The following interview has been edited for clarity and length.
What types of changes, if any, are being made to help St Joe's absorb the additional births after Mad River's birthing center closes, will there be more staff hired, more rooms added?
Park: Something that I think has gone really well with this so far is that Mad River has been really open and forthcoming with information, so we're meeting with them on a regular basis to find out exactly what to expect. And we've also been meeting with open door and united Indian Health Services to find out how many patients we should be able to expect from them, what types of patients, what we should look for, to prepare for. And I think that it has been a really good community collaboration. I'm really proud of the work that we're doing in that space. And then, with that information, Michelle's been really including her bedside teams in problem solving and coming up with a plan. We keep saying that we need a short term plan and a long term plan. So we gotta figure this out for next month, and then we'll see what that looks like. And then, you know, we'll talk about a long term plan later.
Harrison: So like most organizations, we've already prepared a search plan so that that plan has been in place for a long time. In case we did go over our bed capacity, we already had a plan in place. So part of what we're doing is just solidifying that plan and making it a little more formal and a little more permanent. So as Sarah said, we are engaging our bedside caregivers because they're the ones that deliver care, and they know best how to deliver care. So we're organizing extra rooms on a floor, one floor up from the childbirth center, to provide space for postpartum moms. We already have about around 60 caregivers in the childbirth center, but we are looking at staffing levels and see how we can increase those as needed to support the volume that we are expecting to get.
I understand that a big part of why other birthing centers have closed is because of a drop in the rate of births over the years. But what about if that changes again? I know we can't predict the future, but what considerations are being taken related to increased births, particularly with the expected growth in our area's population in coming years?
Park: Yeah, these conversations are funny, because we look at it as an average over the year, right? So we're like, it's going to be like, 30 patients a month, but some months that might be 40 patients, and some months that might be 15, right? So we have an average, but we're preparing for the ebbs and flows.
Harrison: Yeah, we expect somewhere between 25 and 30 extra births a month.
Park: We just reviewed,like our strategic plan as a team. And it really shows that birth rates are declining across the country, like people are just waiting longer to have babies or having less babies. And so I don't really know that we can say that it's going to go up just because our population goes up. I do think that we'll have to adjust, we do have space to adjust, as far as our postpartum moms go. And hopefully, if we had some huge growth in babies that need to be delivered, some of our other local facilities would be able to pick that up again. Moonstone Midwives has their birthing center, and there's a lot of movement in the country to allow more moms to deliver at birthing centers. So I think one of the issues that open door has talked about a lot is that there's inequity in insurance coverage, right for what your insurance will cover and where you can deliver. So for example, like Partnership won't pay for a woman to deliver at a birthing center. So we need to look at that as a country and a community, on what inequities exist for choices for moms, and how we can address that.
I know many of our areas, medical facilities and staff, already work together a great deal to coordinate prenatal and labor and delivery care. Could you talk a bit about how different agencies are working together to make this transition possible?
Harrison: So we're constantly in open communication. They're giving us data of how many patients they're going to have to deliver in the next so many months. And so it gives us some idea of what we need to prepare for, yeah, and in there, also giving us data on the patients that we're planning to deliver at Mad River. Because we already have a relationship with them. They do deliver some of their patients here at St. Joe’s currently, but understanding how many patients they have that are planning to deliver at Mad River has really helped us in our planning.
Park: Yeah, and there's like, the data sharing aspect, which is what Michelle was just speaking to. They're really just openly sharing what they know so that we can plan appropriately. But then it's also stuff like they are helping promote our open house. So people that are planning on delivering at Mad River, we want them to know that they can come here, that we're gonna have space for them. We want them to come see their rooms and understand what it's gonna be like for them. So they're helping us promote that.They're handing out flyers, they're helping us make sure that our community feels safe. You know, the last thing we want is for pregnant moms to feel like, “Oh my gosh, it's not going to be safe for me, or I'm going to be delivering on the side of the road or in the parking lot” or whatever. And we want them to know that that's not what's going to happen, and for them to be able to come see that their doctor already delivers here. It's not like their doctor was only delivering at Mad River, and this is what the room is going to look like, and this is who your staff is going to be.
I can only imagine this is most distressing for the families who are currently in prenatal care, especially if this is their first time giving birth. Can you speak to how the parents are being made to feel comfortable about the change to their plans and what types of resources are available to them?
Harrison: So we do offer free childcare classes, and those are published on our website. We have expanded we offer a monthly tour of the chopper center, but I know that we have expanded that and offered several sessions from now to the end of the year, several extra sessions, and these are nurses that are doing the nurses doing the tours, also do the childbirth classes and work on the unit. So they are really a good source of information for incoming parents. They know our practices. They work with our patients. So I think it helps to alleviate some fears when they are available to talk to.
Park: Michelle's team, our bedside nurses, sponsored a lactation booth at the Humboldt County Fair, and this announcement came out during that time. So they were kind of bombarded at the fair with people just like coming in to ask them all these questions, and they handled it so well. And I think it does comfort the community when it comes from the bedside nurses. But I'm giggling a little bit because we're trying to gauge how it's going. And we're like, reading comments on Facebook. We don't know where to get that information. Like, are we getting our message out there? We really want people to know that they can come here. We're going to meet them where they are, as Michelle said, And that we're going to provide a safe space for them to go through this experience.
Harrison: It’s very important for us to meet patients where they are and to give them the birthing experience they need. So that's the other reason we wanted to have an open house so they could come into our argument. They can come and talk to leadership. Leadership will be there and of the chopper center. And they also can come and talk to some of our nursing staff. We're very supportive of giving them the birth experience that they would like. And I think sometimes when you think about coming into a hospital, it seems very “medicalized,” if that's a word. And we offer all kinds of options, we're going to support you in your birthing journey. We want the community to know that we're going to take care of them. We're going to meet this challenge, because that's what we do, right? And we're going to support them on their birthing journey and get them what they would like.
And what about concerns from the staff? The Lost Coast Outpost article that came out about the Mad River birthing center closure did quote a nurse, who chose to remain unnamed, but at least that person seemed to have big concerns about taking on the additional volume of births. Can you speak to that?
Harrison: Losing any healthcare in the community is a sad time, right? I mean, it is, and I know it's a loss to this community to lose the OB services at Mad River, and we recognize that, and we appreciate that. And there may have been some initial concern about taking on the volume, but I think now that we've sat down, we started the planning, I think people are very comfortable with the plan that we have in place and are feeling like we're going to meet this need. We can do it. We've got lots of support from senior leadership here in the organization to do whatever we need to do to meet the needs of the community.
Is there anything else you want to add that you feel we didn't cover, or a last message you want to get out to the community?
Park: Something we didn't cover is that we are also talking about short term and long term. We're also working on increasing our outpatient services for moms and like, we know that this is going to affect other services that we have, and so we are looking at the big picture and how we can, you know, provide more outpatient services for pregnant moms.
Harrison: Our classes are published on our website, so we definitely recommend that they get on there, sign up for our classes. That includes a tour. But there are also tours that are published on our website. There’s a number there to call. It will go to a voicemail, but my childbirth educators are really good about calling people back if they have questions or concerns. And I really highly encourage people to come to our open house. We are doing an open house in preparation of the November 1 closing for those mothers that will deliver with us that had plans to deliver with Mad River. That's the demographic we're really targeting. But anybody's welcome to come, and part of that will be a tour within that. We do monthly tours, but we're going to do a special open house. It is September 28th and it's from 11 to 2.
