Each year, nearly 500 babies are welcomed into the world at Dignity Health Sierra Nevada Memorial Hospital. Every day, the physicians, nurses and staff members who help to deliver those babies are working to ensure each birth is as safe, comfortable and complication-free as possible.
Like all hospitals around the country, a big part of that focus at SNMH in recent years has been to reduce the rate of cesarean section, or c-section, births. In January of this year, Smart Care California (a public-private partnership working to promote safe, affordable health care in California) honored SNMH for consistently having a cesarean rate well below the state's target c-section rate of 23.9 percent. SNMH has been recognized for achieving that goal since the inception of the award two years ago.
"We applaud the hospitals (like SNMH) that have hit the 23.9 percent target two years in a row," said Elliott Main, M.D., who leads the California Maternity Care Quality Collaborative, a multi-stakeholder organization committed to ending preventable morbidity, mortality and racial disparities in California maternity care. "Sustainability is hard, but these hospitals have shown it can be done. It involves a commitment from leadership and the engagement of the entire team of nurses and doctors."
While life-saving in certain cases, c-sections can pose serious risks to both babies and mothers, and once a woman has a c-section, she has a 9 in 10 chance of having a c-section for future births, increasing her risk of major complications.
Reducing the c-section rate is just part of SNMH's effort to ensure a healthy delivery for mothers and babies.
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"As a team, our goal for each mother is to provide care that is as holistic as possible," explains Ann Erdmann, MSN, RN-C, Director of the Women & Infant Care Unit at SNMH. "Our nurses focus on being in tune with their patients and families. We do everything we can to make each birth special and to honor family birth plans, while working together with doulas and midwives who may accompany them to the hospital."
The nursing team at SNMH has received extensive training in managing births of all types, including newborn stabilization and specialized training on interventions to reduce the need for c-sections.
Those interventions may include using peanut balls for positioning and to aid in walking during labor.
"When laboring women require monitoring in order to ensure the health of the mother or the baby, we have the option to use telemetry monitors which enable the mother to still change position, walk around, and even use the soaking tub," said Erdmann.
Pain relief options are also expanding at SNMH. Epidural pain relief – the gold standard for complete pain relief – is currently used by about 45 percent of SNMH patients.
In addition, the hospital is in the process of adding patient-controlled nitrous oxide as an option for pain management, giving laboring women one more choice for pain relief.
The hospital is also focused on supporting new mothers in their efforts to breastfeed, implementing the best practices recommended by breastfeeding advocacy organizations and earning recognition for its high breastfeeding rate.
Local physicians who deliver babies at SNMH include:
Dr. Lystra Celestine: St. George’s University School of Medicine, Grenada, West Indies “I have a passion for giving patients the tools they need and helping them understand that they can change their own outcomes by choosing to make lifestyle changes.”
Dr. Christopher Genobaga: Loma Linda University School of Medicine, California
Dr. Richard Goddard: Uniformed Services University of the Health Sciences, FE Hebert School of Medicine, Maryland “My philosophy of care is to do what is best for each individual. I do not prescribe therapies based on a ‘cookbook,’ and that has enabled me to keep c-section rates and complications low.”
Dr. Sarah McKenzie: Rocky Vista University College of Osteopathic Medicine, Colorado “I work with my patients toward achieving their goals. I listen to their desires and I strive to offer a gentle, kind experience.”