Mother & Baby Care: Preparing for your Big Day

Mother & Baby Care: Preparing for your Big Day Your big day is almost here! As you prepare for your baby s birth, you probably have lots of questions about your hospital stay. The information in this packet will answer those questions and help you become more familiar with the Women s Services provided by Baptist Health System. Page What s Inside: 2. Getting Ready for the Big Day It is important to choose a pediatrician before your baby s arrival. If you have not chosen one, the hospital will contact the on-call pediatrician for your baby s first examination 3. PACKING FOR YOUR HOSPITAL STAY Use this list as a guide in packing for your hospital stay, items to bring for your baby and for your trip home 4. QUICK FACTS ABOUT Labor & Delivery and PostPartum Care Overview of anesthesia services Delivery expectations: A review of vaginal and cesarean births Nursery Services: Standard screenings including Phenylketonuria (PKU) Photo and video services available Breast feeding: Information about our lactation consultants and equipment rentals 6. Common Questions And Answers about Labor & Delivery 8. newborn Security 10. PEDIATRIC CARE AT BAPTIST HEALTH SYSTEM 11. Parents Resource List Information about local and national organizations and agencies that support new parents 12. NOTES

Getting Ready for the Big Day Hospital Tours & Classes Baptist Health System offers hospital tours to help parents learn more about where they will deliver and how to get there. Ask about parking during your tour. Childbirth classes are also available and include: Prepared Childbirth, Baby Care Class, Breastfeeding Class and many more. You are encouraged to register for classes early, by your 4th month of pregnancy, to receive your choice of class dates and times. Please visit our website for a current list of classes offered. For information about tours or to register for classes, call (210) 297-7005. Phone lines are open 24 hours a day, seven days a week. PRE-REGISTRATION We highly encourage you to pre-register for your hospital stay as soon as possible. By completing the required paperwork ahead of time, you will have one less thing to worry about when your big day arrives. A pre-admission form is included in this Women s Services guide. You can also pre-register online at. Important Phone Numbers Ask your physician if he or she wants you to notify their office prior to going to the hospital when you are in labor. The Labor and Delivery phone numbers are: Baptist Medical Center...(210) 297-7075 Mission Trail Baptist Hospital...(210) 297-3075 North Central Baptist Hospital...(210) 297-4075 Northeast Baptist Hospital...(210) 297-2075 St Luke s Baptist Hospital...(210) 297-5075 Selecting a Pediatrician We recommend that you select a pediatrician or family practice physician before you come to the hospital for the birth of your baby. Please check with your insurance company for a list of providers as you make your selection. If you have not selected a physician prior to delivery, or if your physician does not have privileges at Baptist Health System, the hospital s on-call pediatrician will provide care for your baby while you are in the hospital. To find a Baptist Health System pediatrician near you, call (210) 297-7005. PAGE 2

PACKING FOR YOUR HOSPITAL STAY Use this list as a guide in packing for your hospital stay. These items may be useful or provide you comfort during your labor and postpartum stay. PACKING LIST/THINGS TO BRING WITH YOU TO THE HOSPITAL o Focal point (meaningful small object or picture to focus on during labor) o Lotion o Toothbrush and toothpaste o Chapstick or lip balm o Non-slip socks o Tennis ball, ice pack, back massager (for back labor) o Birthing ball o Relaxing music o Hairbrush o Hair clip or ponytail holder to pull long hair away from neck and face o Comfortable pillows (you may want more than we provide) o Colored pillowcases (so they aren t confused with the hospital s white ones) Items for Postpartum stay o Nursing gowns and/or robe o Non-slip socks o Nursing bras (1-2) o Toiletries (toothpaste, toothbrush, chapstick or lip balm, deodorant, tissues, contact lens solution and case, etc.) o Maxi pads o Extra clothes and toiletries for support person if they wish to stay overnight o Loose-fitting clothes for mom to wear home Items for baby o Baby book (for guests to sign and for baby s footprints) o Outfit for baby to wear in baby portrait taken at hospital o Weather-appropriate going home clothes and blankets for baby o Car seat. Learn how to install and use car seat prior to the birth of your baby. Information can be found by going to txdps.state.tx.us. o Snacks for partner o Childbirth Class handbook o Long distance phone card or cell phone o Pen and paper o Camera with new batteries (may not photograph procedures or actual birth) o Change of clothes PAGE 3

QUICK FACTS ABOUT LABOR & DELIVERY AND POSTPARTUM CARE LABOR & DELIVERY A nurse will monitor your labor and keep your physician informed of your progress. If an emergency arises, the on-call obstetrician will be notified immediately. Your physician group has someone on call 24 hours a day. Some Baptist hospitals have a laborist in-house. You will remain in your labor/delivery/recovery room during the labor and delivery process and through the initial recovery period. A support person may remain with you throughout and after the birthing experience. Discuss your wishes with your physician and your nurse. There may be times when your support person will have to wait in the waiting area. This will be at the discretion of the physician, nurse and/or anesthesiologist. If this happens, every effort will be made to keep your support person informed of your status. ANESTHESIA Dedicated obstetrical anesthesia services are available 24 hours a day, seven days a week. During your OB/GYN office visits, be sure to discuss how you would like to manage your pain control during labor. TYPES OF DELIVERY Vaginal Many women who have had a healthy pregnancy will have a vaginal birth. In a vaginal birth, the baby will come out through the birth canal. Most women give birth at around 38 to 41 weeks of pregnancy. On average, the length of stay for an uncomplicated vaginal delivery is 24 hours after delivery. However, how long you stay with us is primarily determined by your physician and occasionally, your health insurance company. Cesarean Section (C-Section) A C-section is a surgical procedure during which the baby is delivered through an incision in the abdomen and uterus. Cesarean births and highrisk deliveries are performed in conveniently located surgical suites within the labor and delivery unit. Most moms stay in the hospital for 48 hours after a C-Section delivery. AFTER DELIVERY After your baby is born you will both be moved to a private postpartum room. We encourage you to spend as much time as possible with your newborn by keeping them in the room with you. Your nurse will be available to help with your new baby and answer any questions you may have. Our staff will ensure both mother and baby are doing well and provide plenty of time for mothers who choose to breast feed their baby. All staff in Women s Services are trained to assist with breastfeeding. However, if additional assistance is needed, Certified Lactation Consultants are available upon request. You will receive regular visits by your obstetrician. Many mothers find it helpful to prepare a list of questions to ask, including options for birth control. Prior to your discharge from the hospital, your nurse will give you home care instructions and follow-up appointment information for both you & your baby. Newborn NURSERY After an initial time in labor and delivery, your baby will go to the nursery for a transition period. This process generally takes two to four hours. While in the nursery, your baby s heart rate, breathing and color will be checked often during the first couple of hours after birth. The nurses will also weigh your baby, complete their measurements and take footprints. During this time in the nursery, your baby will be given his or her first bath. Your baby s temperature and vital signs will be monitored closely, and, once your baby is warm, he or she will come to your room. NEONATAL INTENSIVE CARE UNIT (NICU) If your baby needs special care or treatment, all five Baptist Health System hospitals have Level III Neonatal Intensive Care Units (NICUs) staffed by highly skilled nurses and neonatologists and the most technologically advanced equipment to care for your newborn. The NICU multidisciplinary team is available 24 hours a day, seven days a week and embraces a family-centered approach to patient care. During your baby s stay, we will work closely with you in planning developmentally appropriate care based upon the needs of your baby and family. PHOTOGRAPHY SERVICES Photography services are provided by an outside vendor and are available for purchase. The photographer will bring you information regarding pictures. You may want to dress your baby in an outfit brought from home. Photos are taken in your room with your permission. You have the option to purchase pictures or load your own images and have them posted on the hospital website for friends and family to see at CaringBridge.org. CIRCUMCISION Many pediatricians will perform circumcisions during your son s initial hospitalization. If you wish for your son to be circumcised before you are discharged from the hospital, please discuss this when you select a pediatrician. PAGE 4

LACTATION The American Academy of Pediatrics recommends mother s milk as a baby s best source of nutrition. At Baptist Health System, we support your choice to provide the best for your baby with: Texas 10 Step Certified Facilities (TexasTenStep.org) a program encourages breast feeding as the preferred method of feeding newborns and infants Inpatient and outpatient consultation provided by Certified Lactation Consultants Breastfeeding educational materials and support products Breast pump rentals, instructions and support Special support for babies in intensive care Consultations for mothers returning to work Assistance with feeding multiples Telephone consultations A full line of breastfeeding products are available for purchase Ask your nurse for more information on lactation support. MOTHER S MILK BANK COLLECTION CENTER Baptist Health System is a Mother s Milk Bank Collection Center should you want to donate your breast milk. In partnership with the Mother s Milk Bank at Austin (MMBA), North Central Baptist Hospital (NCBH) and Northeast Baptist Hospital (NBH) have arranged to act as mother s milk collection sites for San Antonio. As collection sites, NCBH and NBH will provide sterile containers for donor mothers, distribute literature about the MMBA, accept and log donated mother s milk, and maintain the freezing receptacle dedicated to storing donations until it can be collected by the MMBA. For more information about the Mother s Milk Bank, contact the Mother s Milk Bank at Austin toll free at (877) 813-MILK(6455) or online at mmbaustin.org. Discharge The following details need to be taken care of so you and your baby are ready for discharge. If you have any questions, please feel free to ask your nurse. We encourage you to plan to be discharged by 11am Arrange transportation in advance to avoid delays Your physician must write your discharge orders before you may go home Your baby s physician must write his or her discharge orders before your baby may go home You will be given discharge instructions for both you and your baby, including information on follow-up appointments and prescriptions You will be escorted in a wheelchair, or you may walk, to your vehicle with a staff member or volunteer. Your baby will be transported out in his or her car seat. Notify your nurse when you and your baby are dressed and ready to leave the hospital to ensure that security devices have been removed Please check your room carefully for personal belongings before leaving the hospital Mom will need to sign the baby s identification form Have a family member or friend bring your baby s car seat (without the base) to your postpartum room to transport your baby to the car You may receive a follow-up phone call and/or a patient satisfaction survey from Baptist Health System. We are very interested in finding out if your doctors and nurses always communicated well with you, if the hospital was always clean and quiet at night during your stay, if your pain was managed well and if your needs were met. Please let us know if there are any areas we can improve upon and/or if you would like to recognize any of your caregivers. DOCUMENTATION Pre-Registration We recommend that you pre-register online for your hospital stay. By completing the required paperwork ahead of time, you will expedite the admission process. Birth Certificate Information After the birth of your baby, a representative from the Birth Registrar s Office will visit with you to obtain the information necessary to complete the birth certificate. Your baby will need to be named prior to your discharge in order to prevent a delay in this process. A birth certificate is a legal document, which by law, must be completed and submitted to the State of Texas Bureau of Vital Statistics within three days of the date of birth. This certificate is required for registering your child for school, proof of citizenship, obtaining a Social Security card, etc. It is important to provide complete and accurate information, as errors are difficult and expensive to correct after the certificate is filed. You will receive a complimentary hospital birth certificate during your stay or in the mail. You will need to purchase the official birth certificate from the San Antonio Metropolitan Health District (SanAntonio.gov). During your hospital stay, you will receive a form explaining how to purchase a birth certificate. Other Important Documents Baptist Health System will request a Social Security number for your baby if you choose to receive one. The card will be mailed to the address provided on the birth certificate. A Certification of Birth Facts can be provided upon request for insurance purposes. If you are not legally married to the baby s biological father, an Acknowledgement of Paternity will need to be completed by the father and can be done prior to the baby s birth. This document requires the signatures of both parents and photo identification. Baptist Health System does not perform paternity testing. For more information go to oag.state.tx.us. PAGE 5

COMMON QUESTIONS & ANSWERS ABOUT LABOR & DELIVERY HOW MANY PEOPLE CAN BE WITH ME IN THE LABOR & DELIVERY ROOM? We ask that no more than two people be in the Labor & Delivery Room at one time. WHAT ARE THE HOSPITAL VISITING HOURS? Our goal is to provide a patient care environment that is supportive of the patient s relationships with family and friends. Your guests are welcome as long as you feel up to having them. If you want rest, your nurse can post a note on your door asking guests to leave a message for you at the nurses station. While we have a family-centered open visitation policy, the hospital may limit visitation based on your safety and/or condition. You may have an adult (18 or older) stay with you at night. Children must be supervised in both the patient care and waiting areas by a responsible adult and may not stay overnight. WHAT ARE THE PHOTOGRAPHY/VIDEOTAPING POLICIES DURING LABOR AND DELIVERY? Cameras are welcome, and we encourage you to photograph non-medical activities prior to and after the delivery of your baby. Medical procedures such as a cesarean section and the actual delivery of the baby may not be photographed or videotaped. Video is not allowed in the newborn nursery or of staff members without their consent. If you have questions about what you and your visitors may or may not photograph/ videotape, please ask your nurse. HOW LONG IS THE AVERAGE STAY FOR NEW MOMS AND BABIES? Most moms who deliver vaginally typically stay 24 hours. Moms who deliver by cesarean section usually stay 48 hours. Please make arrangements for transportation by 11:00 a.m. on the day of discharge. WILL MY BABY BE ABLE TO STAY WITH ME THROUGHOUT THE HOSPITAL STAY? You and your baby will likely stay together in Labor & Delivery until your baby is one to two hours old, after which time both mom and baby will move to the postpartum unit. Within two hours of birth, the baby must be assessed and bathed, which may require them to be in the Nursery for two to four hours. Within 24 hours, your pediatrician or family practice physician will visit the hospital to examine your baby and discuss his or her health status with you. We encourage you to spend as much time as possible with your newborn during your hospital stay by choosing to PAGE 6

have your baby in the room with you. However, if you feel you need rest, you have the option to have the baby in the Nursery as needed. WHICH NEWBORN TESTS ARE PERFORMED WHILE MY BABY IS IN THE HOSPITAL? The Texas Early Hearing Detection and Intervention Program The Baptist Health System provides hearing screens for all newborns to detect early hearing loss. This screening usually occurs at least 12 hours after your baby s birth to ensure the fluid has cleared from his or her middle ear and ear canal. The test is performed while your baby is asleep or resting quietly. The results are available as soon as the test is finished. About 2% of babies receiving this screen will not pass and will need a follow-up screen after discharge. For more information, go to dshs.state.tx.us/tehdi. The Texas Newborn Screen The state of Texas requires all infants have two rounds of screening tests for certain disorders, inheritable and other. The first Newborn Screen (PKU test) is performed 24 hours after the infant s first feeding. The second test is performed between 7 and 10 days after birth either in your pediatrician s office or an outpatient laboratory. This test requires a small amount of blood from your baby s heel. This blood is placed on a collection card and is sent to Austin for testing. The Texas screen currently tests for 27 different disorders for which there is not a cure but early treatment my prevent serious complications such as growth problems, developmental delays, deafness or blindness, mental retardation, seizures or even early death. You may only opt out of this screening for religious purposes. For more information, go to dshs.state.tx.us/newborn/expandparent.shtm. Jaundice Screening Jaundice or Hyperbilirubinemia, is when your baby s skin has a yellowish color. This color change usually starts at the face and moves towards the toes. Infants with jaundice are usually tired and do not feed very well. During your baby s hospital stay, the nurses and doctors will monitor your baby s jaundice level and will check this level around 24 hours after birth. Further testing and treatment may be needed if your baby s jaundice level is high or is rising quickly. If your baby s level is too high, it may be treated with special blue lights (phototherapy) for 1-2 days while in the hospital to get the jaundice level down. For more information, go to ncbi.nlm.nih.gov/pubmedhealth/pmh0002526/. WHEN ARE MEALS SERVED? Patient meals are served between 6:30 a.m. and 6:30 p.m. Staff will provide you with meal service information. Each Baptist Health System hospital has a cafeteria available for family and visitors, or they may bring food into the hospital or order delivery from nearby restaurants. IS BREAST FEEDING HELP AVAILABLE? WHAT ABOUT BREAST PUMPS? All Baptist hospitals are Texas Ten Step Certified and have earned this designation by providing care that supports breastfeeding. A Texas Ten Step facility has trained staff and policies that will support your decision to give your infant the very best. All of our nurses are trained to assist you with breastfeeding should you have questions. Certified Lactation Consultants are also available upon request should you require additional assistance. Breast pumps and other breastfeeding supplies are available for rent and/or to purchase. Check with your nurse or lactation consultant for more information. PAGE 7

MOTHER & BABY CARE: NEWBORN SECURITY MEASURES Everyone at the hospital is working to keep your baby as safe as possible. Staff in the maternal and child care area have been trained to spot a potential abductor. There are also strict rules on who can handle your baby, and how your baby is moved for examinations or tests. Security systems have been installed to help stop an abductor including door locks, cameras, and an electronic infant protection system. The small tag around your baby s ankle or umbilical cord means that your baby is being monitored at all times. If anyone tries to take your baby through a protected exit, an alarm will sound at the nurse station. Try to keep away from protected exits with your baby. You might set off an alarm by accident. Your nurse will give you more information on the infant security system once your baby is born. KNOW YOUR NURSES At the beginning of each shift, the nurse who will be taking care of you and your baby will come to your room to introduce him/herself to you. It s a good idea to become familiar with the staff in the maternal and child areas. Keep the bassinet beside your bed, on the side away from the door. At night it is also a good idea to keep at least one light on so the nursing staff can help you keep an eye on your baby. CHECK FOR AN OFFICIAL HOSPITAL ID BADGE Be cautious of any person you do not know entering your room. Before you let anyone touch your baby, check that person s photo identification (ID) badge. It must be facing forward so you can see the employee s name, picture, and the hospital s official logo. If you re not sure about someone who has come into your room, press your Nurse Call button for immediate help. Sometimes, hospital employees who are allowed to handle babies have to wear more (or different) identification. Ask what kind of ID you should look for to identify an authorized person. LEARN THE HOSPITAL S ROUTINE Ask your nurse about the schedule for routine activities like feedings, bathing and physician rounding. Nursing staff will be glad to answer any security questions you may have. NEVER LEAVE YOUR BABY UNATTENDED While in your room, keep your baby in sight at all times. Whether you re taking a nap or just going to the bathroom, ask a family member to watch the baby for you, or call your nurse. PAGE 8

SAFETY AT HOME For information about how to prepare your home for your new arrival see the Resource section of this packet on page 11 for information on the Consumer Product Safety Commission and National Safe Kids Campaign organizations. DON T GIVE OUT PERSONAL INFORMATION At home, just like in the hospital, do not give out any personal information about you or your baby over the telephone or in person unless you know the person well. INFANT SAFETY CHECKLIST Make sure you review the following points with hospital staff. If you have any doubts or questions about procedures or your baby s safety while in the hospital, don t hesitate to ask. Know who your primary nurse is on each shift Know all security procedures and the schedule for feeding and bathing Never allow your baby out of your sight. This includes when you go to the bathroom or take a nap When your baby is in the room with you, keep the bassinet beside your bed away from the door Only give your baby to hospital staff wearing a hospital photo ID badge clearly showing the hospital logo and the caregiver s name, and any unique identifier showing they are authorized to transport infants Know when tests for your baby are scheduled. Call the nurse s station if someone you don t know insists on taking your baby for an unscheduled test or procedure Always see that your baby is transported by bassinet Restrict visits to your closest family and friends Only give information about you or your baby to people who you know well and trust AFTER GOING HOME It is important to stay on your guard after you leave the hospital. Abductions can occur not just in the home, but anywhere you and your baby may go. Take these steps to keep your baby as safe and secure as you can. ONLY LET FAMILY AND LONGTIME FRIENDS CARE FOR YOUR BABY Be aware of strangers who seem to want to help with your baby. Never give your baby to someone you don t know, or know only slightly. It s best to have family and longtime friends baby-sit your baby. Ask for references of anyone you plan to hire as a baby-sitter. CHECK HOME VISITORS FOR ID BADGES Any health care worker who comes to see you should be wearing an ID badge showing the person s name, picture, and the official logo of the facility. Do not let anyone into your home until you are sure that the person is official. Call your health care provider before letting the person in your home if you re not sure. KEEP A PHOTO OF Your BABY As a precaution, take at least one color picture of your baby (full front view), and put together a complete written description, including your baby s weight and length, plus hair and eye color. PAGE 9

PEDIATRIC CARE AT BAPTIST HEALTH SYSTEM Next Level Pediatric Care Inpatient and Outpatient Pediatric Services are offered at the Baptist Regional Children s Center located at North Central Baptist Hospital Dedicated Pediatric Emergency Room at North Central Baptist Hospital, Kids Care pediatric emergency care at Northeast Baptist and coming soon at Mission Trail Baptist Hospital Comprehensive pediatric specialist coverage: ENT, Nephrology, Neurology, Orthopedic Surgery, Pulmonology, Radiology, GI, Cardiology, Endocrinology, and Infectious Diseases Dedicated Pediatric Surgery and Anesthesia Specialized Pediatric Sedation Unit including nitrous oxide technology and certified nurses Pediatric Intensive Care Unit and Inpatient Pediatric Hospitalist coverage Pedi Q Outpatient testing and treatment Strong roots, Powerful future As a pediatrician, I want the best for my patients and their families. I can always count on the Baptist Regional Children s Center at North Central Baptist Hospital for excellent, comprehensive care. Plain and simple the pediatric care at North Central Baptist is second to none. It s where I would take my family. melanie Mitchell, MD, Pediatrician & former Chief of Staff at North Central Baptist Hospital PAGE 10

Mother & Baby Care: Parents Resource List There are hundreds of agencies and organizations that offer new parents information, support and answers to your most pressing parenting questions. The following are just a few: American Academy of Pediatrics The AAP offers dozens of free brochures with information on topics such as toy safety, allergies and diaper rash. (800) 433-9016 or aap.org American Red Cross The Red Cross provides comprehensive information about health and safety. (202) 303-4498 or redcross.org/services/hss Consumer Product Safety Commission The Commission provides recorded information about product recalls; consumers can also file reports about unsafe products. (800) 638-2772 or cpsc.gov Depression After Delivery, Inc. A non-profit organization whose mission is to raise awareness about mood and anxiety disorders surrounding pregnancy and childbirth. (800) 944-4773 or depressionafterdelivery.com International Lactation Consultant Association This organization helps families find a certified lactation consultant in their communities. (919) 861-5577 or ilca.org La Leche League Offers support and information for breastfeeding mothers. (847) 519-7730 or www.lalecheleague.org March of Dimes National voluntary health agency whose mission is to improve the health of babies by preventing birth defects and infant mortality. (888) 663-4637 or marchofdimes.com National Organization of Mothers of Twins Clubs Network of local clubs that promotes the special aspect of child development related to multiple birth children. (877) 540-2200 or nomotc.org National Safe Kids Campaign Dedicated to preventing unintentional childhood injuries. (202) 662-0600 or safekids.org Newborn Screening Program State program that identifies infants who have certain serious birth defects to assist with early treatment and prevention of complications. (800) 422-2956 ext 2129 or tdh.state.tx.us/newborn/why_new.htm Parents Without Partners International nonprofit organization dedicated to single parents and their children. (561) 391-8833 or parentswithoutpartners.org Also, visit the Conditions and Diseases - Pregnancy and Childbirth section of An alphabetical listing of conditions related to pregnancy and childbirth. This comprehensive listing is physicianreviewed and reflects the most current, evidence-based information by reputable sources. Relevant sources are provided for each fact sheet. Other Helpful Numbers and Websites: PAGE 11

Mother & Baby Care: Notes PAGE 12