What to know if you must give birth in the ER

Because I’ve written about it before, I won’t talk about Bonner General Health’s closure of the Labor and Delivery Department today. What I will tell you about is what happens when you need to deliver in the Emergency Department.

To help me explain this somewhat rare occurrence – only six deliveries of seven babies happened in the ED this year – I’ve enlisted the help of Emergency Department Manager, Ryan Kerouac, RN, CEN. First, I wanted to know what typically causes a woman to deliver in the ED?

“The most common reason we deliver babies in the ED is when labor progresses so quickly that the mother is unable to reach her planned delivery hospital before the baby is born. In our area, this often occurs when a mother who lives north of Sandpoint begins labor and starts traveling but progresses more rapidly than expected and is unable to make it to her destination safely.

“In those situations, she may come to our ED, where we are prepared to assist with the delivery and provide immediate care for both mother and newborn. Our staff is trained to respond to these situations, provide immediate care and stabilization, and coordinate any additional services or transfers that may be needed for the mother or newborn.”

As for preparedness, Kerouac said that the emergency department staff have undergone extensive training and earned certification in specialized areas. For instance, PALS (Pediatric Advanced Life Support) focuses on the recognition and management of critically ill or injured infants and children, particularly those experiencing respiratory or cardiac emergencies.

NRP (Neonatal Resuscitation Program) provides specialized training in the assessment and resuscitation of newborns who may have breathing or heart-related complications at birth.

“S.T.A.B.L.E. is the newest certification our ED nurses have begun completing since the closure of the BGH OB unit,” he said. “The program focuses on the care of newborns during the first few hours of life, including temperature regulation, airway management, blood sugar stabilization, and the identification and initial management of common neonatal conditions and birth-related complications.”

Kerouac said that “beyond individual certifications, BGH was the first Critical Access Hospital in Idaho to receive Pediatric Readiness Certification. This designation was awarded based on our demonstrated ability to care for pediatric patients, including our staff training, specialized pediatric equipment, and commitment to pediatric emergency preparedness.

“Our primary role in pediatric and newborn care is stabilization. We are trained to rapidly assess, treat, and stabilize infants and children who present to the ED and then arrange transfer to the most appropriate level of care when needed.”

I was curious if there were any special resources or pieces of equipment now in the ED that previously were in the OB department? He told me that the answer is “several.”

He said, “One of the most important pieces of equipment is our infant warmer, which provides a controlled environment for newborns immediately after birth, particularly if they are having difficulty transitioning to life outside the womb. We also have the specialized equipment associated with neonatal care, including oxygen delivery systems, airway management equipment, and supplies needed to assess and stabilize newborns.”

Kerouac credited BGH’s partnership with Life Flight Network as one of the most critical resources. Not only do they ensure newborns who require a higher level of care are safely transferred to the proper facility, they also play an important role in BGH staff’s ongoing education and preparedness.

“This combination of specialized equipment, ongoing training, and access to expert neonatal transport services helps ensure that we can provide immediate, high-quality care to newborns and mothers who present to our Emergency Department,” he said.

“The ED team at BGH is committed to continuous improvement. We are constantly evaluating our processes, refining our skills, and looking for ways to provide the best possible care for our patients.

“Most importantly, if a baby is going to be born before a mother can reach a hospital with obstetric services, it is far safer to deliver in an ED staffed by trained physicians and nurses with specialized equipment than in the back seat of a car or in an uncontrolled environment. We are proud to provide that level of emergency care and preparedness for our community.”

Kathy Hubbard was a charter member of Bonner General Health Foundation. She can be reached at [email protected].