Birth: The Enduring Miracle of Life

Successfully delivering a newborn takes a lot of patience and care. Meet some of the passionate health professionals who share the excitement of birth with new mothers and fathers.

It began slowly. A busy night turned into a busy week. And this fall, the babies just keep coming.
Pat Joschko, head of women’s services at FHN, says that whenever her co-workers experience a “baby boom,” they can’t help but count back nine months. The long, cold, snowy winter last year means the FHN OB staff has been seeing a lot of new little ones arriving lately.
That’s just fine with them, though. Like so many people who are driven to work with mothers and babies, FHN staff members consider their profession to be a calling. In fact, many labor and delivery nurses across northwest Illinois say they wouldn’t be happy doing anything else.

There from the Beginning

Often called a “passion,” maternity and newborn care sometimes involves helping mothers through challenging pregnancies, which can involve hospital bed rest. OB departments see women through labor and delivery – which sometimes requires surgery – and longer hospital stays.
Trained medical staff may need to treat newborns for complications such as being born too early, or to facilitate their transfer to another hospital. During an average birth experience, parents often have just 48 hours to learn the ropes of newborn parenting. During that time, nursing staff try to teach parents all the basics, from feeding and changing diapers to safe sleep positions and car ride safety.
Maternity departments don’t just focus on medical care – they focus on some of life’s biggest transitions: life in the womb to life in the world; role of woman to role of mother.
Watching a couple transform into a family or siblings meet for the first time is all part of the job for staff members of local hospitals like FHN in Freeport, Rockford Memorial (RMH) and Katherine Shaw Bethea Hospital (KSB) in Dixon. It’s all about helping families off to the best possible start.

A ‘Hidden Gem’

For KSB Hospital, there are many ways that being “smaller” works.
The organization offers a full-service department for moms and babies, care for women experiencing challenging pregnancies and connections with area hospitals, in case a baby needs extra care. And its partnership with Rockford Memorial Hospital means babies have quick access to a Neonatal Intensive-Care Unit (NICU), if necessary. The department has seven adult beds and 10 nursery beds, in case of multiple twin deliveries. KSB staff members pride themselves on getting to know each of their patients personally, and being able to thoughtfully customize care.
That’s one of the beauties of being what KSB Director of OB Sandy Dennis calls “a hidden gem.”
“I think sometimes people think they need to go out of town, but our physician and nursing care here is at an extremely high level of quality,” she says. “Our patients are happy to be able to come right here.”
One of the things that makes KSB unique is its diversity of OB providers – mothers can work with a variety of physicians or a certified nurse midwife. Each offers a slightly different approach to pregnancy and labor care, Dennis says.  
Families can even choose to have the family physician, who treats Mom, Dad and siblings, bring their baby into the world, which isn’t so common anymore, Dennis says. It’s an important part of KSB’s spectrum of care.
“I think it says that we value two things,” says Dennis. “We value Mom’s desire to have the whole family cared for by the same provider, and we value the physician’s desire to maintain that part of his or her practice.”
As part of an effort to provide “everything you could want in the newborn world,” the hospital is pursuing Baby-Friendly Hospital status, a 10-step, four-phase World Health Organization and UNICEF initiative that promotes breastfeeding.
“It’s really getting us to recognize what we should have known all along, that mother’s milk is the best food for newborns,” Dennis says. The hospital is currently on Phase 3, and is on track to be surveyed and certified by next year.
The reasons for pursuing the designation were twofold. First, KSB received support at the local, state and federal levels. Then, they teamed with the Lee County Health Department to be “partners in newborn nutrition.” 
To best support mothers, the entire newborn staff helps moms immediately after birth, and lactation consultants are available during the remainder of the family’s stay.
The hospital has taken a big step in recent years, by ending the practice of giving out free formula gift bags. Not long ago, this was common practice in OB wards and pediatric offices.
“We felt like it was truly sending the wrong message,” Dennis explains. “We were saying, ‘we don’t trust breastfeeding to work out, so when you fail, here’s formula.’ It’s just not the right thing to do. We’re not advertising anymore for the formula companies.”
This isn’t to say, however, that a mom who doesn’t want to breastfeed will be forced into it. Again, that’s where KSB’s customized care shines. “If we know a mom is not comfortable breastfeeding, that’s OK – we’re here to support her,” Dennis says.
The OB nursing staff, made up of many who’ve been with the department five to 10 years or even longer (“time flies when you’re having fun,” Dennis says), values that rapport with new moms.
“My nursing staff is an extremely intelligent group – they love what they do and it shows through in the kind of care they give to people,” she says. “It’s just so important to them that they are giving the best care. OB is unique. It’s really a passion.” 

Caring for the Smallest Babies

They see the tiniest patients – the ones born early, who sometimes arrive via ambulance or even helicopter, shortly after entering the world.
 RMH is a Level 3 Perinatal center, the designated perinatal hospital for 11 counties in the northwest Illinois region.
“We’re the leader,” says Linnette Carter, director of women and children’s services.
During the past several years, the hospital has taken big steps to advance its NICU, to make cesarean births more family-friendly, and to encourage breastfeeding in new ways – all in an effort to support newborn patients and their families.
As part of the Vermont Oxford Network, a worldwide collaborative working to improve the quality and safety of medical care for newborn infants and their families, made up of almost 1,000 neonatal intensive care units around the world, RMH works with other NICUs “to help achieve the best possible outcomes for babies,” says Carter.
Involvement is voluntary for NICUs, and participation has helped the RMH department in many ways. For example, a recent clinical initiative provided valuable learning about weaning babies off ventilators more quickly, which has been found to help lung development.
The department makes every effort to use breast milk in the NICU because it provides the best protection for tiny systems, says Carter. Breast milk can even help to prevent complications like necrotizing bowel disease (the death of intestinal walls).
But RMH’s commitment to sterling obstetric care begins long before birth. Two years ago, the hospital started exploring the idea of offering “family-centered cesareans,” which means keeping babies and mothers together throughout surgery and recovery.
“It used to be that mothers and babies could be separated for up to four hours, which could be very stress-inducing,” Carter explains. So when three labor and delivery nurses, who were all pregnant, offered to be the first to try a new approach, the hospital embraced the opportunity.
“Based on research and their help, we were able to implement it and patients absolutely loved it,” says Carter. “Their feedback led to more positive reinforcement with doctors, and, since January two years ago, we’ve offered this to all patients who are medically stable. The rate is more than 85 percent who can enjoy non-separation and immediate skin-to-skin contact.”
Skin-to-skin contact, also sometimes called “kangaroo care,” is the practice of placing babies next to their mother’s (or sometimes even father’s) skin. It has many benefits, including helping babies’ body temperatures to regulate, even in the case of premature newborns.
It’s one of many practices implemented as part of the hospital’s effort to become a Baby Friendly Hospital – an accomplishment they hope to complete as soon as March. RMH is currently in Phase 4 of the process, and to Carter and her staff, becoming a Baby Friendly Hospital is about supporting all families.
“We’re OK if you breastfeed or formula feed – there’s no pressure,” Carter says. “But we’re saying that, if you choose to breastfeed, we’ll do everything we possibly can to support you.”
 That includes offering follow-up visits to the hospital’s free outpatient lactation clinic. Parent support groups and NICU graduate reunions with the people who helped care for them in their earliest days and weeks are another RMH staple.
“Every year we have a big NICU reunion party,” Carter says. “Any graduate is welcome to come back, and it’s great – the nurses get to see how well everyone is doing.”

A Holistic Approach

Not so long ago (and perhaps still in the movies) babies were whisked to the nursery after birth so that exhausted mothers could get what seemed like much-needed rest. But Pat Joschko, women’s service line director at FHN, Freeport, says her all-registered nurse department has become focused on keeping mothers and babies together, and, whenever possible, seeing birth as a “health event.”
It’s part of a holistic approach that may include the services of a certified nurse midwife or doulas (labor support coach), as well as breastfeeding support and helping mothers to get to know their babies’ cues right away.
The department has seven beds in which women can labor, deliver and stay, so moms and babies don’t have to move from room to room; staff encourages “rooming-in” of babies, 24/7.
“We’re really focused on what we call ‘the golden hour’ – the first hour after birth,” says Joschko. “We encourage skin-to-skin, to help babies learn to regulate their body temperature and help facilitate breastfeeding. Babies have a keen sense of smell and they will literally go get their mother’s milk, if possible.”
FHN has a Level 2 nursery for babies who don’t transition well after birth, but even if a mother is sick or if a baby is born via cesarean, moms and babies are brought back together as soon as possible. “There’s a lot of media attention on how exhausted mothers are and the need for rest, but moms and babies are on the same brain waves and they rest and sleep at the same times,” Joschko says. “Keeping them together means that Mom learns baby’s signals early on. Babies shouldn’t scream. Life should be gentle. Mostly babies just want to be held. They’re used to that 24/7, having been in a tight, quiet cocoon.”
FHN’s nurse-midwife offers a more holistic approach to pregnancy and childbirth. She spends a lot of time teaching patients about nutrition, exercise and staying healthy. The department’s experienced obstetricians are available to provide advanced care.
The hospital has partnered with the Stephenson County Health Department, which offers another unique service that many patients enjoy – doula care. Doulas are birth assistants who work with the family before and after delivery. Doulas assist in preparing a birth plan before delivery, support mothers while they’re in labor and help to care for the newborn. The program focuses on teen and first-time parents, especially those without a close family member to support them. The hospital also encourages private doulas and birth plans, although sometimes for medical reasons, not all requests are possible.
“If we can’t do something, we really try to help them understand why,” says Joschko. “It’s not like a wedding plan – birth is a lot less predictable. Our focus is always on the safety of all of the family members.”
Joschko is quick to point out that extended family members can play a big part in labor, delivery and even the breastfeeding experience.
Although the staff, in concert with the health department, works hard to provide breastfeeding support, and although the State of Illinois and the World Health Organization really push for breastfeeding, “the challenge continues to be to get the public on board,” says Joschko. “There’s a lot of emotion surrounding childbirth, customs and outside forces. We haven’t, as a society, really dealt with cultural issues. We haven’t brought the social mores up to the same level. So, getting it into practice remains a bit challenging.”
Still, it’s a challenge her department gladly accepts. All staff members receive 15 extra hours of breastfeeding education, and the department has three lactation consultants.
In fact, Joschko’s staff is on a mission to support each and every family that comes through its doors.
“We all have a passion for moms and babies and it’s a privilege and honor to be with moms when they give birth – it’s something we cherish,” Joschko says.
“I’ve been doing this for 40 years and I still see it as a miracle. None of my staff members would want to go do anything else.”