FORT LEONARD WOOD, Mo. -- The Thomson twins, Carlee and Addie, are one of three sets of healthy twins born here recently at General Leonard Wood Army Community Hospital.
"Twin pregnancies are by definition high-risk, but thorough discussion about what was best for both mothers and children, and close monitoring and supervision, that made it possible for these ladies to deliver vaginally, which was their preference," said Maj. (Dr.) Melissa A. Grant, MD, FACOG, chief, Department of Obstetrics and Gynecology at GLWACH. "These three sets of healthy twins highlight the extraordinarily safe, patient-centered care provided here."
Practicing in a rural setting does not decrease GLWACH's standard of care and in many ways it improves care by enabling closer attention to patients, Grant said.
"We have had substantial success with vaginal deliveries of twins here with excellent neonatal outcomes," said Col. (Dr.) Peter Nielsen, GLWACH commander, a board certified physician in both Obstetrics and Gynecology as well as Maternal-Fetal Medicine.
Obstetricians must balance risks and benefits of vaginal delivery and cesarean section with careful attention to avoid risks to the baby, while considering patient preference.
"We're from Wisconsin so rural is relaxing and not intimidating," said Jessica Thomson, mother of the twin girls.
GLWACH's exceptional, balanced and coordinated rural health care exceeds that of many big-city facilities.
The overall cesarean delivery rate at GLWACH was 22.9 percent between April 1, 2013 and Mar. 31, 2014, according to the National Perinatal Information Center/Quality Analytic Services (NPIC/QAS). The national cesarean section delivery rate is higher, 31 percent from 2011, as reported by the Centers for Disease Control and Prevention in 2013.
The primary cesarean delivery rate (number of moms having their first cesarean section) was 16.3 percent compared with 21.4 percent for the state of Missouri, as reported by the National Vital Statistics Report.
For most pregnancies which are low risk, a major surgery such as cesarean section poses higher risk than vaginal delivery. For higher risk pregnancies including prior cesarean sections, blood pressure concerns, and multiple gestations, the decision about whether to deliver vaginally or by cesarean section must be carefully discussed between provider and patient, and is specific to each patient's circumstances.
"I feel like people are just misled about the value of rural health care," Grant said. "You get to know your care team closely. I get to see my patients at Walmart, but at the same time we're tied in with larger military treatment facilities and Western Regional Medical Command, while still working closely with PCRMC, with Springfield, with UMC. We provide big facility healthcare with a small-town feel."
"They were very personable--they seemed to know us every time they came into our room," said Capt. Billy Thomson, an Army Engineer stationed here with his family. "The staff's experience and knowledge--and the fact that the hospital commander is an OB and was on the team advising our doctors was just comforting."
In fact, the GLWACH Mother Baby Unit recently received the "Best Customer Service in MEDCOM" award for the second year in a row, an award based on independent customer surveys sent by patients directly to the Army Surgeon General's Office.
"GLWACH also offers both physician and nurse midwife providers, which means that low-risk, healthy patients have the opportunity to choose a midwife as their provider here," said Ms Linda Punch, a certified nurse midwife at GLWACH's Department of Obstetrics and Gynecology.
GLWACH takes pride in managing all pregnancies, both low and high-risk, based on current evidence and clinical practices, while providing and implementing safe options with a patient centered approach, Grant said.
"Through involvement with local consultants and other military facilities, we provide coordinated patient care which meets or exceeds local standards," Grant said. "We also participate in patient safety programs such as NPIC/QAS and others to receive constant feedback on maintaining the highest level of patient care in our facility."
Last year, the GLWACH MBU began offering "Peek-a-Baby," a system that allows GLWACH moms to see their babies when infant transfers are required and mothers need to stay behind.
"It's an awesome thing to see a new mom burst into tears when we hand her a laptop showing her baby looking up at her on the screen," said Maj. Ashonda Trice, GLWACH's Mother Baby Unit chief.
The hospital's Mobile Obstetrics Emergency Simulator is another cutting-edge technology offered at GLWACH. The MOES is a realistic "mechanical mom" that simulates common obstetric emergencies so students and staff can train on situations involving fetal distress, neonatal resuscitation and post-partum hemorrhage that can arise during a delivery.
"So, the perception that rural healthcare is substandard healthcare--that's just not true," Grant said.
(Editor's note: John Brooks is the marketing and public affairs officer at General Leonard Wood Army Community Hospital)
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