Birthing Methods
Expectant mothers are just as likely to be sitting on a birthing ball as on a bed.
Wireless fetal monitors can track a mother's contractions even as she walks the hall.
And the most important time is after the delivery, during “the miracle hour.”
There are changes in the birth process, and it's not all because of the COVID-19 pandemic, said Nancy Gross, director of the OB-GYN unit at Butler Memorial Hospital.
In some ways, delivering a baby follows an age-old script.
“A patient arrives at hospital, is evaluated and treated in labor and delivery area as she progresses in labor,” Gross said.
“They're allowed one support person, and the labor, delivery and recovery is one room,” she said.
The rooms themselves have a few more homey touches than the typical hospital room.
They have a wooden TV cabinet, storage of luggage and a sleeper couch so the mother's support person can be comfortable.
The laboring mother is attended by two nurses and a medical provider — who could be a physician or a midwife, or both, if necessary — as well as the support person.
Gross said three of the five birth rooms are equipped with wireless fetal monitors.
“She can get up and walk in the hallways,” Gross said. “We can monitor the baby and contractions wirelessly.
“I think that's a huge benefit to the mom. The last thing we want them to do is feel trapped in bed. They should be moving around and doing as much as they can.”
Gross said that the hospital wants expectant mothers “to work through the contractions and get as far into the labor process as they can.”
To that end, the rooms are equipped with birthing balls, similar to exercise balls found in gyms.Mothers can sit on balls, which allows them to be out of bed. The balls can provide more positions for the laboring mother to be comfortable.Following the labor, Gross said the newborn and the mother have what is called the “miracle hour.”The mother and the baby have skin-to-skin contact and the baby's first feeding during the hour after birth.“It's a concept that has become very, very popular,” Gross said. “Research shows that's the best way for a mother and baby to get acquainted.”The baby's blood sugar and temperature stays stable.“The baby adjusts to being out of the uterus best when placed skin to skin to the mom,” she said.Following the delivery, the mother, baby and support person, if any, are taken to a two-bed room where they stay for a minimum of 24 hours for observation.If the baby needs to kept for further observation, mother and child will stay together in the hospital for another 48 hours.
The arrival of the pandemic caused other changes to be made in the OB-GYN unit.“Last March, we had prepared an area on the department where we could isolate a COVID-19-infected mother for delivery and she could stay at the hospital so they are not near the other mothers and babies,” Gross said.” It has come up a fair amount of times.”The area is in a separate room down a different corridor.The unit also uses a separate staff to provide for the COVID-19-infected mother and baby.Expectant mothers arriving at the hospital are tested for COVID-19.“We have had no situation where we have had any concerns about the babies where their mothers have COVID-19,” Gross said.But like so many other activities, the pandemic has canceled the hospital's prenatal classes for expectant mothers.Gross said the hospital has adjusted by using a technological substitute.“We have the Wellbe Education Program, which was started before the pandemic to reach out to families who can't come to in-person classes,” she said.It is an automated email.Every two weeks, based on the mother's week of gestation, she receives an email covering such subjects as what to pack, when to go to the hospital, what door of the hospital to use and other information. The emails are created in collaboration with the hospital's education department.Gross said the hospital can also provide expectant mothers with virtual tours of the hospital, walking them through the doors and hallways.“That decreases anxiety like you wouldn't believe,” she said.
The hospital also provides information to the new mother heading home with her new child.“Twenty years ago, we would have put on a VHS tape about bathing, burping and feeding the baby,” Gross said. “What we have now is a 35-page book with each of the subjects.“Within that book are bar codes. Mothers can use their own phones to go over the bar codes. A video will pop up on the subject on their phone and gives instructions on bathing, etc.”She said the hospital has “found young folks more interested if they have phone in their hand. If they missed a point, they can watch their video over and over again.“I feel very strongly that has enhanced the education of becoming a new mom.”Gross said such innovations, as well as the work of the staff and physicians, is responsible for Butler Memorial Hospital being named in Newsweek's top 100 maternity hospitals for both 2020 and 2021.The magazine used the Leapfrog Group, an independent nonprofit that monitors the quality and safety of health care, to find hospitals that meet Leapfrog's standards for excellence in maternity care.Leapfrog looked for hospitals that have low rates of C-section, episiotomy and early elective deliveries, and follow important protocols to protect mothers and babies.
