Welcome to Birthways A Helpful Guide for Expectant Moms and New Parents

1111 D U F F AV E N U E , A M E S , I O W A 5 0 0105 15 - 2 3 9 - 2 4 4 4 • W W W. M G M C . O R G

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Welcome to Birthways . . . . . . . . . . . . . . . . . 2

Your Nurses and Doctors . . . . . . . . . . . . . . . . 2, 3

Class Offerings . . . . . . . . . . . . . . . . . . . 3

Pre-registration . . . . . . . . . . . . . . . . . . . 3

Scheduling Elective Procedures . . . . . . . . . . . . . . 3, 4

Your Stay . . . . . . . . . . . . . . . . . . . . . 4

Cesarean Delivery . . . . . . . . . . . . . . . . . . 5

Neonatal Intensive Care Unit . . . . . . . . . . . . . . . 5

Build the Bond . . . . . . . . . . . . . . . . . . . 5, 6

Quiet is Good Medicine . . . . . . . . . . . . . . . . 6

Your Visitors . . . . . . . . . . . . . . . . . . . . 7, 8

Newborn Security . . . . . . . . . . . . . . . . . . 8

Photography . . . . . . . . . . . . . . . . . . . . 9

Decisions, Decisions . . . . . . . . . . . . . . . . . 9, 10

Breastfeeding . . . . . . . . . . . . . . . . . . . 10-13

Birthways Pacifier Policy . . . . . . . . . . . . . . . . 13, 14

Frequently Asked Questions . . . . . . . . . . . . . . . 15

Important Numbers/Notes Page . . . . . . . . . . . . . . 16

Table of Contents

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• Allregisterednursesarespeciallytrainedformotherbabycare.

• Lactationconsultantsandbreastfeedingexpertsareavailablearoundtheclock.

• Birthwaysprovidesadischargeplannertohelpyouandyourbabytransitionhome.

PREPARING FOR BABY

Toprepareyouforyourarrival,werecommendyoutakeadvantageof

oneofourclassofferings:

• BigBrother/BigSister

• ChildbirthEducation

• Breastfeeding

Youcanregister,orlearnmoreaboutourotherclasses,byvisitingwww.

mgmc.org/eventsandclickingonBirthways.Ifunabletoregisterfor

classesonline,call515-239-2444.

PRE-REGISTRATION

Pre-registrationisnecessarytoensurethatwehaveallofyourpertinent

insuranceandcontactinformation.Pleasemakesureyouhaveyour

insurancecardshandybeforecompletingtheonlinepre-registration

form,whichcanbefoundbyvisitingwww.mgmc.org/birthwaysandclickingonthePre-RegistrationandInsuranceMatterslink.

SCHEDULING ELECTIVE PROCEDURES

Forsomewomenitisnecessarytoscheduleaninductiontolabor.Ifitis

elective,itistherecommendationfromACOGandAAPthatthisisafter

39completedweeksofgestationtoallowthebaby’slungstomatureand

foryourbodytobereadyforlaborandasuccessfulvaginaldelivery.For

somewomentheremaybeamedicalreasonforinductionoflabor.This

decisionisadiscussionbetweenyouandyourprovider.OnBirthways,

wetryveryhardtoaccommodatealllaborpatients.However,theremay

Welcome to Birthways

Congratulations!Welookforwardtocaringforyouandyourbaby!

BirthwaysatMaryGreeleyMedicalCenteriswhereexpectantmothers

fromthroughoutcentralIowacometodelivertheirbabies.Wewelcome

morethan1,000newbornsintotheworldeachyear.Ourunitisdesigned

withyouandyourfamilyinmind,providingyouacomfortableand

soothingplacetohaveyourbaby.

PleasetakesometimetolearnaboutourBirthwaysunitatwww.mgmc.

org/Birthways.We’veputtogetherlotsofresourcestohelpprepareyou

foryourpregnancy,deliverydayandbeyond.

YOUR NURSES AND PROVIDERS

WhatmakesBirthwayssouniqueisourpersonalapproach.Birthways

isstaffedbycaring,highlytrainedprofessionalswithmanyyearsof

experience:

• Allphysiciansareboard-certifiedintheirspecialty.

• 24houranesthesiacoverage.

• Nurse-midwivesarecertifiedbytheAmericanCollegeofNurse-Midwives.

• Pediatrichospitalistprogram

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from7:00a.m.to8:00p.m.andallroomsareequippedwithcable

televisionandaprivatebathroomwithshower.

CESAREAN DELIVERY

IncaseofCesareanbirth,thetwooperatingroomsonBirthwaysallow

youandyourbabytoreceivethecareyoubothneedonthesameunit.

NEONATAL INTENSIVE CARE UNIT

Havingtherightpeopleinplacetoprovidespecialattentionforyour

babymakesallthedifference.That’swhyBirthwayshasalevelIIneonatal

intensiveandintermediatecareunitwiththelatesttechnologyforcareof

criticallyillinfants.

TheNICUoffersspeciallytrainedstaff,includingtwopediatric

hospitalists,whospecializetakingcareofnewbornsandchildreninthe

hospital.

BUILD THE BOND

Ourspaciousandprivatelabor/delivery/recovery/postpartum(LDRP)

roomsprovideawonderfulenvironmentforbonding.Weallowyouand

thebabytoroomintogether.Thispracticeprovidesyoutheopportunity

tolearnyourbaby’shungercuesandnightbehaviorswiththesupport

betimesthattherearetoomanypatientsthatarriveinlaborandwe

mayneedtopostponeelectiveproceduressosafecarecanbegivento

allpatients.Weappreciateyourpatienceifthishappensandhopeyou

understandwewantallourpatientstohaveawonderfulexperiencethat

meetstheirexpectations.

YOUR STAY

AtBirthways,westrivetosupportournewfamiliesasmuchaspossible.

Wehave13speciallydesigned,homelikeroomsthatallowyoutohave

yourlabor,deliveryandrecoveryallinoneroom.Eachoftheserooms

includesawhirlpoolbathtubtohelpprovidecomfortwhileinlabor,

alongwithotheramenities,including:

• Flat-screentelevisionwithDVDplayertuckedinasolidwoodarmoire.

• Aspecialchairorsofathatconvertstoabedforyoursupportpersontostayovernight.

• Wirelessinternetaccessforyourconvenience.

• Squatbarsandlaborballsavailableuponrequest.

Wealsohavenineregularprivaterooms.Patientsareabletoorder

anythingoffofourcafeteriamenutobedelivereddirectlytotheroom

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YOUR VISITORS

Yourbirthingexperienceisallaboutyou,yourbabyandyourfamily.At

Birthways,weunderstandthatyouwantyourfriendsandlovedonesto

meetyourbabyandshareinyourexperience.Pleasereadthesevisitor

recommendationsfromtheMcFarlandClinicPediatriciansandPediatric

Hospitalists:

We, the McFarland Clinic pediatricians, would like to extend our

warm congratulations to you on the upcoming birth of your baby! The

incredible journey and responsibility of raising a happy, healthy child

from birth to adulthood starts with good prenatal care and keeping

your focus on your child’s health. We view the pediatrician’s role in this

journey as supportive and educational and look forward to working

with you as partners to keep your infant healthy.

We understand the need to share the joy of the birth of your baby with

your family and close friends. While these visitors can offer wonderful

support to you during your stay at Birthways, they can also interfere

with your need for rest and introduce infections to you and your infant.

The spread of infectious illnesses in the hospital is especially worrisome

during the winter and flu seasons. In addition, newborn babies have

weak immune systems and can become very ill and sometimes die

from illnesses that are considered mild in adults.

ofthenursingstaff.OnBirthwaysweencourageroominginwithyour

newbornasmuchaspossible.Thesafestplaceforyourbabytosleepis

inthecribonhis/herback.Ifyourbabyneedstobeoutofyourroom,we

haveskilled24-hourstaffthatcanwatchovertheinfant.

TheAmericanAcademyofPediatricshasrecommended“continuous

rooming-in”since2005andnowotherorganizationsliketheAmerican

CollegeofObstetriciansandGynecologists;theAssociationofWomen’s

Health,Obstetric,andNeonatalNurses;CentersforDiseaseControl;

andJointCommission(theyaccreditourhospital)agreeitisbest

practiceforhospitalbirthingunits.Itallowsformoreskintoskincontact,

whichmakesforasmoothtransitiontolifeoutsidethewombandearly

parentresponsetobabies’feedingcues.

QUIET IS GOOD MEDICINE

Throughouttheentirehospital,westresstheimportanceofquietaspart

ofourfocusonexcellentpatientcare.Visitorsarerequiredtocheck-inat

thenurse’sstation,soifyou’rejustnotuptovisitors,we’llletthemknow.

Everyafternoonfrom1:30–3:30p.m.weaskthatnovisitorscometothe

floor.Currentvisitationhourswillbecommunicatedtoyouonadmission

andpostedontheunit.Wewillstrictlyenforcethehourstoprotectthe

quietenvironmentforourpatients.Rememberwhileyourvisitorsare

homesleepingatnightyouareawakefeedingyourbaby.Youneedyour

restandyourlittleonedoestoo.

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PHOTOGRAPHY

Weofferaprofessionalphotosessioninyourroom,personalizedfor

eachfamily.

DECISIONS, DECISIONS

Fromthetimeyoufirstfoundoutyouwerepregnant,you’vebeen

makingdecisions.Therearetwoinparticularthatyoumayhavealready

decidedon,buttheywillneedtobeconfirmedondeliveryday.

• Ifyougivebirthtoason,we’llneedtoknowifyouplanonhavinghimcircumcised.Circumcisionisnottypicallymedicallynecessary,andisusuallyelective,meaningitisyourchoicewhethertohaveitdone.

• We’llneedtoknowifyouplanonbreastfeeding.Allstaffreceiveadditionaleducationtohelpyousucceedwithbreastfeeding.Wealsohavebreastfeedingexperts,includinglactationconsultants,availabletoprovideadditionalsupport.Apagehasbeencreatedonourwebsitededicatedentirelytobreastfeedingtohelpansweranyquestionsyoumayhave.Tolearnmore,visitwww.mgmc.org/breastfeeding.

Onthenextfewpageswe’veincludedinformationaboutbreastfeeding.

To keep your baby healthy and reduce the risks of illness to you and

your baby, we would like you to consider our recommendations in

regards to visitors on Birthways:

• Limit visitors to those that are very important to you and your immediate family. Although all love to share in the joy of a newborn, many well meaning friends do not realize your need for rest and privacy.

• Make sure that visitors do not deprive you of rest or interfere with breastfeeding and bonding with your baby. Birthways provides a mid-afternoon “Quiet Time” period to assist you in getting rest. Please ask visitors to schedule around this time.

• Other than your baby’s brothers and sisters, it is wise to limit children visitors. Toddlers and school age children are the first in our community to spread seasonal illnesses. Potential visitors who have a cough, fever within the last 24 hours, open skin sores or feel ill, should NOT visit Birthways.

• We recommend that all parents, close family contacts and day care providers receive influenza vaccines during the fall/winter months and be updated with the tetanus-diptheria-pertussis vaccine to protect your infant from these potentially deadly diseases for infants.

• Even though it is your responsibility to decide who visits you and your baby while you are on Birthways, both the Birthways staff and we, the pediatricians, are happy to answer any questions concerning these recommendations and assist you during your stay on Birthways.

NEWBORN SECURITY

Inadditiontobeinglockedfromthelateeveninghoursuntiltheearly

morninghours,Birthwaysfeaturesacomprehensivesecuritysystemto

protectournewborns:

• Matching,non-removableidentificationbandsforbaby,momandonepersonofthemother’schoosing.

• Electronictransmitterslockexitdoors.

• Surveillancecamerasmonitoreachexitofftheflooratalltimes.

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Themanyhealthbenefitsofbreastfeedinginclude:

• LessriskofSuddenInfantDeathSyndrome(SIDS).

• Fewerearandrespiratoryinfectionsforyourbaby.

• Enhancesnewbornbraindevelopment.

• Lessdiarrheaandconstipationforyourbaby

• Lessriskofdevelopingulcerativecolitis,Crohn’sdiseaseandceliacdiseaseforyourbaby

• Lessriskyourbabywillbeoverweight.

• Lessriskofdiabetesforyourbabyandyou.

• Lessriskofpostpartumdepressionforyou.

• Lessriskofbreastandovariancancerforyou.

• Fasterrecoveryforyou.

Whenyoubeginbreastfeeding,you’llwant

tonurseyourbaby8-12timesinthefirst24

hours.Manybabiesnursemoreoften.Allow

yourbabytonurseaslongashe/shedesires.

Don’tlimitthelengthoffeeding.Many

babiesnursefromonlyonebreastateach

feedinginthefirstfewdaysafterbirth.Ifthe

babyfeedsfromonlyonebreast,usethe

alternatebreastwiththenextfeeding.

Manybabiesaresleepyinthefirst24hours

orsoafterbirth.Full-term,healthynewborns

arebornwithadequatefluidstores,sosupplementationwithwateror

formulaisnotrecommendedunlessthereisamedicalproblem.Ifyour

babynursedwellafterdelivery,thenyoucanrestassuredthatwhenyour

babybecomesmorealert,breastfeedingwillcontinuetogowell.

• Itisagoodideatoawakenyoursleepybabyandattempttonurseevery1to3hours.

• Somebabiesawakeneasilywithgentlestimulationsuchasunwrappingandadiaperchange.

BREASTFEEDING YOUR BABY

AtMaryGreeley,wewantyoutoknowyourchoiceabouthowtofeed

yourbabywillbesupportedandrespected.Wehopeyouwilllearnas

muchasyoucanaboutinfantfeedingandthemanyhealthadvantages

thatbreastfeedingoffersyouandyourbaby.Ifyoudecideyoudonot

wishtobreastfeed,wewillhelpyoulearnalloftheimportantaspectsof

safelypreparingandfeedinginfantformula.

Ifyouareonthefencewithyourdecision,

youmighttrybreastfeeding.Itiseasierto

stopnursingthantowishlaterthatyouhad

started!

Breastfeedingyourbabycanbeoneofyour

greatestpleasuresandmemoriesofyour

motheringexperience.Youmayhavemany

questionsandconcerns.Itistrue,itcan

sometimesbechallengingatfirst.Ifyouget

thehelpandsupportyouneed,youwillbeamongthemillionsofwomen

wholookbackonthistimeasoneofthemostwonderfulandfulfilling

experiencesthey’vehad.

• Breastmilkcontainshundredsofnutrients,growthfactors,hormonesandantibodies.

• Breastmilkistheperfectfoodforhumaninfants.Breastmilkcontainseverythinganinfantneedstogrowwellandstayhealthy.

• Exclusivebreastfeeding(breastmilkonly)isrecommendeduntiltablefoodsarestartedat6months.

• Oncetablefoodsarebegun,itisrecommendedthatmotherscontinuetobreastfeedforayearorlongerfortheresearch-basedbenefitsforbabyandformother.

• Thebenefitsofbreastfeedingarerelatedtothelengthoftimeababyisbreastfedandhowexclusivelyababyisbreastfed.

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• Useyourbaby’shungercuestodecidewhentonurse—nottheclock.Anabundantmilksupplyisrelatedtothefrequencyandcompletenessofmilkremovalfromthebreast.

• Waituntilfeedingisgoingwellbeforeintroducingabottleorpacifier.Earlyuseofbottlesandpacifiersoftenleadstofeedingdifficultiesandearlyweaning.

OurInternationallyBoardCertifiedLactationConsultantsareavailable

duringyourhospitalstayaswellasinanoutpatientsetting.All

breastfeedingmomsreceiveacomplimentaryvisitwithoneofour

lactationconsultants.WealsorecommendtheNationalBreastfeeding

Hotline(800-994-9662),whichisavailableMonday-Fridayfrom8:00

a.m.–5:00p.m.toanswerquestionsthatmayarise.TheOfficeon

Women’sHealthisalsoagreatresourceandhasanexcellentwebsite

thatweencourageyoutovisitbygoingtowww.womenshealth.gov/

breastfeeding.

BIRTHWAYS PACIFIER POLICY

AllBirthwaysstaffreceiveeducationandtrainingtohelpyouandyour

babygetthehangoffeeding.

TheAmericanAcademyofPediatricsrecommendsnotintroducinga

pacifieruntilbreastfeedingiswellestablished,orbetween3-4weeks.

Thenitisrecommendedatnaptimeandbedtimeuntilyourbabyissix

• Tryholdingyourbabyskin-to-skinagainstyourbodyandexpressadropofcolostrumintohis/hermouth.

• Ifyourbabydoesnotawakenafter10to15minutesoftrying,putbabyskin-to-skinagainstyourbodyandtryagaininanhour.

• Ifyourbabydoesawakentonurse,youmayneedtocontinuewithsomegentlestimulationtokeepyourbabyfeeding.Tryliftingthebaby’supperarm,strokinglegs,feetandhead.

• Afterlongperiodsofsleep,somebabiesgothroughamarathonnursingphasewheretheywanttonurseallthetimeandcan’tbeputdown.Thisfeeding,knownasclusterfeeding,isnormalfornighttimewhenyourprolactinlevelsarehighestformakingmilk.

• Allowingyourbabytoeatasoftenashe/shewantsisbest.Ifyourbabydoesfinallyfallasleepduringthisfrequentfeedingphase,youcanusuallygetabreakfromnursingifyourbabyisheldandcuddled.Whenyouputyourbabydown,he/shemaysoonawakenandwanttonurseagain.

• Remember,themoreyounurse,thesooneryourmilkcomesin!

Breastfeedingisnaturalforyouandyourbaby,butitisaskillthatneeds

tobelearned.Speakupandaskquestionsaboutbreastfeedingbefore

yourbabyisbornandwhileyouareinthehospital.

Nomatterhowyoufeedyourbaby,lifewithanewborncanbe

challenging.Forthefirstseveralweeks,mostbabiesdonoteatand

sleeponaregularschedule.Thefollowingtipscanhelpyoucontinue

breastfeedingwhenyoureturnhome:

• Ifyouencounteranydifficultynursing,askforhelp.Problemshavesolutions.

• Keepyourbabyskin-to-skinafterbirthtoeaseyourbaby’stransitionfromwombtotheoutsideworld,andputyourbabytobreastassoonaspossibleafterbirth.

• Continuetonurseyourbabyevery1to3hours,oranytimeyourbabyisawake,hastheirhandstotheirmouth,movestheirtongue,orturnstoatouchofthecheek.Thisisthelanguageyourbabyusestosay,“I’mhungry.”

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CAN I USE MY CELL PHONE ON THE BIRTHWAYS FLOOR?

Yes,cellphonesarepermittedonBirthways.Aphoneisalsoprovidedin

yourroom.Youcanmakelocalcallsatnochargeoruseacallingcardor

callcollectforlongdistance.

SHOULD I CALL BEFORE I COME?

WesuggestcallingyourproviderduringofficehoursorFirstNurseafter

officehoursbeforecomingtothehospital.Available24hours,First

Nursecanbereachedbycalling:

• Ames:515-239-6877

• AnywhereinIowa:800-524-6877

IF I BRING MY LAPTOP, IS INTERNET ACCESS AVAILABLE?

Yes,youmaycheckyouremailonthecomputerinourvisitorslounge,or

ifyouhavealaptop,freewirelessisavailableforyourconvenience.

WHERE DO I PARK?

Pleasetakeadvantageofourfreevaletparking,availableMonday

throughFriday,6a.m.to8:30p.m.Ifyoudocomethroughthe

EmergencyDepartment,pleasehaveyourvehiclemovedfromthe

EmergencyDepartmentlotassoonaspossible.

HOW DO I GET INTO THE HOSPITAL IN THE MIDDLE OF THE NIGHT?

After9p.m.,enterthehospitalthroughtheEmergencyDepartment.

monthsoldaspacifiershavebeenshowntodecreasetheincidenceof

SuddenInfantDeathSyndrome(SIDS).

Sotogetfeedingofftoagoodstart,wedonotusepacifiersforhealthy

babiesinthehospital.Eachtimeyourbabysignalsthattheyarehungry

bycueslikerootingorsuckingontheirlipsorfists,iswideawake,oris

makingsuckingmovementswiththeirmouth,wewillencourageyouto

feedyourbabyratherthandelayafeedingbyusingapacifier.

Whennewbornsarefedinsteadofgivenapacifierinresponsetothese

feedingcues,yourbabyislesslikelytohavepoorweightgainand

jaundiceandyouarelesslikelytohaveproblemswithengorgement.

Sometimesbabiesstillwanttosuckevenfollowingagoodfeeding.In

afewweeks,oroncefeedingiswellunderwayandyourbabyisgaining

weight,givingyourbabyafingertosuckonorapacifier,canbean

option.

Birthwayswillonlyusepacifiersforprocedureslikecircumcisionandthey

willbediscardedaftertheprocedure.Thisisforanynewbornregardless

offeedingchoice.Listedbelowareotherresearchbasedreasonsnotto

usepacifiers:

• Adecreaseinbreaststimulationandmilkremovalmaydelaythemother’smilkfromcominginandleadtolong-termlowmilksupply,aswellasearlyweaning.

• Babiessuckledifferentlyonapacifierthanonabreast.Thepacifier’sshapelendsitselfeasilytoapursedlipandatightjawposture,whichcontributestoapainful,shallowlatchwithlittleornomilkremoval.

• Thesurfaceofthepacifierisirregularandporousandwhencombinedwithmoistureandroomtemperaturescanleadtoyeastgrowth,whichmaycontributetothrushinfections.Pacifierscanalsoincreasetheriskofearinfectionanddentalproblems,andtheeventualweaningfromapacifiermaybeagreatsourceofstressforboththechildandparent.

PleasefeelfreetocallBirthwaysat515-239-2444ifyouhaveany

questionsaboutthispolicy.

FREQUENTLY ASKED QUESTIONS

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Important Numbers:

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Notes:

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Welcome to Birthways A Helpful Guide for Expectant Moms and New Parents

1111 D U F F AV E N U E , A M E S , I O W A 5 0 0105 15 - 2 3 9 - 2 4 4 4 • W W W. M G M C . O R G