Hospital Birth // What to Expect
individualized care with a high level of integrity
Hospital maternity wards have long been mired in a reputation of busyness and bureaucracy, leaving patients feeling out of their element as they navigate their visits. Powerlessness is an undesired feeling for most populations, but especially for expecting mothers as they await one of life’s most unpredictable experiences: childbirth. While some factors are beyond a provider’s control (e.g., staffing shortages, managing operations during COVID-19, etc.), many are aware of this enduring perception and making strides to correct it, banding together with staff to make each individual feel welcome, valued, and supported, as is the case at Regions Hospital.
“One big myth related to hospital birth that we work to bust is the misconception that patient-centric birth experiences are difficult to have in a hospital setting,” says Dr. LeeAnn Hubbard, medical director of the Regions Hospital Family Birth Center. “We create this environment [of feeling welcome and valued] prior to a birthing patient’s arrival by ensuring they have easy access to care in the clinic with a provider that understands their unique needs. And we coordinate care across the continuum of prenatal, in-hospital, postpartum, and pediatric care so families never feel unsupported.”
WHY AN OB-GYN?
“We have four years of medical school after college, plus at least four years of residency. This allows us the ability to care for high-risk patients and pregnancies, deal with emergencies, and perform cesarean deliveries if needed. Not only do we do deliveries; we are also surgeons and take care of women in their teen years to menopause.” —Dr. Leigh Koidahl, Southdale ObGyn
Rochelle Johnson, director of nursing at Regions Hospital Family Birth Center, says it’s important for patients to see themselves—cultures, genders, races—in the providers that care for and treat them. “We ensure that the care we provide starts with asking the birthing families what their expectations are and how we can support them through this highly personal and intimate experience,” she says. “With 60 percent of Regions’ patients being people of color and 25 percent of them needing an interpreter for their care, we are committed to meeting our patients where they are and partnering with them for care throughout their pregnancy and beyond.”
Maternal Care Services
Hospitals across the country are increasingly recognizing and understanding the appeal of birth centers, taking inspiration from their homelike atmospheres to create a space that feels peaceful and personal, with medical backups in place so an emergency is just a wheel down a hallway versus a trip to the ambulance—melding together the best of both worlds.
“Our expanded birth center was designed with the input of our diverse community of families,” says Hubbard. “We started with guiding principles that included creating warm, open, and welcoming spaces that would support gathering, celebrating, and healing.” Special features at the Family Birth Center at Regions include:
- Larger labor and delivery and postpartum suites (including a tub for water births)
- Access to Ob-Gyns, certified nurse-midwives, labor and delivery nurses, certified lactation consultants, pediatricians, and more
- Minnesota’s first enhanced couplet care rooms (which keep mama and baby together from the start)
Johnson adds that the spectrum of pregnancy and birth is addressed with individualized care. “Our families can experience low-risk, low-intervention water birth in our beautifully appointed water-birth suites, or they can experience highly complicated surgical procedures supported by their families and doulas in our nonthreatening operating room suites.”
Ask Your Hospital:
• How many people are allowed in the labor and delivery room?
• Can my doula or midwife be present?
• How often will you perform pelvic exams during labor?
• What’s the hospital’s C-section rate?
• How do you support a mom’s feeding choices?
Average Hospital Stay: 2-3 days, depending on the way a person has delivered. A cesarean section usually extends the stay by a day.
Birth Centers // What to Expect
more homelike than hospital, more medical than home
Birth centers usually assume one of two forms: a freestanding facility that provides family-centric services independent of a hospital, or a center located within or near a hospital, marked with some type of hospital affiliation. The Mother Baby Center (TMBC), with locations in Minneapolis, St. Paul, and Coon Rapids, is a partnership that integrates Allina Health’s maternity care with Children’s Minnesota’s neonatal services.
“Birth centers are best suited for the very low-risk pregnancy, while hospitals are equipped to care for patients across a wider range of risk factors,” says Dr. Lisa L. Saul, president of the Mother Baby Clinical Service Line, illuminating the differences between the binary options. “The Mother Baby Center offers our families care across a wide range of needs, from a very low-intervention birth to epidural for pain management and high-risk conditions such as preeclampsia. Our partners at Children’s Minnesota provide the safety net of neonatal care to meet the needs of all newborns.”
The model for TMBC wasn’t developed in a silo—its design, continuum of care, and amenities were influenced by neighboring centers in an attempt to bridge modern comforts with its brand of specialized care. When an expecting mother intends to deliver at a freestanding birth center, only to be transferred to a medical center due to a potential or emerging health issue, the switch-up can feel jarring, even disappointing for some.
“We partner with several birth centers in our community to allow for seamless transitions of care when needed,” says Saul. “At times, transition to a hospital setting can feel like a failure to patients because a hospital birth was not part of their plan. The more birth centers can establish relationships with hospital partners who can be viewed as part of their care team, the better the experience for patients and families.”
Maternal Care Services
Birth centers have lower rates of interventions, like labor induction, episiotomies, and C-sections. Those who partner with a hospital have more access to emergency care in the event that it’s needed.
“We offer all patients private rooms with showers and soaking tubs,” says Saul. “Our care team is well versed in natural birthing techniques, and we offer calming therapies, like massage, aromatherapy, and acupuncture. We can comfortably provide this level of intimate care because they know that, if needed, more advanced care is readily available.”
Ask Your Birth Center:
• Is this center licensed by the state?
• Are the midwives certified and licensed to practice in Minnesota?
• Do you offer childbirth classes?
• What is your rate of transfer? Which hospital(s) would I be directed to?
• What follow-up care do you provide after birth?
Average Birth Center Stay: 48-72 hours, patients typically remain in the center 48 hours after a vaginal delivery and just under 72 hours after having a cesarean birth.
A Quiet Epidemic: Pelvic Floor Disorders
Pelvic floor disorders have long afflicted new moms due to the strain of pregnancy and birth on the pelvic system’s network of muscles and connective tissues. Dr. Melvin Ashford, founder and CEO of Minnesota Women’s Care, says that persistent postpartum pelvic pain affects approximately 20 percent of women following vaginal delivery of a baby. “Even patients who ‘get over’ the symptoms may have ramifications later if the pelvic floor impact is not addressed,” he says. “Symptoms like fecal incontinence, urinary incontinence, and painful intercourse are not uncommon.” While Kegels can be somewhat effective, all women with tightening pelvic floor muscles will have better outcomes by seeking out a pelvic floor expert. America has lagged behind other nations for decades in its pelvic floor assessment following vaginal deliveries. “France, for example, mandates coverage for postpartum rehabilitation for all women after delivering a baby,” Ashford says. This lack of evaluation is not the fault of the patients—women have been complaining of symptoms for ages. “Most women will have improved pelvic floor function later in life with early evaluation and rehabilitation.” While early intervention is best, it’s never too late to get seen. “We [at Minnesota Women’s Care] have developed a center called WomanWoRX that utilizes exercise, yoga, and Pilates directed by a physical therapist, chiropractors, and exercise physiologists to assess and improve pelvic floor dysfunction.”