With Texas by some accounts leading the nation in maternal deaths, Christus Health and The Children’s Hospital of San Antonio aim to lower mortality rates in mothers and newborns, officials said.
Christus Health has embraced a Texas legislative requirement for the Maternal Levels of Care Designation – identifying ways to minimize such tragedies, while also improving fetal/newborn health.
“We have in place all the things that should give people peace of mind such as reducing hemorrhaging, maternal fatalities and more. Smaller hospitals may not know how to handle those issues. We’re prepared to handle high-risk moms,” said Cris Daskevich, CEO at The Children’s Hospital of San Antonio and senior vice president of maternal services for Christus Health.
The World Health Organization estimates about 830 women globally die from pregnancy or childbirth-related complications daily. Though the number is decreasing for most developed nations and improving in many developing ones, it has risen in the U.S., experts said.
Registered nurse Anna Heimbecker knows firsthand the risks of pregnancy. She was diagnosed with intrauterine growth restriction, or IUGR, at her 20-week OB-GYN appointment in San Angelo, where she lives. IUGR is a condition in which a baby doesn’t grow to normal weight during pregnancy. Birthweight may be 90 percent below what would be expected.
Heimbecker’s blood pressure was high and prospects for a successful delivery were threatened, as was her life.
The doctor recommended The Children’s Hospital of San Antonio Center for Maternal and Fetal Care, part of Christus Health’s expanded commitment to help pregnant women and their unborn babies overcome various medical concerns.
Peter Nielsen, obstetrician-in-chief at The Children’s Hospital, said, “Hospitals are having to work to bring together teams of people who are not just taking care of pregnant patients specifically, but having to integrate care of those physicians with other specialties – medical and surgical – that can focus on coordinated care of complex maternal medical and surgical conditions.”
He added, “Generally, maternal care has been seen as a silo — nonphysicians and other providers have been uncomfortable caring for pregnant patients. People that care for pregnant patients enjoy the complexity of dealing with two or more patients in one.”
The ultimate goal is providing the best possible support for mother and child under the maternal-care designations, created in March 2018 after state approval, officials said.
“Pregnant patients are a vulnerable population,” Nielsen said. “This new approach to maternal care will force a collaboration in caring for women who have complex medical and surgical conditions and improve their outcomes,” Nielsen added. “We’re looking at a coordinated system involving cardiology, pulmonary/critical care, hematology, gynecologists, surgeons who care for pregnant patients, neurology and more specialists. They all come together to meet our patients’ needs.”
A Christus Health team of maternal-fetal medicine specialists, obstetrician hospitalists and neonatologists quickly examined Heimbecker. She was admitted for observation due to preeclampsia and other issues.
According to The Mayo Clinic, preeclampsia occurs when previously normal blood pressure suddenly rises. The result could be serious, even fatal, complications for both mother and baby.
Charles Hankins, chief medical officer and neonatologist at The Children’s Hospital of San Antonio, said, “Our teams do a lot of training and simulations to address the issues facing pregnant patients. We think about what do we need to do today for the patient, versus in the future.”
On May 7, 2018, Heimbecker’s daughter, Katherine, was delivered at 25 weeks, six days, some 3 ½ months early. She weighed only 11 ounces, roughly the size of a soda can. Heimbecker’s size 4 wedding ring fit on Katherine’s tiny foot.
During five months in the neonatal intensive-care unit, doctors said the infant experienced very few struggles, and now, Katherine has no complex medical conditions related to her premature birth.
The positive results for mom and baby underscore Christus Health’s commitment to enhancing treatment and outcomes in maternal care, officials said.
“Most pregnancies should be a happy life experience,” Daskevich said, “but we know there is a small percentage that are at high risk for having bad things happen. What we want to do is offer high-risk moms a more confident picture than they may have been used to.”
He added, “At the end of the day, it’s about saving lives.”
Today, Katherine weighs about 10 pounds.
“I am literally amazed at Christus Health. As a nurse, I have high standards for my care, especially when it comes to my children. They blew me away, from pre- and postpartum, the work in the NICU all added up to phenomenal care,” Heimbecker said.
“Christus Health saved Katherine’s life and most likely mine, too,” she added.