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For more than a decade, the birth rate in New York state has been declining — down 7%. In the northeast region, the downward trend was actually 11%. With fewer births, area hospitals found themselves competing intensely for a shrinking maternity patient pool.
In 2010, Bellevue Woman’s Center, part of Ellis Healthcare, began a relationship with Ob Hospitalist Group to help cultivate the hospital’s status as a center of quality in OB care. A critical part of that strategy was to nurture collaborations with the center’s affiliated private Certified Nurse-Midwifes (CNMs) — a group of professionals well-positioned to attract more patients and stabilize the Labor and Delivery unit’s patient volume.
Dr. Julie DeCesare, OB/GYN Residency Program Director at Sacred Heart Hospital of Pensacola, had a double-sided quandary. Contracting with private physicians to be on call for the Labor and Delivery unit on nights and weekends was proving both expensive and insufficient. She carried the daunting challenge of staffing the unit 24 hours a day, plus she needed more faculty for her Residency Program at a time when the hospital was not motivated to hire more OB/GYNs. What to do?
As the number of working OB/GYNs continues to decline, the United States faces a widening gap in access to perinatal care services. The American College of Obstetrics and Gynecology (ACOG) estimates that the profession will experience an 18% shortage by 2030.
The practice of nurse-midwifery has been around for centuries and, despite years of struggle to achieve true legitimacy, recently has gained greater respect and acceptance by the medical community as well as healthcare insurers, who are now reimbursing for nurse-midwifery services in increasing numbers.
Ob Hospitalist Group (OBHG) recently released a case study connecting improvements in the quality of obstetric care at Overlake Medical Center in Bellevue, WA, with the establishment of a 24-hour, OBHG-managed Obstetric Emergency Department (OBED) at the hospital.
Overlake experienced a reduction in unattended deliveries, fewer C-section deliveries, and the complete elimination of early elective deliveries, all of which increase a patient’s risk for complications. At the same time, local physicians described “a total integration” of care with the coordinated services and support of OBHG hospitalists.
Between 2012 and 2014, cases of congenital syphilis tripled in California, with many clustered around the Central Valley and Kern County area. The staff at Bakersfield Memorial Hospital found that most women who gave birth to babies with congenital syphilis had no personal physician and received very little or no prenatal care before presenting to their hospital. Their understaffed Labor and Delivery triage unit often was the first and only caregiver these women had seen.
BACKGROUND: St. David’s North Austin Medical Center
St. David’s North Austin Medical Center (NAMC) was recently named one of The Top 100 Hospitals in the nation by Truven Health Analytics. The 332-bed multi-specialty, acute care facility is dedicated to the highest level of women’s health services, including maternity and newborn care with Level I, II and III nurseries at the adjacent $83-million St. David’s Women’s Center of Texas, as well as a 24-hour emergency department, heart and vascular center, neurology and neurosurgery, a kidney transplant program, inpatient and outpatient surgery and acute inpatient and outpatient rehabilitation.