WEBVTT

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(melancholic music)

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(sighs)

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(door knocking)

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<v ->Lillian.</v>

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Hi!

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<v ->Hello.</v>

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<v ->I'm Dana.</v>

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I'm the nurse practitioner

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who will be examining you today.

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<v ->Okay.</v>

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<v ->Would you like to sit in a chair?</v>

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<v ->Sure.</v>

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<v ->Okay.</v>

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You know, those tables

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are not the most comfortable,

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are they?

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<v ->Thank you.</v>

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<v ->You know, my favorite aunt's name is Lillian.</v>

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I've always thought that it was such a pretty name.

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<v ->Thank you,</v>

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actually, my real name is Liliana.

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I was named after my abuelita,

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that's my grandmother.

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<v ->Oh, that is lovely.</v>

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Well, I want to thank you very much

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for bringing all of your records.

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I see you've been getting

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some real good prenatal care in Chicago.

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<v ->Mm-hmm.</v>

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<v ->Did anyone talk to you about your ultrasound?</v>

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<v ->Yes.</v>

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<v ->So, I guess you already know what you're having.</v>

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<v ->A boy.</v>

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I always wanted a boy.

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<v ->If a woman enters your room,</v>

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there's an opportunity at hand

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for some influence and support

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that could make a difference

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in someone's life forever.

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She might not be making eye contact,

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might be fidgety,

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she might be just verbalizing discomfort,

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fear, uncertainty.

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It's gonna be critical that you stop,

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and you say, almost to yourself,

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not out loud,

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that I need to take time here.

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This woman needs more of my time today,

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and to make that happen.

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And to make, hopefully, make her feel like,

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she's really the only person that matters today.

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She's your only patient.

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That is where you are really showing that person

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that this relationship is about respect.

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And the goal is to have a relationship

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that is of mutual respect.

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<v ->Are you sleeping well?</v>

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<v ->It seems all I ever do is sleep.</v>

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Last night, I laid down with Christina,

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that's my five-year-old,

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at 8:30 and I fell asleep in her bed 'till morning.

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<v ->Do you do that often?</v>

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<v ->It's been happening lately.</v>

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<v ->Did you have the same experience</v>

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during your other pregnancy?

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<v ->Not really.</v>

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<v ->Is there anything else about this pregnancy</v>

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that's different from your first?

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<v ->I don't know.</v>

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<v ->No?</v>

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You appear kind of sad.

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Is that how you're feeling?

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<v ->I'm feeling fine.</v>

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<v ->Remember the role of a nurse</v>

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is to see an individual,

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the whole individual,

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emotionally, physically,

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mentally, spiritually.

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So, again,

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the role of the nurse with this individual

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is seeing her as a total person.

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And once you are not going to know

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what the person's needs are

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until you do an assessment.

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So, the first and foremost thing

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is a total assessment,

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total, nonjudgmental assessment.

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<v ->I understand that you recently moved back</v>

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from Chicago to Detroit.

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Was that hard?

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(speaks Spanish)

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<v ->I'm sorry, I don't understand.</v>

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<v ->Oh, I'm sorry.</v>

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My father, he died last year.

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<v ->Oh, I am sorry.</v>

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<v ->Mostly, I moved back to be near my mom.</v>

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<v ->Are you and your mom close?</v>

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<v ->Oh yes,</v>

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very close.

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In fact, we're staying with her,

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Christina and I,

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until I can get settled in a place of my own

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when I find a job.

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We're a very close family.

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<v Dana>What makes you such a close family?</v>

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<v ->Well, it's...</v>

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<v ->The public health nurse wants to know the family,</v>

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wants to know the situation

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that brought this family to their attention.

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So, they wanna ask questions

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in such a way that it makes it possible

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for that pregnant person

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to tell them their story,

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to tell them what's important to them.

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<v ->Yes, people in my family love children.</v>

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<v ->Must have been fun for you growing up.</v>

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<v ->And that's true</v>

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whether it's an African-American family,

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or a Caucasian family,

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or Arab-American family,

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Asian family,

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it's true because you can't possibly know the culture

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and values of every single household.

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But if you ask the questions in the right way,

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people will tell you what's important to them.

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<v ->Lillian, your pregnancy is progressing along very nicely.</v>

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The baby's growing well.

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We heard a nice, strong heartbeat,

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and your blood pressure's just fine.

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It looks like your due date

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is right around August 28th.

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<v ->Okay.</v>

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<v ->Well, how are you feeling about the pregnancy?</v>

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<v ->Fine.</v>

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<v ->Was the pregnancy something you planned?</v>

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<v ->Well, no, not really.</v>

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I mean, I do want more children.

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It's just that I wasn't planning

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to have a baby right now,

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but we just can't predict these things.

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We just move on.

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There's no other choice.

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<v ->What choices have you explored?</v>

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<v ->Well, when I got pregnant,</v>

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I thought,

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I hoped...

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Well, my boyfriend, Joe, and I

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aren't together anymore.

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He moved back in with his old girlfriend.

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He doesn't want a baby.

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That's another reason why I left Chicago.

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<v ->I see.</v>

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So, you were hoping that you and Joe

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would raise the baby together?

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<v ->I don't dwell in the past.</v>

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I just have to move on.

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<v ->What plans do you have now</v>

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for after the baby comes?

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<v ->Well, I don't know.</v>

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I mean, I really wanted to finish my Bachelor's degree.

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But now, with the baby,

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(sighs)

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I'd have to start all over again.

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There's no way I could work and go to school,

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and take care of a five-year-old and a baby.

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I just can't.

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<v ->Who do you think might be able</v>

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to help you care for the baby?

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<v ->I don't know.</v>

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No one.

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My mom, she helped me so much

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when Christina was born,

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but now she's gotta work,

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because, you know, my dad,

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he didn't leave much.

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<v ->What about neighbors,</v>

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friends, someone from church?

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<v ->No, I really can't think of anybody.</v>

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I don't know.

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I don't know what's gonna happen.

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<v ->Kind of overwhelming, huh?</v>

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<v ->Yes.</v>

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<v ->Have you thought about any other options</v>

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other than raising the baby yourself?

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<v ->I love my baby.</v>

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<v ->I can see that.</v>

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Here you go.

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This has gotta be weighing very heavily on you.

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<v ->Yes, I'm sorry.</v>

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I just don't know what I'm going to do.

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<v ->Yeah, I know.</v>

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And you know what?

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You don't have to be sorry.

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It's very helpful to get your feelings out.

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It will make it easier to take a look at your options.

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Lillian, are you familiar with pregnancy counseling?

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<v ->What do you mean by pregnancy counseling?</v>

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<v ->It's actually something</v>

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where you work one-on-one

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with a social worker.

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<v ->Pregnancy counseling is an opportunity</v>

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to talk about the different options available

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that would look like or could look like,

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yes, I am gonna have a baby,

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and I'd like to consider

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if I'm gonna raise that baby

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or would I like to consider adoption?

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Have I thought about anybody in the family

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that might wanna be a part

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of the caring for my baby?

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So, the word pregnancy counseling opens lots of doors.

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It invites a response that says,

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yeah, I'd like to talk more about this.

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<v ->Would you like some more information about it?</v>

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<v ->Yes, okay.</v>

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<v ->Have you ever thought about adoption?</v>

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<v ->I don't think I could live with myself</v>

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if I gave my baby away.

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In my family,

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the way I was raised,

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we don't do that.

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We take care of our children.

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We don't throw them away.

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<v ->You feel that releasing your baby for adoption</v>

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would be like throwing him away?

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<v ->I don't think I could sleep at night</v>

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if I didn't know where my baby was.

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What would I tell my family?

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How could I ever walk into church again?

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What would I tell Christina?

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I gave your baby brother away.

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<v ->You feel there are a lot of people in your life</v>

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who just wouldn't understand.

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<v ->No.</v>
<v ->Adoption is a powerful word</v>

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and it often repels.

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And so, it's difficult for all of us

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in some instances to even raise the issue,

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and describe it as one of the options.

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If adoption can be presented

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as a truly constructive alternative,

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not one clothed with a lot of secrecy and guile,

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and who knows what, deceit,

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but straight up

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that this exists as an alternative.

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It's not for everybody,

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but for some people,

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it really has been actually an answer to prayer.

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<v ->The only thing we can do</v>

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is to present the options to the client,

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but we always have to be respectful

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of where that client is coming from,

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their frame of reference,

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because, culturally, it may be a taboo for them.

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And for them to go against that cultural taboo

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may mean that they are shunned by their family.

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And that may be something

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that they're just not able to cope with

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or able to do.

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<v ->You know, adoption doesn't necessarily mean</v>

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that you'll never see your baby again.

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<v ->I didn't know that.</v>

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<v ->Yeah, you can choose a friend</v>

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or a family member,

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or even godparents to raise your child.

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<v ->Really?</v>

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I didn't know that.

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<v ->Is there a family member you might trust</v>

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to raise your baby?

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What were you thinking about just then?

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(speaks Spanish)

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<v ->Sofia.</v>

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That's my aunt Sofia,

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my mom's baby sister,

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has always wanted a baby so badly.

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Tony and Sofia have tried for years and years.

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Now they're too old, late '40s.

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I'm sure that's passed the cutoff for adoption,

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and they don't have much money,

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and they really don't speak much English.

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They probably wouldn't even be eligible.

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<v ->Lillian, there's an agency in Detroit</v>

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called Latino Community Services.

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Let me go ahead and get you a brochure.

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<v ->Okay.</v>

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<v ->They offer all kinds of services</v>

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to families and children,

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including adoption,

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and the staff there is bilingual.

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Now, I am going to give you the name and phone number

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of a wonderful case worker there.

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Her name is Sonya Ramos.

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Now, you might find it helpful to give her a call,

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just to talk.

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You don't have to make any decisions,

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nothing immediate,

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and I think you'll like her.

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She's real easy to talk to.

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Now, if you decide to call her,

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you can go ahead and do it on your own,

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or I can be there,

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or we can do it together

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and call on the speaker phone,

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and that way, I can introduce you to her.

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That would be just for us to talk.

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There would be no pressure.

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<v ->The helping professions have to understand</v>

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that we each have a role,

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and while it may not be your role

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to handle the adoption,

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it is your role to connect them

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with the appropriate source

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that's going to get them the help that's needed.

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They need to be able to make appropriate referrals

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based upon an individualized assessment

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of that individual person.

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And until you do that,

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you haven't finished your work.

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( music continues)