Pregnancy: A special journey from conception to delivery
By Patricia Deal
CRDAMC Public Affairs
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.”
Darnall’s Centering Program adds an educational and emotional focus to typical prenatal care
By Patricia Deal
CRDAMC Public Affairs
FORT HOOD, Texas – Carl R. Darnall Army Medical Center’s Pregnancy Centering Program adds an educational and emotional focus to typical prenatal care for its pregnant patients.
Pregnancy Centering programs, established by the Centering Health Institute in collaboration with the March of Dimes Foundation, are offered at civilian and military hospitals across the country to encourage pregnant women to adopt healthy behaviors during pregnancy. Centering sessions include individual prenatal care and small group interaction.
Centering groups at Darnall usually have 10-12 moms-to-be with similar due-dates. Beginning at the 16th week of pregnancy, groups meet for 10 two-hour sessions during their pregnancy. Each session starts with an individual, routine prenatal checkup and private consultation with a provider. The rest of the session time includes open group discussions and instruction on a variety of medical and lifestyle topics concerning pregnancy and childbirth. Spouses are encouraged to attend.
“I learned so much more from my Centering group than I could have ever gotten from a book or 15 minute sessions with a doctor at the clinic,” said Sgt. Christina Pressley, from the 504th BFSB at West Fort Hood. She added she is happy she opted to attend the voluntary Centering program in addition to the hospital’s Pregnancy PT program, which is mandatory for all pregnant active-duty Soldiers. “This is my first child and my family is in Mississippi, but now with everything I’ve learned and the support I’ve received from this group, the whole idea of having a baby feels less frightening and overwhelming.”
Centering sessions cover a wide-range of topics such as dealing with back pain, getting better sleep, breastfeeding, options for childbirth and exercising. Often classes will have guest speakers for additional expert advice.
“Each Centering class is structured differently to better meet the needs and goals of the group,” explained Kristyn Leftridge, Centering program coordinator. “There’s no such thing as a dumb question, and frankly, no topic is taboo. We get a mixture of experienced moms along with the first time moms and information is shared both ways. I’ve yet to have a patient tell me she didn’t learn anything from her Centering group.”
The main advantage to the Centering program is the bonds that are forged between women in the groups and even across different groups.
Esperanza Carter, due to deliver her first baby in July, is one of the youngest members of her group and said she appreciates the support of all of her group members. “They’ve all been so wonderful to me. It’s like having a whole bunch of new sisters,” she added.
Many of the Centering “alumni” still stay in touch with their class coordinators and each other, forming weekly playgroups for their children and sharing photos on Facebook. Co-coordinator Sharon Shaw said she can attest to the strong bonding experience of the Centering program, as she has remained close friends with one of her earlier patients who has since moved away but is coming back next month with her child to visit Shaw.
“There are so many good stories that come out of Centering. In one of my groups, a patient was in a terrible car accident just weeks before she was due to deliver. She was in a lot of pain and couldn’t walk. Her husband was deployed and so the other group members rallied around her, taking complete care of her until her husband could get home. And this was around Christmas when everyone is busy with their own families,” Leftridge shared. “You can’t receive that type of care and support from any traditional class. That’s what sets Centering apart.”
For more information about the Centering Program session at Darnall, call the Women’s Health Center at (254) 288-8109. For general information on Centering Pregnancy, visit www.enteringhealthcare.org.
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Captain (Dr.) Paul Hendrix, CRDAMC obstetrician, does an ultrasound on five-months pregnant Kristy Castillo during her prenatal visit. Obstetricians or residents (supervised) see high-risk or complicated pregnancy patients for prenatal care and delivery at Darnall. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
Lieutenant Col. Brenda Houston, certified nurse midwife (CNM) at Darnall, listens to the heartbeat of LaTisha Cones’ baby during what Cones hopes will be her last prenatal visit. In addition to providing prenatal care, CRDAMC CNMs deliver all the babies from moms with no complications, which accounts for the majority of births at Darnall. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
Bethany Webster, nurse practitioner at CRDAMC, prepares an iron infusion treatment for patient Rachel Gebhardt, who is almost eight-months pregnant with her first child. Iron fusion treatments are done at CRDAMC’s Women’s Health Center on an out-patient basis for pregnant women as prescribed by their provider. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
Major (Dr.) Adriena Beatty, CRDAMC obstetrician, monitors labor contractions of 1st Cavalry Division Soldier, Sgt. Jessica Barker, who is ready to deliver her first baby with soon-to-be father Sgt. Paul Barker, also from 1st Cavalry Division, at her side. Beatty had just induced Barker’s labor and anticipates a natural birth. Pregnant patients with no complications stay in the same room for labor and delivery at the new CRDAMC Women’s Health Center. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
Brenda Vazquez, nurse at CRDAMC’s Mother Baby Unit, watches as new dad, Capt. Tom Piernicky from 1st Cavalry Division, uses a bulb syringe to clear baby Alannah’s mouth after a small spitup. After delivery, mom and newborn will stay in the hospital for two to four days and Vazquez said she enjoys that time, helping new moms and dads as they experience their first parenting moments with their baby. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
Members of a CRDAMC Pregnancy Centering Program exchange gifts at the group’s baby shower May 29. Kristyn Leftridge (back, left), Centering program coordinator, said a baby shower is one of many activities offered by the program that help moms-to-be bond and gain support from one another. (U.S. Army photo by Patricia Deal, CRDAMC Public Affairs)
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