Where Do Birth Quest Clients Deliver?

Most Birth Quest clients deliver at Hackley, Gerber, Spectrum Health Butterworth, or home.

Here at Birth Quest, a lot of people ask Beth and I where we most often support birthing clients for their deliveries! Here is the answer with some reflections on each from a doula’s perspective:

1.) Mercy Health Hackley: Over 1/3 of our birth doula work is at Hackley. Beth and I were both born at Hackley and we both live less than a mile from the hospital, so this shouldn’t be a surprise. It also makes sense because we strive to serve our community and this is our community hospital! Being located near downtown Muskegon means there are some good food options, like Ryke’s Bakery, near-by. Design aspects we like about the hospital include having separate bathrooms in the hallway for visitors, a waiting room with an ice machine and being able to enter and leave the floor without having to pass through a security door. We’re not crazy about the separate Labor, Delivery & Recovery and Postpartum floors. Hackley is the only hospital on the lakeshore where midwives still deliver and I like how the nurses treat me like an equal. We’re curious to see the new labor and delivery unit that opens in summer of 2019.

2.) Spectrum Health Gerber Memorial: Many of our lakeshore clients travel to Fremont to have their babies at Gerber because of their reputation for supporting natural and patient-centered births. This support is backed up by Certified Nurse Midwives and their Perinatal Nurse Educator and blogger, Samantha Kauffman, who is both Hypnobirthing and Evidence Based Birth certified! Their Director of Clinical Nursing, Beth Coulier, and I worked together on the FIMR Case Review Team when I worked for Public Health – Muskegon County. She brings a lot of experience and compassion to Gerber and this is reflected in the quality of care her staff provides. Gerber gained a national reputation under the leadership of Dr. Tami Michele, who was innovative in overcoming an official ban in order to support trial of labor after cesarean (ToLAC) and vaginal birth after cesarean (VBAC). Dr. Michele currently works at the Butterworth campus. We like that birthing people can labor, deliver, and recover postpartum all on the same floor. Negatives include being located in a small town with few food options, especially late at night, having to be buzzed in and out of the unit by staff and not having visitor bathrooms on the unit. Although the staff are accommodating, it would be nice to have coffee, ice water and a fridge available without having to ask. You know, like a doula station? A doula can dream!

3.) Spectrum Health Butterworth: Although I would love to assist someone in the Natural Birthing Suites, we have not yet had the opportunity. When women we serve plan to deliver at Butterworth, it’s usually because they are high risk or planning a VBAC, making them ineligible for this option. In these circumstances, all of West Michigan is fortunate to have access to the state-of-the-art care provided there. There are pluses and minuses to being in such a large hospital. On the one hand, most of my clients have no idea who is going to be there when they deliver with a practice. On the other hand, when a woman’s care is transferred, there is a good chance that the care she seeks is available. Some of my favorite birth memories as a doula at Butterworth involve supporting women who want to do something that is met with staff discomfort and do it anyway!

4.) Home: There is nothing like the flexibility and comfort of home, even someone else’s home! Whether small or large, the gathering is always intimate, peaceful and festive. When present, I love spending time with other family members, friends and pets. There is never a struggle to support a natural birth plan, especially when it pertains to newborn interventions, at a home. Cost is the biggest barrier to home birth for those who desire it and fit the criteria. I also hope for a future with more diversity among midwives, to help increase access for all women.

Spectrum Birth Unit Tour, 4-14-15

SH booklet

In preparation for an upcoming birth, I toured Spectrum Health, Butterworth Campus, in Grand Rapids.  My notes are below.  While most of my clients are in the Muskegon area, if a mom has preterm labor or a baby is known to have health problems during pregnancy, the mom will most likely be referred to Spectrum, since there isn’t a NICU, or neonatal intensive care unit, in Muskegon.  Also, Muskegon moms planning a VBAC (vaginal birth after a cesarean) will be referred to Spectrum as they are the nearest facility with 24-hour anesthesia available, which is required at hospitals where VBACs are done.

Notes from Spectrum Health, Butterworth Tour on 4-14-15 with Bonnie Brack, RN

The tour met on floor “A” in the center tower.  We were told to have visitors park in ramp 7 and patients in ramp 6.

The postpartum rooms are on floors 6, 7, and 8 and we didn’t get to see them.  They are private rooms with their own bath and shower.

Women in labor present to triage, which has the same equipment as on the L&D floors.  I later asked if moms who presented further along in their labor had to spend time in triage and she said some women circumvent triage if it is apparent they are close to delivery.  Couples can also take advantage of valet parking.  At 9 PM, the doors lock.  If locked, wait for a guard because they’ll be right back.  Visitors must wear a badge.  In most cases, women move from triage, to the delivery floor, to a postpartum floor.

We went to the 2nd floor.  The 4 former triage rooms are now used to prep moms having cesareans.  The LDR (labor, delivery, recover) rooms are where the moms stay for up to 2-hr. postpartum.  The babies can room-in with them.  The nurse pointed out that the thermostat in the room can be adjusted, as well as the blinds and the lights.  She also emphasized 4 options: a wooden rocker, birthing balls, a squatting bar and a mirror.   When asked, she explained that they have different sized balls (or add or decrease the air to get them the right size), but they do not have space for a peanut ball.  I also asked about out-of-bed options for second stage, such as a birthing stool.  They used to have a birthing rocker, but no one knows what happened to it.  There is a whirlpool/Jacuzzi bathtub in each room, but water births are not allowed.  From the way she made it sound, all women push in bed.  There is no CD player available or MP3 hook-up in the rooms.  There is a couch the folds out into a bed.  TV channels 3, 8, and 13 are informational stations.  Linens, towels, washcloths, gowns and catheter kits are all kept in the cupboards.  Moms are only allowed ice chips in labor.  Up to 5 people are allowed in a room, in addition to staff.  In addition, each floor has its own waiting room.

Most circumcisions are done by the OB, the day after birth.  It’s whoever is doing rounds from the practice you are with.

Dial ‘9’ for outgoing calls.  She suggested bringing a cell phone and charger to the birth.

Nurse said there were no “walking” epidurals and all women with epidurals are catheterized multiple times during labor to empty the bladder.

There is a 1:1 nurse to patient ratio, except maybe 2:1 for patients in early labor.  All patients receive continuous electronic fetal monitoring.

There are 2 c-section rooms on the 2nd floor and another on the 3rd floor.  In an emergency, they can prep a patient in their LDR room.  Only 1 person is allowed in the room with the mom.  They still try to do modified skin-to-skin.  The doctor makes the first cut on the cord and the support person can make the second, if desired.

When I asked if there was a space where visitors could store food, she said there was a clean utility room with a fridge, but didn’t know if it could be used to store food.