BROOKINGS Every year, hundreds of newborns cry out for the first time as they take their initial breath of air in Brookings, due in no small part to the popularity of the pregnancy, labor and delivery services provided by the physicians, nurses and doulas in Brookings Health Systems obstetrics unit.
Since I took (on the) director role, which is about three years ago, weve grown about 20 births a year, OB Director Michelle Sand told the Brookings Register. The last three years have been our biggest years yet, and I think that’s going to be the same this year we should be over 400.
Summer is the busiest childbirth time for the hospital, with women coming from not only Brookings, but many other communities including Huron, De Smet, Madison and Flandreau as well. Sand said there was even a woman who came all the way from Chamberlain for pregnancy care in Brookings.
I think it does show that, you know, you break a leg, youre going to go to your nearest hospital, she said. When its obstetrics and you can plan and you want that certain birth, you can shop around for a provider that fits you really well, or a facility that fits you well, or the culture of the facility that can really fit you well.
Brookings offers a multitude of options, including support for physiologic birth, VBAC vaginal birth after a Cesarean services, along with shared decision-making with patients. A full listing can be found online at https://tinyurl.com/bdcmeh22.
Sand also mentioned that while South Dakota doesnt have the highest birth rate because of its less-than-one-million population, it does have the nations highest fertility rate.
So, there are some areas especially in our area that have very high fertility rates, she said. In those rural areas we will pull from not just Brookings County, but outside counties as well.
That certainly would be another factor in why having babies at the hospital in Brookings is so popular. Throw in some other benefits, such as having an eight-bed maternity unit with five of those beds being labor, delivery, recovery and postpartum suites which are fully equipped to accommodate the entire LDRP process in a comfortable atmosphere and its sort of the cherry on top of the cake.
Multiple challenges
Sand noted that while Brookings and other communities in the region are still well-served by their hospitals pregnancy, labor and delivery services including Madison, Pipestone, Watertown and Huron thats not necessarily the case where maternity deserts are popping up. One of those is in Sisseton, after the hospital eliminated its services. Its produced something of a domino effect that’s visible in Brookings.
Especially with Sisseton closing, Watertown will see more of those patients and then some of Watertowns patients are now coming here because of that … offload of patients, Sand explained. In our area of the state (maternity deserts are) not as prominent, but in other areas of the state its definitely much more.
A nursing shortage is another challenge that faces Brookings, but it isn’t alone as it tries to find solutions to a problem thats nationwide but more pronounced in rural areas.
I would say thats our biggest, Sand said, adding that obstetrics is a specialized portion of nursing, so it does take extra training and orientation to ensure that the nurses are very good to provide that care to patients.
She pointed to another concern, but a smaller one: The proximity of Brookings to the behemoth known as Sioux Falls.
Another, I wouldnt say struggle, but another area is we are really fairly close to Sioux Falls, where they have a lot more specialties, Sand said. There are some great things with that as well, but some people will desire that just for the specialties or the NICU care. But again, like I said, some people choose our size for the more personalized care, even though we dont have all those specialties, we still have them at our fingertips if we need them.
Services, staff important
Challenges aside, the obstetrics unit in Brookings has a plethora of strengths in its quiver as well.
Hands down, our strengths are providing that personalized care to each patient, Sand said. We are kind of in the sweet spot, I feel like, for size were big enough where we do those emergencies often enough to feel that we can do it really well. We can provide VBACs, we can provide different specialty things, but were also not too big where we dont lose that personalization so, really making sure that we can give each person that specialized care, the time they need, to have that birth that they really want.
She likened it to the Goldilocks Zone not too hot, not too cold.
I really feel like we are just in that good spot to provide both areas, or both balances, Sand said.
Those positives are further empowered by a more-than-capable staff:
- Three OB-GYNs that deliver infants.
- Ten family practice physicians that help care for the babies afterward.
- An obstetrics nursing staff that totals about 25 and is a mix of full- and part-time personnel.
Sand said one thing that makes a really good OB nurse is that they really value a home-life balance.
We have a lot of part-time staff, she explained. They can work two shifts a week which would be part time, 12-hours shifts but then still have that home-life balance as well.
Doulas are also a key part of the obstetrics team, Sand said.
Our job here the obstetricians is to take care of the mom; the nurses also take care of the mom and the baby and really making sure everyone is healthy, she said. The doula is primarily just that support person. They can help other support people in the room by leading them say, its the father maybe, leading them in the best way to support the mom. A doula is a very integral part of the team, both prenatally and post-partum as well.
Sand continued, Theres a lot of data that shows that they help prevent certain risk factors, preterm birth, C-sections and also post-partum depression, which is a big thing. So, the more we can support that family, the more we can prevent those issues even up to a year post-partum.
The hospital has a doula program, she added. There are six doulas affiliated with the hospital in addition to community doulas that patients hire privately.
We would welcome anyone to our doors, but we have certain ones that want to partner with us in order to really form those relations, which I think is very beneficial, Sand said. We have good relationships with those doulas, and then the moms team can be just even a little bit more supported that way.
The doula coordinator at the hospital is Victoria Wakeman. Shes also a doula instructor and holds classes at the hospital to train new doulas.
Rewarding aspects, funny moments
Its probably fair to say that childbirth is almost undoubtably an intense experience for women and perhaps even mystical for some.
I think birth is definitely a space that it is our privilege to be in, and so I would say the rewarding aspects are obviously, ultimately, we want a healthy mom and a healthy baby. That is hands down what we want, but at the same time we really want people to have the birth that they want, and being able to help them succeed in that, Sand said.
She continued, Whether that means they want a C-section, that is OK if that is what they want. Whether they want a natural birth. Whether they want an epidural, to breast feed, to bottle feed. Really, just knowing that its not a one size fits all for that birth and making sure that they get that birth that they want ideally to the best of our ability would be the most rewarding.
There are also more light-hearted moments during the childbirth process sometimes including a baby whos in a hurry to enter the world or a soon-to-be fathers thoughts about birth and how it relates to farm life.
Sand laughed a bit, then grew quiet as she contemplated her experiences.
Sometimes the most unexpected thing would be those really fast labors that come in and maybe the doctor can make it here, maybe they cant, she said. Sometimes that would be the most unexpected funny.
Sand also brought up some of the fathers reactions, especially when they compare their partners birth process to that of cattle giving birth.
I know I’ve made the comment before because theyve said, Cant you just pull them out? And I said, Well, you know, cattle come out like this Sand made a motion theres a handle, you can grab the hooves and pull them out. (Humans), theres not a handle, they dont come with a handle.
She said the hospital has also had its share of expectant mothers coming off Interstate 29 to give birth they might have intended to have their baby in Sioux Falls or elsewhere, but their labor went faster than anticipated.
Our doors are always open, Sand said.
Birth preparations
From start to finish, a typical pregnancy lasts 40 weeks. During that time, Sand said education is critical for any expectant parent, but especially those who will be having their first child.
(Make) sure its evidence-based, high-quality education, she noted. You wouldnt prepare yourself for a marathon without working out or being prepared for it, so kind of thinking of birth as that as well. We need to prepare our minds for that space, our bodies and so just that preparation, I would say, would be very key.
Sand also recommended being open-minded. Again, ultimately, our goal is a healthy mom and healthy baby and then the birth that you want (to) the best of our ability, but not every single thing is always 100 percent, she said. Really, just being open to shifting those birth preferences if needed to get the birth that you want to the closest that you can.
In closing, she recommended that people check out the website for Brookings Health System to get a complete rundown on what obstetric services are offered. Its found at https://tinyurl.com/bdcmeh22.
We offer VBACs, shared decision-making (and) we room-in our babies can be in the room with their mom all the time, Sand said. We really take care of the mom and baby as a couplet and not as an individual, and so I think thats really important.
She also suggested that people who are considering pregnancy, or who are early in their pregnancy, call BHS and schedule a tour.
I think sometimes just seeing the space and seeing where you would give birth can really help you decide, so feel free to give us a call to come in for a tour any time, Sand said.
Contact Mondell Keck at [email protected].
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