Special delivery

Today's expectant mothers have more knowledge, choices and control.
By MARY ELLEN PELLEGRINI
VINDICATOR CORRESPONDENT
HE SPACIOUS ROOMS, HARDWOOD floors, beautiful draperies and tasteful artwork with accompanying massages give the illusion of a relaxing spa. But one look at the state-of-the-art medical equipment hidden behind the artwork reveals the room's real purpose. This is the latest in birthing facilities available at area hospitals.
"The cold, sterile operating room style delivery room is gone. Today the rooms are much prettier," said Lori Fombelle, patient care manager for the Maternity Care Center at Jameson Health System in New Castle, Pa. The revamped facilities and medical advancements have in turn transformed attitudes and expectations regarding childbirth.
Then and now
A generation ago husbands paced in the waiting area while mothers labored in a room with curtains drawn between each patient. Mom delivered the baby under general anesthesia and woke up not knowing whether she had a boy or girl.
Today, "the focus is more and more on labor and delivery's being a family event. The ultimate goal is to let the mom steer the ship," Fombelle said. Unlike their mothers and grandmothers, pregnant women now have more choices, more knowledge and more control.
"Mothers today ask more questions and a certain percentage go to childbirth classes," said Maryann Pollander, director of nursing for maternal child services at Forum Health in Youngstown. Additionally, pregnant women have access to the Internet, educational TV and print materials. "They come in knowing 'I have choices. I'd like to try this,'" Fombelle said. CD players and music, videotapes and a family picture are commonly brought in as focal points for relaxation.
The evolution in maternity services occurred during the past 20-25 years, according to Fombelle. "When my son was born 21 years ago, Jameson had just added their first birthing room," she noted. The early birthing rooms gave way to LDR (labor, delivery, recovery) rooms, which "allowed mothers to remain in the same room and gradually encouraged participation by fathers because you did not have to remove the mother," said Pollander.
Mothers also have more choices in pain management. "A lot of women go through the early part of labor in jacuzzis because it is so much more relaxing. The water is warm. Some women walk a lot during their labor because it takes some of the pressure off the back," said Fombelle. Epidurals, not general anesthesia, are the most requested form of pain management, according to the nurses.
At St. Joseph Health Center in Warren, the one-size-fits-all approach to labor and delivery has been replaced by its Birth by Design program. "We customize the birthing experience," said Anna Klejka, nurse manager of maternity services. "Our goal is to make labor a wonderful experience and a memorable one," said Lori Knorr, a birth counselor and lactation consultant at St. Joe's.
Aromatherapy, sound systems designed to offer relaxing music, childbirth classes for moms, dads and siblings and the opportunity for dad to cut the umbilical cord are some of the options now available. "We want to know up front what their expectations are so we can tailor the birth experience to what they want," said Mary Ann Minick, another of St. Joe's birth counselors and lactation consultants. Through all facets of pregnancy, "we strongly encourage our moms to discuss all their options with their doctors," said Knorr.
Medical guidelines
At all hospitals every aspect of the birthing experience must comply with rigid medical guidelines. "The safety of mom and the baby is our main focus. We have to have an atmosphere where we can move about the room and do our job," said Pollander. Doing their job and ensuring patient safety is greatly enhanced by new technology.
Maternity is a high-tech profession, according to Pollander. Infant security systems, electronic charting and electronic fetal monitoring (two transducers placed on the mother's abdomen to record mom's contractions and baby's heartbeat) ensure maximum protection for mom and baby. Pollander describes EFM as a baby sitting in utero holding a microphone. "With EFM we can be in constant contact with the baby and respond to any changes immediately," she noted.
In spite of all the changes in the birthing process one aspect remains unchanged. "No matter how long you do this the miracle of birth is still amazing," said Pollander.