8 | Livingwell a-z | Wednesday, March 5, 2014
Great expectations
Higher levels of care for newborns
continued from the cover
By Debra Gelbart
MIDWIVES: More and more women are
choosing a certified nurse midwife to care for them during pregnancy and delivery. Women can choose a midwife through their obstetrician’s office, independently, or through their delivery hospital. Each hospital system approaches midwifery differently. At Banner Del E. Webb Medical Center, for example, certified nurse midwives who work in an obstetrician’s office deliver the babies of a number of patients at the hospital, Ford said. “Certified nurse midwives get to know their patients very well,” she said, “and provide more individualized care, helping patients avoid medical interventions unless absolutely necessary.” At two Abrazo Health-owned facilities — Phoenix Baptist Hospital and Maryvale Hospital — partnerships with local midwifery groups help connect pregnant patients with certified nurse midwives, Shepherd said. St. Joseph’s Hospital and Medical Center maintains a facility-based program with four certified nurse midwives on staff, Piccinati said. “Our midwife program gives patients the opportunity for a completely unmedicated natural delivery,” she added, noting that the midwives at St. Joseph’s average between 20 and 30 deliveries every month. (For more info on midwives, visit midwife.org.)
DOULAS: More pregnant women are choosing to have a ‘doula’ — a professional birthing coach who helps the mother through labor but doesn’t provide medical care — with them throughout the birthing process. “Evidence shows that doulas may reduce the likelihood of C-section by up to 28 percent,” Piccinati said. “I encourage all couples to consider having a doula attend their birth.” (For more info on doulas, visit dona.org.) PARTNERS: Partners are encouraged to stay with mom and baby overnight in the same hospital room, Shepherd said, so parents can learn together how to recognize baby’s cues for feeding, cuddling and diaper-changing. “When there are issues with soothing the baby or getting him to sleep or feed, they are more easily identified when mom, dad and baby are together in one room,” Ford said. JETTED TUBS AND MORE: Many hospitals offer jetted tubs in the bathrooms of birthing suites or
The March of Dimes estimates that 10 percent of all babies born in the U.S. every year are either premature or have a medical problem requiring care in a hospital neonatal intensive care unit (NICU).
Stacey Piccinati, certified nurse midwife and birth consultant at St. Joseph’s Hospital and Medical Center in Phoenix, talks with expectant mother Mindy Raisor of Gilbert about some of the various tools and techniques, such as using a therapy ball, that can make labor more comfortable. | Rick D’Elia
labor-delivery-recovery (LDR) rooms. “Our patients don’t deliver in those tubs,” Ford said, “but if the tub can relax a mom-to-be so that the only muscle in her body that’s working is her uterus, her labor time is often decreased.” Hospitals offer a variety of additional ways to help moms get through labor and deliver more comfortably, including therapy balls and more.
LEVEL II NICU: Some hospitals, such as Banner Del E. Webb Medical Center in Sun City West, can provide intermediate-level (called ‘Level II’) care for a newborn, said Karon Ford, the hospital’s director of women’s and infant services. “We are able to take care of infants at 32 weeks gestation,” Ford said. “We can handle respiratory issues, infections (and jaundice-related) issues.” If the baby was born before 32 weeks, or “if the baby needed surgery or long-term care, the infant may be transferred to a higher level of care facility.”
BABY CARE: Baby’s first well-checkup is typically conducted right in mom’s hospital room, creating the opportunity for the pediatrician to immediately explain the findings while also educating the parents about what to expect in the coming days, Satran said. Piccinati said most nursing care for the baby — including bathing, hearing screenings, medications and blood tests — can also be done bedside in mom’s hospital room. CELEBRATION MEALS: Celebration meals are offered to new parents at some hospitals, including Paradise Valley Hospital in Phoenix. “We offer a special meal at no charge that includes steak or shrimp once mom has transferred to postpartum care,” said Jean Revard, food service director for Paradise Valley Hospital, which is part of Abrazo Health. • Editor’s note: Where to give birth is a personal choice between parents-to-be and their healthcare provider. While we recognize that some parents are choosing to deliver at home, the focus of this article is on hospital birthing options. We intend to cover home-birthing options, resources and caveats in a future issue of Livingwell.
Andrea Sharfner (left), clinical nursing manager and NICU Parent Boot Camp instructor at St. Joseph’s, works with Maria Garcia, whose son was born prematurely. | Rick D’Elia
LEVEL III NICU: A woman whose pregnancy is considered high-risk likely will be advised to arrange to give birth in a hospital with a Level III NICU, such as Scottsdale Healthcare Shea Medical Center, said LoriAnn Satran, the nurse manager of OB couplet care at Scottsdale Healthcare Shea.
Increasingly, said Stacey Piccinati, a certified nurse midwife and the birth consultant for St. Joseph’s Hospital and Medical Center (which also has a Level III NICU), parents of NICU babies are offered classes specifically tailored to their needs. There is a separate ‘boot camp’ class at St. Joseph’s, for example, just for families whose babies have been in the NICU, she said. At St. Joseph’s, about 600 babies are admitted to the NICU every year.
AFTER THE NICU: Any baby who spends at least five days in a NICU in Arizona qualifies to have home visits from a community health nurse through the Newborn Intensive Care Program, a program funded by the Arizona Department of Health Services and delivered through contracted agencies such as Southwest Human Development, a nonprofit organization that provides families with comprehensive early childhood services. During home visits, the nurse helps parents check their baby’s physical and developmental progress and gives them information about resources such as early intervention, financial assistance and counseling. There is no charge for this service. “Because this can be an extremely difficult time for families,” said Trudi Murch, Ph.D., CCC-SLP, director of services for children with disabilities at Southwest Human Development, “they really appreciate having someone who can be there to help them once they leave the safety of the NICU.”
More info:
Southwest Human Development: swhd.org/nicp, 602-266-5976 March of Dimes Arizona chapter: marchofdimes.com/Arizona, 602-266-9933
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