Family Finds Comfort and Safety During Delivery at SMCH

Dr. Derek Duncan, Glenna, Ruth and Adam Nockels and Dr. Susan Hornback revisit the day Ruth was born in a delivery room at SMCH nearly a year ago.

Dr. Derek Duncan, Glenna, Ruth and Adam Nockels and Dr. Susan Hornback revisit the day Ruth was born in a delivery room at SMCH nearly a year ago.

After enduring the heartbreak of two miscarriages, Glenna and Adam Nockels who live near Carroll, took the advice of their doctor who suspected the miscarriages were caused by a chromosome mutation that increased the risk for blood clots. Glenna began a regimen of blood thinners and folic acid and became pregnant for the third time.

By her account, Glenna’s pregnancy was smooth, a relief to the psychotherapist and her husband who raises naturally grown, chemical free fruits and vegetables. Throughout the pregnancy she and Adam had devised a birth plan documenting their preferences for such things as how to manage labor pain. The couple wanted a natural labor, without medicine to relieve pain or induce labor. When her original physician was not very receptive to their wishes, the Nockels opted to look elsewhere for prenatal care. “I received recommendations from family members for Dr. Susan Hornback, a board certified family and obstetric provider at Stewart Memorial Commnity Hospital in Lake City. Adam’s mom even checked www.healthgrades.com which is a website that helps consumers choose a doctor, dentist and hospital facilities.” Dr. Hornback received high marks from her patients in terms of the level of trust they had in her medical decisions and how well she listens to her patients.

At 28 weeks into her pregnancy, Glenna met with Dr. Hornback. “I was nervous about changing doctors this far into my pregancy, but she was very reassuring. She was open to our birth plan and our preferences. She tried to find a balance with what was medically safe and my needs as her patient.” One necessary compromise addressed Glenna’s fear of needles. “I wasn’t crazy about the idea of an IV. But Dr. Hornback explained that it was hospital policy for OB patients to have an IV because of the risks that exist during delivery. I appreciated that she took my concerns seriously and educated me about the necessity.” During the first visit Dr. Hornback helped manage Glenna’s anxiety by being compassionate and understanding. “She made us feel very comfortable and very confident in her skills,” remembers Glenna. “After that conversation we felt we were in the right place.”

During the pregnancy, Glenna was impressed by Dr. Hornback’s availability. “At our prenatal visits, she took the time to answer our questions, not just relying on her nurse to answer them, though her staff was very knowledgeable,” recalls Glenna. The couple communicated their wishes on the birth plan to a very receptive Dr. Hornback. Included on the plan were their wishes to not be medicated or be offered pain medication during delivery as Glenna desired to use deep breathing and mindfulness to help manage pain. Additionally, the couple wanted to delay cutting the umbilical cord for a few minutes after giving birth. A new study suggests that waiting a few minutes to cut the umbilical cord can help newborns receive an influx of nutrients from the cord blood that can benefit their health even months later.

At 2:00 am on Monday, April 7, 2014, Glenna started to feel contractions. The couple decided to drive to the Lake City hospital at 6:30 am as soon as the contractions were five minutes apart. After checking Glenna’s labor progression and knowing they wanted to labor at home where she was most comfortable, the OB staff at SMCH advised the couple to go home where they spent the remainder of the day until 5:30 pm. “We returned to the hospital around 5:30 when my contractions were consistently five minutes apart. The nurses evaluated my progress and monitored the health of the baby. My water broke around 7:30 and in just 15 minutes I was ready to push. The nurses really helped keep me motivated and comfortable with helpful suggestions for managing my pain and staying focused. I was so relieved to know I had their support all the way.”

Throughout the delivery, Glenna vividly remembers the obstetric nurse who was at her side. “It was chaotic with lots going on, but nobody acted stressed. Tracie Winans was in control the whole time. She was very respectful and encouraging. I remember her telling me I only have to get through one contraction at a time,” Glenna smiles. “She made the whole process very manageable.” Additionally, Adam was impressed by the professionalism of Jenni Macke, director of OB at SMCH.

An initial hesitation for the Nockels in choosing SMCH was that the obstetric doctors work on a rotating schedule. It was not guaranteed that Dr. Hornback would be able to help with the delivery. However, when Dr. Derek Duncan was called in to help on Dr. Hornback’s day off, any anxiety the Nockels’ had disappeared. “Dr. Duncan was extremely calm and very reassuring. He knew our birth plan. It had been well communicated to the entire team,” comments Glenna. “There was great teamwork between the two physicians. He was on the phone with Dr. Hornback, working with her from a distance.”

Dr. Hornback was traveling to get to the hospital in time for the delivery. But when she was told Glenna had delivered, she turned around and went home, knowing this family was in capable hands. She explains, “With the partners I have in Dr. Duncan and Dr. Adam Swisher, I never have to worry about my moms. Our practices are so similar I know our patients are getting awesome care. We are all huge proponents of natural care with as little intervention as possible while still making the experience the safest and most comfortable as we can.”

At 9:16 pm, Dr. Duncan announced to Adam and Glenna that their baby girl, Ruth Elsie, was born. Taking advantage of the first few minutes with skin-to-skin contact between the baby and the mother, vitals were taken at that time. According to the International Breastfeeding Center, “There are now a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby’s temperature, heart and breathing rates are more stable and more normal, and the baby’s blood sugar is more elevated. Not only that, skin to skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases.” When all the blood had left the umbilical cord, Dr. Duncan gave the tools to Adam to allow him to cut his baby’s cord. A few minutes later, the OB staff made use of the Panda Warmer to take her weight and clean her. The healthy baby girl began nursing in the first hour after her birth.

The Nockels were impressed with the lactation support at SMCH. Sara Thorkildsen, RN, worked with Glenna and Ruth during their stay in the hospital, to help with breastfeeding. At their one week checkup, they met with Andreau Kramer, LPN and certified lactation consultant. “I found Andreau to be very encouraging. She was always available when I had questions. I met with her twice and she was able to correct Ruth’s latch and help me nurse comfortably. Now we have been successfully nursing for ten months and so grateful we had her encouragement to keep going during the more difficult start!” says Glenna.

One important attraction to switching doctors for the Nockels was that they could continue seeing Dr. Hornback after Ruth’s birth. “Our initial physician worked strictly with obstetric patients. Dr. Hornback, on the other hand, works in family medicine, making it possible for us to continue as her patients. We’re very comfortable with her and trust her medical expertise in the care of our family,” comments Glenna. “Dr. Hornback and staff supported what I wanted in the most positive way while keeping me and my baby safe. They empowered me to make decisions regarding my care.”