that.

Coordination with the community. So, you know, ethical adoption resources, both at the attorney level and agency level for each hospital that, you know, surrounding that hospital. But also making sure that [00:28:00] hospitals don’t feel like they have to do it all themselves. You should have a community and community resources that are tethered to that hospital.

We work with hospitals all the time that are like, there’s all such resources around the hospital. I don’t know how to get to them. I don’t know what they are and I don’t know how to get my patients to them. And then we work with community resources that are like, there are hospitals next door. We don’t know how to get to those patients, so they need to talk to each other because we’re all taking care of the same people.

So that’s like number one in making sure that we kind of get that coordinated because we’re all caring for the same community members. And making sure that that is a little bit better infrastructure. What we see today is that healthcare is not doing this well, and we just see this huge amount of people coming in.

And by huge, I mean more than we saw prior to the Dobbs decision coming in without a clear plan because they weren’t planning to carry this pregnancy, and now they’re here in our labor and delivery settings and they’re like, I didn’t [00:29:00] plan to parent. and I don’t really have a plan in place cuz in the nine months of this pregnancy, nobody stopped to ask me how I feel about this pregnancy.

So we need to, in the prenatal period, also stop and say, how are you feeling about this pregnancy? Are you feeling okay about parenting? And if you’re not feeling okay about parenting, and that can be anywhere along that pregnancy, we probably should ask multiple times. You can always choose someone else to parent or do you have someone in your family who might be able to support your assist with parenting?

What does that look like? Because we need to evaluate kinship and support kinship placement also. So there’s a multiple step steps along the way that we need to be talking to people who are pregnant around what is their parenting plan and how they’re feeling about pregnancy. And I think that’s step one as we get upstream.

Rebecca, what do you have to.

Rebecca: No, I think it’s great. I think sitting with someone that says, I didn’t know this was an option, and they had told the nurses, I’m leaving, give the baby to the state, and it just [00:30:00] took a conversation to say, you know, we can do that, but this is also an option. And being in that neutral space of the hospital where we’re not making any money based on their decision.

We’re not an adoption agency. We’re not a consultant or a facilitator trying to find babies for someone like we are just making sure they have the information. I think that makes a huge difference and it, and it allow. Them to trust that person that’s bringing that option forward without feeling like there’s some kickback and some benefit to them.

 Which we know right now there’s finding a neutral space is incredibly difficult.

Stephanie: So, okay, let’s get into baby boxes a little bit more. So, I think you mentioned that it is coming out of Indiana primarily. Can you share with us exactly what is a baby box and how is it. Similar or different to Safe Haven.

Rebecca: I think the biggest difference is the complete lack of connection with the person dropping the baby off. So when you talk [00:31:00] about safe haven, there’s often a person walking in and a handoff baby’s handed to, someone at the front desk, a nurse, a paramedic. There’s this, there’s, there’s a face-to-face interaction.

Baby boxes are, they can be on the walls of a fire station, a hospital, any place that is deemed a safe haven site for that state. And they’re temperature controlled. They have an alarm system. You put the baby in, you close it, and the alarm goes off to tell people there’s, there’s a baby in the box.

And. , like I mentioned, we don’t, we don’t get to see the whites of the eyes. We can’t check and make sure that person’s okay. We can’t see if there’s some medical needs that might be going on for them in that moment. And there’s, there’s obviously all kinds of concerns around, you know, is it really a baby?

They put in the box and you know, what, if there’s a problem getting the box open? I mean, there’s kind of a lot of these outside questions as well. But my, my largest concern is [00:32:00] that it being, it’s being promoted as this go-to, as opposed to having a conversation. I think it really encourages the secrecy and shame that we’ve seen in so much of the adoption history, like we talked about on your last show, when I got to share a lot about the adoption history.

To go back to that is really heartbreaking. And so, the idea of the baby boxes, it’s a. Anonymous handoff where someone does not need to face another person, that’s the biggest difference. Would you agree Dix?

Dixie: Yeah. I think the other piece is, is that that child loses their story and their connection to their birth parent, and. , I struggle immensely with the person who gave birth, not being able to receive resources. Also, because again, that’s a crisis situation and so we lose the ability to provide infrastructure to both of those people at the same [00:33:00] time.

And so I think a baby box is one of those pieces that allows us just to objectify the scenario and say, what we’re gonna get out of this is a baby. Great. But what we miss is the humanity. The baby loses their story, their connection, all of those things that emotional development. We know for human development, we need to have that story.

We know from what we have learned. along the way that, you know, adoptees do well and many of them seek to understand their story. And we lose all of that, right? Because now we have this anonymity and we don’t know anything about this newborn. And then the person who gave birth, we lose the ability to care for them.

And if there’s a crisis situation, then there’s care that’s needed. And so as a healthcare provider, I struggle immensely with it because it’s just objectifying saying one and done. Like, check the box, [00:34:00] literally check the box, we’re done. We got what we needed, but actually we missed an entire infrastructure of care that should have been provided.

And you know, the whole reason for Safe Haven was because the risk was, is that the baby would be placed in un safe situation like a dumpster, and we would have a baby that died, right? Like that was the big risk. We have a baby that’s placed in a dumpster and that baby will die. Well. Yes, we have a baby that didn’t die absolutely hands down.

We are very happy about that situation. However, what we have seen is that if you place that million dollars and additional funds into housing, childcare, economic strengths that we know across the board allow for parenting infrastructure and foundational care to develop parenting skills, affordable quality care for families, and bolster those things, then guess what?

Those crisis situations drop exponentially. So let’s go there, like let’s go to [00:35:00] the reason why we have the crisis in the first place. And really look at those pieces of the puzzle. And when you look at postpartum, psychosis and postpartum, perinatal mood disorders, let’s put infrastructure into making sure that you know, for women and birthing persons, that we have perinatal mood disorder programming in place for our healthcare teams to.

provide care for those patients. So all of those things get missed and we just instead have go all the way down the line and we’re like, it’s okay cuz we have a box there that will catch that baby at the very end if we have a problem. But we’ve missed the 87 steps before that.

Stephanie: Do you have any statistics on how many people or how many babies have been left in a baby box or just safe haven in general?

Rebecca: . I wanna say that it’s, Maybe 10 over the years, I wanna say.

 I’m thinking the Indiana specifically

space where they, because it’s so highlighted there, there is a woman who [00:36:00] was abandoned that is a spearhead champion in Indiana for baby boxes because of that, because of her own personal story.

Which is just, again, it’s interesting, I think that how, how do we find the balance, right? How do we find the balance of meeting needs and having those interception points when you’re talking about, like Dixie said, the psychosis situations, the dumpster situations, but how can we also be more proactive?

And Dixie, just to, to kind of step off what you had said as well, talking about putting parenting structures in place. , if they still are not able to do that, there is a healthy way to do adoption. So if they’re not gonna parent, if they really were not in a space to parent, even putting the infrastructures in around how do we do informed consent around infinite adoption in the healthcare space has [00:37:00] become, just one of my passions.

Because again, if we’re manipulating information, if we don’t really understand what ethical adoption looks like, if we don’t have ethical resources in place, we’re really setting people up to fail even on the adoption side. And so there’s a lot of opportunity that’s not being taken because this does feel like we can just check the box.

So, Dixie, are you Googling? Are you looking for numbers?

you’ve got that.

Dixie: I can’t find any. I think it’s a really hard one to track because again, it’s state by state and there’s no formal data repository.

Rebecca: Yeah, like I said, I wanna say, I wanna say there’s been like 10

maybe.

Stephanie: In Indiana. Yeah.

Rebecca: So

Stephanie: Well in, yeah. Interesting. Thank.

Nicole: All right, so there, I know we’ve kind of touched on this a little bit, that there may be a lot of folks who are listening and maybe saying to themselves, well, a, a box baby or a safe haven baby is better than a dumpster baby. Can you unpack why this line of thinking may [00:38:00] be problematic?

Rebecca: Yeah. I think that, as Dixie mentioned, we just, we lose connection with mom or the person dropping the baby off. We, the baby loses their story. I guess one thing we haven’t mentioned is, That as an adoptive mom, what information does that family receive for the lifelong, hopefully that that permanency for them with that child and their care?

We don’t know what that baby’s coming with, you know? And I think we’ve really downplayed over the decades about, oh, it’s blank slate. It’s fine, love is enough, nature, nurture, all those things. And the bottom line is these kids come with such intense wiring. We know the impact of cortisol in pregnancy. I have often said that I didn’t work with one mom considering adoption that was not stressed out.

I mean, think about just, I know a million moms that are stressed out that are gonna parent, like it’s this cortisol effect on these [00:39:00] kids is really immense. And I think there is a disconnect when we start. Advertising or or glorifying the idea of what they call a stork drop baby in the industry. Like, oh, I can pay extra and get in line for a stork drop.

That means that mom walked in, said, I don’t want the baby, and I got the baby from the hospital. I didn’t have to meet the mom. I didn’t have to pay medical bills, I didn’t have to pay any expenses. I won the adoption lottery. And it’s like none of that is true. The only thing you won is a fast adoption with not as much financial hit then, but you don’t have all this information and you don’t have the education about how to care for a child that’s gone through the trauma of losing their mom on their birthday.

And so that whole concept of disregarding. The information that child needs and the family that will raise them needs, is another misstep.[00:40:00] And I don’t, I don’t think I can be an empowered parent without the education and understanding trauma. When you have a child that’s come to you through an adoption situation, no matter whether it’s foster care, stork drop, I hate that term. Domestic infant, doesn’t matter if I lived with my son’s birth parents and talked to their belly every day. Fact is on their birthday, they lost their mom, her smell, her voice, the gate of her walk, and that absolutely causes trauma for kids through adoption.

Stephanie: It’s very sad to think about.

So can you talk to us about like better alternatives? I know Dixie got into that a little bit with kind of going upstream and, and funding those things. So could you talk a little bit more about better alternatives to Safe Haven or Baby Boxes?

Rebecca: Well, I, I think the fact that we’re having this conversation, makes me really happy. Thank you for inviting us. Because once the Dobbs decision came down, once we started talking to [00:41:00] people about those that weren’t gonna carry to term, they wanted to terminate their pregnancy and couldn’t, what kind of resources were available for them and how many people were coming into the hospital without a plan and what position that was putting the hospitals in.

And we frantically. . I shouldn’t say frantically. It was well thought out, but it was definitely something we put on the calendar very quickly to do a series of Safe Haven webinars to go through the content to understand what Safe and Haven was about. And then also what’s the alternative? We received a grant from Dave Thomas Foundation for adoption because what happens when the hospital is concerned with the safety of a child or a mom is they just immediately will flag that child for social services for a follow-up.

And I have yet to find a hospital that has said to me, oh, no, no. We look at community collaboration and we try to create a safety plan. I mean, it’s just, it’s the hot potato. I’m just gonna hand [00:42:00] it off to Child Protective Services, social services, whatever the terminology is in that state, and. . Now what are they going to do?

you know, when all these, these moms, these babies that didn’t have a plan walking in the hospital, now are going home and need oversight, need connection, need a parenting plan, et cetera. And so, Dave Thomas gave us a grant saying the system can’t do this. The system can’t be in charge of helping people parent.

And we also see the concern around the adoption industry. We know there’s close to a million families that wanna adopt. We know there will only be about 20,000 adoptions this year. So you can imagine the market that is out there for newborns, it’s just the perfect storm. And so having programming it within the hospital and whether that is a nurse navigator, a patient advocate, I was actually looking at my phone earlier cause I had a call coming in from Washington, dc We’re talking at a federal level of how [00:43:00] do we fund a position in hospitals that.

will actually sit with a patient and talk about their parenting resources, adoption that’s ethical. What does this look like So that it’s a third party neutral space. just like organ donation. You know, having someone there that can have the conversation that’s not gonna make money off the decision, that’s not gonna call their sister cuz she’s gonna adopt has been, oh wait, my sister’s been waiting.

Let me call her. I’ll tell her that you don’t want your baby . Like, no, no, you can’t do that. So setting up that infrastructure within the hospital I think will make all the difference for that informed consent, shared decision making, empower decision making with information that’s not being manipulated.

Dixie, what would you add? Cuz you’ve seen the Unique Families program in your hospitals. How did you see the changes?

Dixie: No, I think you hit it on the head. I think the big piece of the puzzle is that healthcare needs an abundance of education, and today healthcare providers do not have it. And so recognizing [00:44:00] that the Dobbs decision came down with the assumption that we were just gonna continue on as is, and we were behind the eight ball to start, and then Dobbs came. And we didn’t do any, we didn’t change our practice at all. Everybody was like, it’ll be fine. And we were like, no, really, it’s not fine. It’s not fine at all. Because our OB, G Y N teams and our labor and delivery teams immediately started waving the white flag and said, I don’t think the rest of the world understands that this changes our entire practice, our entire world.

And you guys have seen, and I think most US of a scene, it changes everything about pregnancy care and it changes many of the aspects of pregnancy care. And that’s a whole nother, you know, discussion. But in addition to when we get to the inpatient setting where now we have a conversation around what is parenting, because we have carried those pregnancies and we have been with those patients, but what we haven’t done is educated our healthcare team around.

important [00:45:00] conversations. So we, most of the dialogue within, you know, the media today has been around healthcare management. You know, medications that we don’t have access to or interventions that we don’t have access to. But what we haven’t been talking about is how do we train and educate healthcare providers and teams to say h again, how are you feeling about this pregnancy?

What is your parenting plan? Because if you can’t access what you thought you were going to do related to this pregnancy, and now you are carrying, what is your infrastructure around this pregnancy? And that is the big miss. That is the big piece of the puzzle that we have not addressed because. When you go in for your ob gyn appointment and you are pregnant, it’s a 15 minute appointment and that a seven minutes or less with your ob gyn provider, I can guarantee you that those conversations are not occurring in that moment.

And so infrastructure has to be put into place because the assumption that healthcare will just manage this is a poor assumption because we are [00:46:00] not managing it and we can’t manage it. And so I love that we’re talking about it at the federal level. The federal level will move slower than the actual world as far as what we’re seeing for patients today because those patients are already coming through the doorways.

So something has to be done both at the federal level as well as the bedside today. And I think that’s where family to Family Support Network comes into place. We’re working with hospital teams because they are already saying, come and put this program into place. Help us with policy, practice, procedure, scripting, updated language, and then.

we are seeing some healthcare teams already start to put in their own nurse navigators, their own care coordinators, to be that person, to start to connect the dots, be take the load off of those that are at the bedside because the load is already heavy for their care, and ease those conversations, which are really important conversations and be able to assist with some of those pieces of the puzzle.

But again, we have to put more infrastructure in place, not less. And healthcare [00:47:00] coming outta covid is not coming out in a well-suited place to be able to manage this in addition to unfortunately.

Nicole: So what are some specific policies or procedures that clinicians could work to implement at their facility or in their community for a pregnant person in crisis?

Dixie: Yeah. So we say, and when we teach all the time, we’re like you absolutely on the inpatient as well as in the ambulatory or the clinic setting. You need three very clear policies. You need an adoption placement policy, you need a Safe Haven policy, and then you need an infant abandonment policy. So let me break that down a little bit.

You need best practices and care of someone who is making an adoption plan. You need best practices and care for someone who is doing the relinquishment for Safe haven, which is outside of the inpatient setting. So that is someone who is outside of the hospital that is going to relinquish that child.

Maybe bring them to your emergency department or bring them into your hospital. And then you need [00:48:00] an infant abandonment. So that is someone who is in an inpatient, so they’re in your labor and delivery, or they’re admitted to your hospital for some reason and they are not going to be able to parent.

And so you need a policy in place and what are you gonna do in that scenario? And those are the three policies that we work with hospital teams all the time about. Some hospitals will have those three policies blended. We work with them and say, no, no, no. Those need to be three totally separate policies.

Totally separate practices and clarity needs to be brought to the team in how to provide care in those three scenarios.

Stephanie: Just curious, what, what type of person would you initiate that conversation

Dixie: that’s a great question. So

we.

Stephanie: I wanna know for myself,

Dixie: It’s a great question. So typically we work with, nursing directors, on the inpatient side as well as, and then clinic managers and directors on the ambulatory side. And we work with them together. We say, gosh, if you have a adoption policy, obviously that person [00:49:00] is pregnant and they’re starting in the clinic.

And then they, the adoption actually, Through usually when they, after they give birth, so that’s a joint policy that we may have of one version that’s for the outpatient side and one version that’s for the inpatient side. But we start that conversation with those leaders, so whoever’s running that area.

So, uh, the operational leaders, the nursing directors, the clinic managers. I tend not to start in full transparency with the physicians cuz physicians don’t do policy. Right? Like that’s not their specialty. So I oftentimes will start with the nursing leaders or the clinic managers. Or sometimes if you have a clinical nurse specialist or an educator who’s responsible for educating staff, they also have very skilled in policies.

And we’ll start with them..

Rebecca: We used to joke, you need to go high enough to the high enough to someone that can make a decision, but not so high that they haven’t been at the bedside , because when you start

talking.

Stephanie: Which is a nurse

manager, right?

Rebecca: [00:50:00] the CNO that, because when you start talking about what it feels like to care for a patient, when you don’t feel you have the tools to do it, you see them go back to their bedside experience and go, oh my gosh, Rebecca, I, I hated when I didn’t know what to say and I’d put my foot in my mouth.

Or some of would come in and, and Gibber jabber about Gibber jabber, they’re just talking, talking, talking. Cuz they’re so afraid they’re gonna say the wrong thing. Or they come in and they just shut down and they don’t talk to the patient because if they talk to the patient, they’re gonna say the wrong thing.

And we always wonder if we’re really a, like, concerned that we’re gonna say the wrong thing. And we’re constantly thinking that, what does that do to the clinical care? Like if we’re just concerned about not saying the right thing, are we able to give the best care possible? So that’s where the scripting can really help too.

Stephanie: Yeah. So let’s get into that. So let’s say one of our listeners are. , wanting to maybe utilize in their, in their institution a safe haven or baby box or [00:51:00] just like that they’re having conversations with a patient who wants to abandon their infant, or maybe even in crisis, what would you want them to know or how should we communicate

with that patient or that.

Dixie: I’m gonna take it from, if they’re inside the hospital and they’re in your labor and delivery and they say to you, I can’t take my baby home. You know, they’re a labor and delivery patient. They just gave birth and they say, I can’t take my baby home. The number one thing is to recognize and kind of check yourself and your own thoughts.

This doesn’t mean they don’t love their baby. This doesn’t mean that they don’t want to be a parent to their baby, but obviously there’s something going on in their world and their life that they’re not able to do that. And so we need to check our own biases in that very moment, because that’s a first step, to make sure we’re providing neutral compassionate care.

And then we need to have the conversation around, is there someone in your family that can care for this child? That kinship piece is [00:52:00] really important. We need to be able to say, you don’t have to go to the Child Protective Services. We don’t have to go straight to, you know, this baby going into foster care.

Is there someone in your family who can take care of this child? And if they say no, the other question is, is you know, you can make an adoption plan if you’d like to choose someone to parent your child. And so those are the things that we need to help hospitals with scripting, because sometimes when we’re working with hospitals, they’re like, I can’t say the adoption, because they’ll think that I think they’re a bad. Well that’s our own biases. So we gotta practice. Be able to say, well you can parent or you can choose someone else to parent. Say that 20 times to get it outta your system so you can say it clearly to a patient without sounding like you’re judging. And we’re not judging. We’re actually just giving them the options of what they can do, cuz it’s their decision, not ours.

So those are the type of things that we really need to help hospitals and help healthcare teams be able to [00:53:00] do for that. I think when we’re o outside of the hospital and we’re working with police departments and fire departments or emergency departments that may have a child brought to them and the Safe Haven rule is going to be used.

And that Safe Haven law is helping them understand what type of things that they may wanna consider. And so when we look at that, there are things like, you know, are you the custodial parent? Like, are you the parent of this child? They can ask that question. The person doesn’t always have to answer, but they can ask the question, right.

Are you yourself be willing to be checked? Like, do you need medical care if they are in the emergency department? If they’re in the fire department, do you intend to return for the baby? There’s questions that can be asked. And so making sure that you educate those that are receiving those infants as to what are appropriate questions and what are inappropriate questions.

And I think that goes back to our [00:54:00] very beginning conversation around if you don’t have clear policy practice and procedure and expectations of behaviors, that’s where, you know, civil teammates, such as the fire departments and police departments as well as, you know, healthcare providers can get themselves in trouble because we say things that we shouldn’t say.

 I don’t ever want someone that is in those scenarios to say, why are you doing? That that’s not an appropriate question. And so we want them to ask questions that are appropriate. Questions like, , would you like to voluntarily, you know, surrender this newborn? Is that what you’re doing?

Like clarity around what exactly is occurring in this moment, and making sure that we have clear understanding of those pieces.

Rebecca: I would, I also would throw in the fact that, Not before, but as a piece of clarifying policy to just sit down with case management and say, if a woman is looking at doing adoption, what do you give her? Like what information do you have? I [00:55:00] have asked multiple hospitals that, and literally they’ll reach down and pull a file folder out and open it and it’s full of, it could be full of brochures, business cards with couples that are waiting for babies.

They could have notes from, that have laws that have been changed, that have been like crossed out and written above. Like, and I remember one hospital was like, I can’t believe we give this to people. Like, it doesn’t fit our marketing theme. It doesn’t, everything needs to go out looking professional.

for whatever reason, no one had gone in there and said, do we have an ethical list of resources for women considering adoption? And how are we vetting these, you know, how do we even know who to call? Who do we have to come in and do some counseling with her? If that’s what she’s asking for. And who do you trust to do that?

Because, We know right now we have some consultants, facilitators, baby brokers as we call them out there that are advertising that they have [00:56:00] partnerships with hospitals that you can get in line for a stroke drop baby. You have to pay extra, but you can pay extra and have that subscription on your adoption profile that you will be in line for a baby that’s been dropped off at the hospital or a woman that decides last minute.

And so we have to make sure we keep those folks out of healthcare that they are not coming in, they’re not bringing big food baskets and all the fancy things to make sure they’re the first call that comes when a woman wants to relinquish. Oh, I always work with this lawyer. Oh, like, are we getting a kickback here?

Like, we have to have conversations about that because there’s absolutely speculation that there are kickbacks happening around the hospitals, because of the amount of money that’s changing hands.

Stephanie: Seriously. So it’s like when the pharmaceutical rep would come in with a big lunch, but this time it’s adoption agency

Rebecca: Yeah. And actually that’s, there’s some interesting history there. I won’t go all into it, but there was, an infinite adoption training [00:57:00] initiative that was federally funded a hundred million over 10 years. And it was to allow hospitals to share information about adoption. And so adoption agencies receive that grant to come in and do trainings in hospitals, but when they did, it came across as marketing and to no fault of their own, it was just they were coming in between the pharmaceutical rep and the formula company.

Right. And so it looked like they were bringing in food to have it be so you’d call them when there was a woman that wanted to relinquish. And we know those babies are worth. 40, 50, 60, up to a hundred thousand dollars right now for an adoption. And so that marketing piece is really important that we tackle that and we make sure that there are not foxes in the hen house that are getting into healthcare and making sure they can get in front of these women and, and promise of things that are not true.

We, we’ve had a, we had a story when we were doing a training of a nurse that heard a lawyer look at a family and say, oh, just throw the phone away. She’ll never find you. [00:58:00] It’s a burner phone. Take the baby, throw the phone away. She’ll never find you. And so this open adoption that had been sold to this patient, she thought she was gonna have a relationship with this family and her child, and the attorney stepped in and told the family just to throw away their phone that they’re, they didn’t have to keep a relationship with her.

That absolutely has to be followed up and made sure that person does not do placements in the hospital. These babies are all being born somewhere. So why do we not have more oversight and protection for our patients?

 that’s

a whole other show for you guys. Give me a

call.

Stephanie: My gosh, I had no idea. Like, and I think a, at least in my experience, and it might be because I’m primarily in academic medicine, they don’t allow pharmaceutical reps or, or formula reps or whatever, or at least not like how they used to.

 But then to see like if, if that’s still happening regarding human lives, is really crazy.

love [00:59:00] level of human

trafficking,

Rebecca: glad you just said that. That’s exactly what I’m just gonna say was, you know, it’s, it’s trafficking that has become socially acceptable as an infant adoption framework, and yet, if we don’t have informed consent, if there is coercion going on, if there is a power differential that’s going on and she feels that she does not have an option.

We know that women are going into adoption plans in hospitals and when they wanna change their mind, they’re being threatened. They’ll have to pay back all the money that the family’s given them and they can’t do that. Or that’s one of the reasons we didn’t receive money for deliveries that were involved in adoption until finalization happened.

Cuz we never wanted that woman to feel that they paid the hospital bill. So she had to go through the adoption. And so we never wanted that to be the reason. And so little pieces like that to shine a light on that during a time that we are going to see more pregnancies being carried, a term that people are not prepared to parent, [01:00:00] we have to make sure we get in front of the industry and put some guardrails in place.

Or it’ll continue to be the perfect storm in, in hospitals and healthcare. And I don’t want it to be. A huge trafficking story that makes hospitals finally care. Like, let’s just look at what’s happening now and let’s get in front of the storm as much as, like Dixie said, we’re behind the eight ball. This is already happening.

Nicole: So where can listeners go then to learn more about Safe Havens and what Safe Haven laws may be looking like in their state or, or even really any. Anything they need to be aware

Rebecca: No, I love We do have, on our website family two family support.org, we have opened our new portal that has free education. It has the whole safe haven. Informa, actually what I’ll do is I’ll give you the, the new portal link for you to put in your show notes because you’ll be able to set up an account.

There is also the Dave Thomas Foundation for Adoption webinar. The title of that one is called, utilizing [01:01:00] Shared Decision Making Tools to Assist Expected Patients and Clients in the Post Roe era. And Dixie and I did that and talked all about how do you have those conversations? How do you.

Put resources in place that protect patients. How do we make sure that we understand the laws and the procedures that are ethical? Where do we send them? We work with adopt match.com, which is a vetted, system of adoption professionals that you can go on there and see different adoption agencies and attorneys that have been vetted by them that are practicing best practice as far as ethics are concerned.

So thank goodness we don’t have to keep up on that cuz adopt match.com is doing that. They are also rolling out Adopt Change, which will allow you to go in and put in the name of a website and it will tell you who else owns that website, what’s going on behind the curtain is it for-profit, nonprofit. So it’ll give you, transparency to so much of the industry with adoption.

So that’ll be coming out in 2023 as well.[01:02:00]

Stephanie: Awesome. look at those for sure. Alright, what is the one thing that you want all of our listeners to take away from today’s conversation?

Dixie: I think for me, for those that are out there who are. especially working within the healthcare industry, and are working with patients and, you know, actively caring for women who are pregnant, working within women’s healthcare fields or working with birthing persons. I think the big piece of the puzzle is to understand that many of us, our training is insufficient.

And just to be really open and honest and understand that our language needs to be updated and our thought processes need to be updated to current practice. And through no fault of our own, we have not had those avenues. But the best part is that we do have [01:03:00] avenues now to be able to go through that and to have that updated.

 And it’s our obligation and our duty to make sure that we are using accurate language, that we are using updated knowledge and understanding, and that this is really complex. But many of this is soft skills. Soft skills, meaning it’s not about how you are clinically managing the medication that you’re administering, the procedure that you’re doing.

It’s about how you’re speaking to your patients. It’s about how you are using your language and how you’re using your influence with your patients. And that is the key to the care for neutral compassionate care. Whether you’re caring for someone that’s considering an adoption plan, whether you’re caring for someone who has an unplanned pregnancy, and now that person’s going through what is their pathway of decision making, but we have a responsibility to our patients to make sure we have updated practice.

Rebecca: I think my number one takeaway would be to insist on [01:04:00] accountability. around these areas to insist that leadership has clear education, thus clear accountability at the bedside. So we can’t hold nurses accountable for respectful, neutral, compassionate care if we have never taught them what that looks like.

And we can’t hold them accountable for unethical adoption practices within the hospital when we’ve never addressed that with our staff. And so that’s my biggest takeaway is just to get in front of this and to do the work. It’s not a huge heavy lift considering the lifelong impact it will have on patients and just the feeling of being the efficacy for your staff to walk away from a patient and think, I handled that right.

I handled that well. I knew what to do. I knew where the tools were, I knew who to call. They left feeling cared for, and they left feeling like I saw them and. . I just think we have to raise the bar. We, we have to be able to, we, we need to stop saying that. [01:05:00] Oh, that’s just that nurse. That’s just how that nurse treats those kind of patients.

I’m not, they know , you know, if you’ve gone, as I joke a nurse Betty, I don’t know who she is, but she’s out there. But if you’ve got that nurse Betty that you’re always saying, oh, we gotta make sure we don’t give Betty to this family. She doesn’t do well with those families. No, no. Betty needs to learn how to do well with all families.

And that’s part of understanding our implicit bias. Making sure we’re aware of how that gets in the way of patient care. How do we approach that patient with a neutral, compassionate approach with updated language? Whether I agree with it or not, I don’t get a vote. And I think Dixie and I have seen we’re we’re, we get more pushback and we have in the last six months around unique family care from people that say, well, I don’t believe in unique families.

I believe in traditional families. And I’m like, well, you don’t get a vote cuz who’s walking through the door? Our families. Period. They’re just families and you need to care for all of them. So I think we have to raise the bar and understand, and in faith-based hospitals as well, [01:06:00] that’s been one of the questions we’ve had where if we’re truly gonna show the love and compassion in our faith, we need to show love and compassion to everyone.

You don’t qualify for that. You don’t have to, meet my moral guidelines to make sure I’m gonna treat you with compassion. That’s not how this works, or it’s not how it should work. So I think that would be my main hope is that we would just make this non-negotiable and leadership would step up and say, I want, I want my staff to know how to care in a respectful, neutral, compassionate way for everybody.

Stephanie: So I think that’s my favorite phrase that I learned from you both is you don’t get a vote , and that, is in that episode on neutral compassionate care. They talk about that more. But I use that with my son a lot now cuz they’ll be like, this person was wearing blah, blah, blah. And I’m like, well, you don’t get a vote like they can.

they can wear whatever they want

Rebecca: love it. It’s a good, we call it life rule in our house.

Things happen. I’ll be like, Hey, that’s a life rule. You don’t get a vote.

It’s [01:07:00] true.

Stephanie: You get to vote in what you wear. They get to vote in what they wear.

Rebecca: It’s so good.

Stephanie: All right, so Rebecca and Dixie, I would personally like to thank you so much for your time and commitment to advancing sexual and reproductive healthcare through communication. Love talking to you as always. Do you have any last thoughts that you would like to add before we end?

Dixie: I just wanna thank both of you for continuing the conversation. The work that you’re are doing is so important and, I’m just really grateful for all of the pieces of the puzzle that you’re putting together out there for the listeners. So thank you.

Rebecca: Yes.

Stephanie: to you. Thank

you.

Nicole: Yes. Thank you both so much. Always fun.