Photo By David Bedard | Air Force Staff Sgt. CaTeah Bryant, medical technician, Air Force Capt. Omayra Nunez,...... read more read more
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From the time an expecting mother presents a positive pregnancy test, healthcare professionals of the 673d Medical Group at the Joint Base Elmendorf-Richardson hospital are ready to promote a healthy pregnancy and the safe delivery of the baby.
Airmen of the Women's Health Clinic and the Perinatal Service Unit are instituting a number of initiatives to improve the experience of mothers and babies during the pregnancy and through delivery.
If a woman suspects she is pregnant or has a positive over-the-counter pregnancy test, she needs to see her primary care manager for a clinical pregnancy test.
Air Force Maj. Angela Gookin, Women's Health Clinic flight commander and a certified nurse midwife, said a patient with a positive test will then be referred to her clinic.
“It's as simple as coming to the front desk and checking in,” Gookin said. “There is some lab work we ask them to do. There is some paperwork we ask them to fill out, and then there is a checklist we ask them to accomplish, especially for our active-duty members.”
Expecting service members are given a profile by the Public Health Department, which will schedule a work site visit if appropriate to deem whether it is safe for pregnancy.
“For instance, if the person worked on the flightline, and they are an engine mechanic, working on the flightline is not a good idea while you're pregnant,” Gookin said. “[The Public Health Department] would determine if and when that individual would need to be removed and put someplace else.”
Once the mother has delivered the baby, the old profile will be cancelled, and the Women's Health Clinic will issue a new profile.
Gookin said the mother's first full appointment will be a registered nurse intake covering matters such as nutrition and safety.
“We like to do that in a group setting because it's a little more efficient for patients, not to mention it gives them an opportunity to meet people that are probably going to be delivering about the same time that they are,” Gookin said. “It's a chance for them to network with other people.”
Networking is a big part of the clinic's methodology, Gookin said. They ideally like to match mothers who have experience delivering with first-time mothers.
Key to this methodology is the use of Centering Healthcare Institute's CenteringPregnancy prenatal care. The care regimen follows the recommended schedule of 10 prenatal visits, but each visit is longer giving women more time with their provider while networking with other mothers who are expecting around the same time.
Gookin said there is value in expecting mothers sharing their stories.
“A lot of what we find in pregnancy is anecdotal,” Gookin said. “Women will say, 'This is what happened to me in my pregnancy.' Another will say, 'Oh that's right, that happened to me too.' It really does help to facilitate discussion.”
Topics covered during appointments cover matters such as nutrition, exercise, dental health, lactation, breastfeeding and relaxation techniques for delivery.
Future mothers can expect to visit the clinic every four to six weeks at the beginning, then every four weeks, two weeks and every week at the end of term.
Before 12 weeks, a mother will get her first ultrasound, which establishes dating and verifies the pregnancy, giving midwives the ability to pinpoint conception within six days.
The second ultrasound is between 18 and 22 weeks. Though the gender can be determined and disclosed to the parents if they so wish, the ultrasound is done for other reasons as well.
“It's better known by the public as the 'gender ultrasound,' but that is not the purpose,” Gookin said. “The purpose is to ensure the baby is growing appropriately. We look at all of the vital organs. We're looking to rule out any anatomical or genetic defects that we wouldn't normally know about.”
Other prenatal screenings are also offered as well based on the mother's request and if the pregnancy is deemed high-risk or not.
Though care is focused on the mother for obvious reasons, Gookin said fathers have a role too.
“We highly encourage all fathers to come to all of the prenatal visits because these are not just well-woman visits,” Gookin said. “These are well-pregnancy visits. The husbands have a lot to offer when it comes time for their wives to come in.”
When it is time to deliver, mothers will check in with the Perinatal Service Unit, commanded by Air Force Maj. April Franklin, a registered nurse - labor and delivery.
Franklin said mothers will be dilated to 6 centimeters before full admission for delivery.
The hospital has five delivery rooms, each equipped with a delivery bed, a full suite of medical instruments to monitor mother and baby, and a jet bath for hydrotherapy.
A new feature of perinatal care at the hospital is the offer of nitrous oxide gas for pain management. Franklin said the JBER hospital is one of the first in the Air Force to offer it.
“You can still move around with nitrous,” Franklin said, contrasting the method with intravenous and epidural pain management. “It gives you relaxation between contractions.”
She said the patient is the only one authorized to use the mask during labor.
“It really does put pain control back in the hands of the patient,” Franklin said. “For other women whose only options used to be IV pain medication or an epidural, once we've given it to them we've taken their control away. This really puts the control of the delivery back in their hands.”
The hospital has two operating rooms where Caesarean section delivery can be performed if necessary, Franklin said. A C-section drape is offered so the mother can see the birth and get skin-to-skin contact immediately upon delivery.
Franklin said skin-to-skin contact is critical immediately following all births, so they follow a regimen of delayed umbilical cord clamping and delayed bathing to immediately get the baby to the mother's arms.
For more information about prenatal care at the JBER hospital, call the Women's Health Clinic at 580-5808.
| Date Taken: | 12.12.2017 |
| Date Posted: | 12.12.2017 20:15 |
| Story ID: | 258576 |
| Location: | JOINT BASE ELMENDORF-RICHARDSON, ALASKA, US |
| Web Views: | 1,215 |
| Downloads: | 0 |
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