Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, July 12, 1990 TAG: 9008080079
SECTION: PARENTS' GUIDE PAGE: 2 EDITION: METRO
SOURCE: Sara Cox
DATELINE: LENGTH: Long
Birthing rooms - called LDRs (labor/delivery/recovery) or LDRPs (labor/delivery/recovery/postpartum) are a must. Community Hospital of Roanoke has eight; Montgomery Regional, two; Radford Community, three; Lewis-Gale, six; and Roanoke Memorial, four.
Some hospitals entice patients with special delivery packages; many send new mothers home with bags stuffed full of free samples. Hospital tours for expectant parents and siblings are only a sample of what hospitals offer in the way of prenatal preparation.
Classes range from prepared childbirth to breastfeeding, from exercise to childhood emergencies. Even after the baby goes home, morning coffees have been organized to keep mother in touch with vital issues.
In June 1988, Lewis-Gale Hospital redecorated its entire maternity unit. The muted colors and carpeted floors make this unit, filled with women in labor and recovery, look like a nice hotel floor. At the end of the hall is a special children's corner, outfitted with a size-small table and chairs.
Private LDRP rooms are furnished with large easy chairs that swing out into single beds for fathers in for the long haul; these rooms also have cozy tables and chairs for the celebration meal at the end of the stay.
But Lewis-Gale aims to accommodate all kinds of preferences. "Birth is such a private, personal experience. I have mothers that still want the sterile atmosphere," said Andi Isenhour, coordinator of Women's Health for Lewis-Gale.
Those women get the labor rooms. And some, she said, prefer to move after the baby is born, leaving the memories of pain far behind. When birthing rooms were first developed, she said, they were designed for high-risk situations so the mother wouldn't have to be moved. Now, throughout the Roanoke and New River valleys, they are common and in much demand.
With the merger of Community and Roanoke Memorial hospitals, maternity units will move to Community and, according to an area obstetrician as well as Community Hospital's Donna Sams, plans include a redesign of that entire function.
Dr. Douglas Althouse, of Pediatric Associates in Roanoke, said the neonatal and pediatric intensive care units also will move to Community within a year.
"Having combined strengths will help to enhance services and capabilities," he said.
Now, no hospital in the New River or Roanoke areas can offer genetic amniocentesis or corionic villi sampling - patients are sent to the hospital at the University of Virginia - because correct professional help is lacking. However, Sams said Roanoke Memorial is expecting perinatologist Dr. Lynn Keene to begin work in August.
"Besides a perinatologist, she's a geneticist," said Lynn Smithson, director of patient care services at Roanoke Memorial. "Patients can stay here for genetic studies [after she arrives]."
Smithson said Keene also plans to offer genetic counseling. Additionally, counseling is given at Lewis-Gale.
All hospitals offer sonograms and amniocentisis to check things such as maturity of the baby's lungs. Non-stress also are given.
Routine lab work, which might include alphafetaprotein tests, Rh factors, rubella and hepatitis, is also done in Roanoke.
Emphasis throughout the area is placed on preparedness. And, to help expectant parents gear for their baby's arrival, hospitals are offering a wider variety of classes than ever.
The basic prepared-childbirth class reviews relaxation techniques, educates parents in the birth process and what to expect and shows how coaching and functioning as a team can help. This class is offered at all hospitals (Community Hospital gives prepared-childbirth classes through its College of Health Sciences).
Another class, often known as a baby basics course, teaches parents in one- or two-night stints how to feed, bath, dress and otherwise care for their newborn.
A newer class is one on breastfeeding. The College of Health Sciences, for $15 a couple, has a certified lactation consultant teach this four-hour (two different sessions) class in establishing milk supply, how-to techniques, breast pumping and milk storage, returning to work and family adjustments.
According to Mary Jane Witter, director of continuing education, this 1 1/2-year-old old course is very popular - "a lot of men come to this class," she said.
Lewis-Gale has on its staff a lactation consultant who teaches a class and is available in the hospital or for home visits. Hospital tours often are regarded as a necessity rather than a frivolous extra, especially with visiting siblings.
Montgomery Regional Hospital offers a sibling class, required if the parent has a child age 2 to 12 who will visit the hospitalized mother. Children are told what will happen in the hospital and given a tour of the maternity floor. They also have their temperature taken to make sure they're not sick, and they receive a scrub brush to take home and practice with since they are asked to scrub their hands before entering the mother's hospital room.
Lewis-Gale's Isenhour said their sibling tour is done from a child's point of view - parents accompany their children but are not usually addressed.
The competitive spirit also may be responsible for maternity packages offered at Lewis-Gale and Roanoke Memorial Hospitals.
The Special Delivery Program, offered through Roanoke Memorial to its paying patients, includes an LDR room, a special delivery canvas tote bag stuffed with free samples and information booklets, a 20-percent discount on the bill, a special delivery gourmet dinner and a free infant car seat.
The Our First program at Lewis-Gale, started in February, includes a Stork Line phone number for mothers to call after going home; a newsletter that begins arriving in the prenatal months; an area merchant discount card; and a take-home diaper bag filled with baby supplies.
Although Community Hospital doesn't have a formal "program," it gives patients a diaper bag filled with supplies, a congratulatory dinner for the parents and a follow-up phone call at home to see how everyone is adjusting.
But after the special packages, the prenatal classes, the tours, the birthing rooms and the baby, there is the bill. Roanoke Memorial Hospital gave a cost of $2,500 for a vaginal delivery, which included the three-day stay and care for both mother and infant, but did not include doctor's fees. Its Caesarean sections cost approximately $5,000.
According to Isenhour, Lewis-Gale charges approximately $1,900 to $2,100 for a vaginal delivery, and $4,500 for a Caesarean. This includes care for infant and mother, without doctor's fees.
At Radford Community Hospital vaginal deliveries average $1,300; Caesareans, $2,900. Newborn care and doctor's fees are not included in those averages.
Erin Cruise of Montgomery Regional Hospital said fees - "just ballpark figures, as of April," range from $1,800 to $2,200 for a vaginal delivery and $2,800 to $3,200 for a Caesarean section.
"This includes room and board, care of mother and baby, delivery or operating-room charges and medical/surgical supplies. It does not include doctor's fees, and there is a separate bill for the anesthesiologist's charges," Cruise said.
There is a very special service that only one hospital in the Roanoke and New River valley's offers, but that all hospitals in this area tap into. Roanoke Memorial is a Level Three Hospital and has the only neonatal intensive care unit west of Lynchburg. Critically ill newborns from all parts of the area are transported in the Lifeguard Ten helicopter with the help of Neonatal Transport Coordinator Diane Goode.
The transporting of infants started in 1979. At first, it was done in a van especially designed for neonatals. In June 1984, air transportation was introduced.
Goode and a respiratory therapist go to the outlying hospital that needs an infant stabilized, taking with them a battery-operated incubator equipped with a ventilator, IV pumps, oxygen and a cardiac monitor.
The infant must be stabilized before leaving the original hospital, because there is a greater danger of its dying en route. "If a baby is very, very stable you can travel long distances,"said Goode. "I stay there [the outlying hospital] from a minimum of two hours to as long as six. Our success rate has been very good. No babies have died in transit."
Babies needing cardiac surgery must go to the the University of Virginia Hospital.
Goode, who has been on this job for 11 years, said that stress on her is far outweighed by the results. "It's something that those babies need. If we didn't do this, they wouldn't survive."
Goode says that often parents cannot be with their newborns, so nurses in Roanoke Memorial's neonatal ICU take pictures of them, send parents cards from their babies and involve families as much as possible in the feeding and care.
"I'm always the lady that's known as `You took my baby away, lady.' It's a great responsibility," said Goode. Goode, as well as many other staff members, soon will be moving to Community Hospital when the redesigned maternity-pediatric plans are finished.
"You're talking to a person who has 26 years at Roanoke Memorial - it's going to be difficult, but I look for good things to happen."
The bottom line is this: Competition seems to have made services more attractive at all of the hospitals in this area.
by CNB