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Health Information Giving Babies a Great Beginning

The next generation of obstetric and neonatal care is here.

A cry, a breath — and so it begins.

A baby is born — wet and a little cold but hardwired to shift from the warmth of mom's womb to breathing, eating and thriving independently.

Newborns aren't on their own, of course. In the first 20 minutes of life, they're the center of a lot of attention. And according to Robert Kimura, MD, a neonatologist at Rush University Medical Center, the attention babies get in the delivery room sets the stage for the rest of their lives.

That's why Rush brought its labor and delivery, neonatal, and obstetrical surgery services together on one floor.

Those first 20 minutes

Most babies take their first breath just seconds after birth. "With that breath, the baby's blood vessels open, and you suddenly have blood flow to the lungs," Kimura says. "The newborn is now taking in oxygen and getting rid of carbon dioxide."

That exchange is key because every cell in the body needs oxygen. "If a baby doesn't get enough oxygen, those cells can be injured," Kimura says. "And that can mean a lifetime of problems, from learning disabilities to cerebral palsy." Fortunately, most newborns begin breathing just fine.

A baby's first breath is quickly followed by a first cuddle. Most full-term babies born at Rush are snuggling on their mom's chest within moments. This helps stabilize the baby's temperature and is also a chance for the baby to nurse for the first time. Mom's milk hasn't arrived yet, but her breasts contain colostrum, which provides many protective factors and all the nutrients and fluid a newborn needs.

Soon after delivery, the medical and nursing staff is assessing not only baby's breathing, but heart rate, muscle tone, reflexes and skin coloring as well. The results — the Apgar score — tell doctors whether an infant needs additional medical attention. At five minutes old, most newborns score above seven (out of 10), which means they're adjusting well to life outside the womb.

That's the beginning every mother-to-be imagines, and it's what happens for most full-term babies. However, for the small percentage born prematurely or with a medical problem, doctors who specialize in treating newborns — neonatologists — intervene. At Rush, that intervention takes place on the eighth floor of Rush's hospital, the Tower, in the new, specially designed Rush Family Birth Center.

The beginning of a new model

During the planning stage for the Tower, Kimura and his colleagues had a rare opportunity: to create the optimal obstetrics, labor and delivery, and neonatal intensive care unit (NICU) facility. Based on their years of experience, that meant making sure the best staff and the most advanced equipment were together, in close proximity.

On the Tower's eighth floor, the center's new labor and delivery rooms, with their large windows, city views and natural light, have all the necessities and amenities to support mothers during labor, including birthing balls, showers and help with pain management. And if a baby needs additional care, neonatologists, surgical operating rooms and the NICU are just steps away.

This provides the ready availability of needed staff in those unpredictable occasions when a baby needs help at birth. In this way, the dream-come-true space Kimura and his colleagues designed departs from a set-up that's common in many hospitals, where the NICU may be a few floors away — or even across town.

After delivery, families move across the sky bridge to the mother-baby unit on the Atrium's eighth floor. Newly renovated suites offer privacy for quality time together. "The mother-baby unit has space not only for babies and moms, but also for dads, siblings and other family members," says Kimura.

Kimura believes the Rush Family Birth Center is a model for the next generation of obstetric and neonatal care in hospitals. "When people see it, they often say, ‘Why isn't everyone doing this?'" Kimura says. "Our hope is we'll be copied. That would be a great compliment — but even better, it would mean more babies and moms receiving optimal care."

Spring 2014

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