By Ms. Patricia Deal (Army Medicine)May 30, 2012
FORT HOOD, Texas--For the woman who just found out she's pregnant, her head is usually spinning with thoughts of everything she needs to do over the next several months. Carl R. Darnall Women's Health Center has guided tens of thousands of women on their journey, from prenatal care to delivery.
"We know that pregnancy, while exciting and joyous, can be daunting for many women. They will have many appointments and lots of questions," said Sharon Moton, Obstetrics and Gynecology (OB/GYN) Clinic reception head nurse. "We help them every step of the way, and beyond. We offer so many different treatment services and such a variety of information and educational classes that we can honestly say we have you covered no matter what you need."
It all starts with a positive pregnancy result documented by a healthcare provider or lab. Then all pregnant patients register with the Women's Health Center where everything's mapped out for them as to appointments, tests and services.
Patients are assigned to a color-coded team of providers who will care for the patient throughout the pregnancy. "The team approach to care gives patients continuity of care and quicker access," Moton said. "Our patients like the idea of having the same team-member provider take care of them. It instills a greater sense of confidence in the quality of care they receive."
A patient considered to have a low-risk pregnancy has about 10-12 prenatal visits, including her ultrasound. Throughout the pregnancy, patients will typically see certified nurse midwives (CNM) and nurse practitioners, with nursing assistants and or other support staff assisting. Obstetricians or residents (supervised) see high-risk or complicated pregnancy patients for prenatal care and delivery.
Lieutenant Col. Brenda Houston, CNM, said she likes the team concept and continuity of care. "Since I see my patients so regularly, I really do develop a bond; so much so that I have a twinge of sadness when they deliver. I know I will miss them," said Houston, who has spent the last 16 years of her 25-year Army medical career as a CNM. "Midwifery is about empowerment, and it is rewarding for me as I do more than just attend to their medical needs. I am attuned to my patients, and help in whatever way I can to help them become the parents they were meant to be."
In addition to normal prenatal care, the Women's Health Center also sees pregnant patients for any acute health care needs. Moton said patients should call in the morning for same or next-day appointments, but that the WHC would try to work in patients without an appointment.
While the WHC staff takes care of the pregnant patients' medical needs, they address the educational side, too. The center offers many classes such as Pregnancy PT (weekly class mandatory for active-duty Soldiers), Breastfeeding, Prepared Childbirth, Anesthesia, and Siblings. The center's website at www.crdamc.amedd.army.mil/default.asp?page=whc provides even more information and helpful links.
The WHC's Centering Program expands prenatal care and support for all pregnant patients. Expecting women attend 10 Centering sessions, which include individual prenatal care and small group interaction for pregnant patients with similar delivery due dates.
Sargent Jessica Barker, a 1st Cavalry Division Soldier, took time to reflect on her prenatal care while she began her labor May 22. "I thought everything was great. This is my first child, and I had a lot of questions. The Pregnancy PT class covered every topic and answered so many of my questions. Everyone helped me, from my midwife to other staff," she said. "Now I'm just so ready to have this baby."
Barker and all other pregnant patients do look forward to the next and final stop on the journey--delivery.
The WHC, with its new year-old facility, has every aspect of that covered, too.
The Labor/Delivery/Recovery (LDR) rooms in are spacious, comfortable and more family-friendly environment. Patients stay in the same room for labor and delivery, and the rooms are equipped with everything needed for mom and newborn.
Patients with no complications deliver in their room by a CNM. Complicated patients (including all cesarean sections) are delivered by obstetricians or supervised residents.
"The majority of births at Darnall are delivered natural (vaginally) by our CNMs. Although not the preferred, some deliveries do require Cesarean sections. Fortunately for our patients, Darnall's average C-section rate is 29 percent, which is lower than the national average of 32 percent," explained Maj. (Dr.) Nader Rabie, chief of Obstetrics.
The surgical aspect of delivery makes the obstetrician a full-rounded provider, which appealed to Capt. (Dr.) Paul Hendrix when choosing his specialty. "I see high risk patients in the clinic environment for their prenatal care, and operate when necessary. Nothing about my job is boring or routine. Not even the patients, as each one is as important as the next," he said. "Obstetricians have to be compassionate throughout all aspects of their job."
Obstetricians and midwives at Darnall don't always deliver the same patients they have been seeing prenatally, Hendrix added, so there has to be high level of trust amongst themselves.
"All of us treat each patient as if they are our own. Midwife or doctor, we all share that same commitment to our patients. It's all about making sure that we do whatever we can to take care of the patients," he said, adding that he knew his wife was in good hands when his son was delivered at Darnall in February.
While pregnancy lasts for months and labor can last for hours, the actual birth only takes minutes. Once the baby is delivered and mom and newborn have received required post-delivery care, both will stay in the hospital for two to four days, depending on individual circumstances.
"This is really a happy time for moms and dads and babies as they spend their first moments together as a family. I find this part of my job so rewarding," said Brenda Vazquez, nurse at CRDAMC's Mother Baby Unit.
Vazquez has 24 years of experience as a maternal care nurse, plus she's had experience as a patient, having delivered her two babies at Darnall in 2000 and 2001.
"There have been a lot of changes over the years, and I think mothers today have the best of it," she said. "But the one thing that hasn't changed over the years is the look of appreciation I get from the moms and dads as I help them with these last few things before they go home and start on a whole new journey."
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