Giving Birth in Philadelphia
Where and how to deliver a baby in the Delaware Valley
Giving birth is as old as time itself, yet just like fashion, maternity trends come and go. Whether you’re about to have your first baby or your first baby in a few years, here’s the latest on where and how to have a baby in the Delaware Valley.
After a rash of maternity unit closures several years ago, there are currently six hospitals delivering babies in Philadelphia. While the reduction in maternity wards led many to worry about a shortage of providers, insiders say worst fears haven’t been realized.
Indeed, claims Arnold W. Cohen, MD, chairman of the Department of OB/GYN at Philly’s Albert Einstein Medical Center, “The quality of care has actually improved.” He cites as proof the fact that a doctor dubbed a “laborist” remains on the labor floor 24/7, to address spur-of-the-moment occurrences — from emergencies to early arrivals — and provide additional reassurance for new parents.
One recent trend that obstetrical experts have their eye on is the high rate of Cesarean sections performed in American hospitals. It’s so much of a concern that in February the American College of Obstetricians and Gynecologists (ACOG) released a statement with the goal of reducing C-sections. In 2011, one in three women gave birth via C-section. In New Jersey, that rate has been as high as 40 percent. An estimated half of these were performed on women with low-risk pregnancies who likely could have given birth nonsurgically, some of whom scheduled elective procedures to deliver at a time convenient to family or doctor.
“Elective primary C-sections were a very short trend,” says Marian Thallner, senior vice president overseeing maternity services at Holy Redeemer Health System in Meadowbrook, PA. Due to recent education efforts touting vaginal delivery as the optimal route for first-time moms with no medical indication, fewer women are scheduling elective procedures.
Another related stat that’s shrinking is the number of women who’ve had a C-section yet try labor with a subsequent baby. “In the last five years or so the pendulum has swung back,” says Elizabeth M. Zadzielski, MD, the medical director of Christiana Care Health System's Women’s Health Ambulatory Services in Newark, DE. “We very much support a trial of labor after a C-section.”
Nonclinical and natural support
The February ACOG statement recognized doula support as an underutilized resource in lowering the Cesarean rate. Independent pregnancy professionals who provide nonmedical support during the birth experience, doulas help women understand their delivery alternatives as well as facilitate conversations with medical staff. “We never tell them what to do but tell them what their options are,” says Jodi Green, a doula practicing at the Better Birth Network in Cherry Hill, NJ.
Doulas offer support in the setting of the mother’s choosing, whether at home, a hospital or at a freestanding birth center, where mothers with low-risk pregnancies give birth with no or minimal medical intervention under the supervision of nurse midwives.
Kathleen McCarthy, certified nurse midwife and co-owner of The Birth Center in Wilmington, DE has noted an increasing use of birth centers around the country, attributing the trend — a healthy, small-scale, rise from .25 percent of overall births to .39 percent since 2008, according to the National Center for Health Statistics — to the broader holistic movement and the power of Google.
“The younger generation are such researchers,” says McCarthy. “They look at all their options,” which leads some to choose an alternative to medical birth. Parents-to-be go to birth centers for the “low-tech, high-touch treatment” in a quiet environment accessed by “minimal people,” both in terms of staff and visitor flow, says McCarthy. Birth is treated as a “natural process, not a medical procedure.” As such, women are encouraged to move around, shower, eat and drink during labor; when it’s time for delivery, they give birth naturally in comfy rooms with double beds decked out to look like a bed-and-breakfast or in a spa-like suite with a tub dedicated to water births. Postpartum, babies are not taken to a separate nursery but stay with the mother skin-to-skin to facilitate the initiation of breastfeeding.
For women who want such comforts in a medical setting, hospitals are attempting to re-create coziness in their maternity wards. Most hospitals have moved toward private rather than shared rooms, says Dr. Cohen; this helps with “the golden hour” of newborn-to-mom bonding immediately after birth, prevents the spread of patient-to-patient infection and makes more generous visitation policies possible — a feature Thallner says comes directly from patient request. “New moms want a lot of people to visit whenever they want,” she notes. Holy Redeemer, which recently completed a $10 million maternity center expansion, even offers overnight accommodations for guests in its hotel-like recovery rooms.
“Patients really want to be pampered,” continues Thallner. Post-delivery massage and mani-pedi services are available for an additional fee, and in-room aromatherapy options are coming soon. Additional perks at area hospitals include family photo shoots and on-site infant car seat checks. Important postpartum depression screening and support are also widely available.
Across the area, maternity care providers are seeing women ask questions and make more informed choices about everything from nutrition to health care costs. Says Green, “Women are invested in being active participants in their own care.”
Suzanne Koup-Larsen is a contributing writer to MetroKids.