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Health: Mother and child are doing fine

By Jason Lesley
Coastal Observer

Nurses check Lucy’s pulse as her labor pains intensify and she begins to complain about pain.

“How much longer?” asks Lucy, her feet in the stirrups of a delivery table with a half-dozen doctors and nurses watching. Lucy’s chest gently rises as she breathes. “Tell me what to do,” she demands. “Ohhh! I can’t do that.”

The nurses know she can.

Laboring Lucy gave birth 18 times last Friday at Waccamaw Community Hospital. Life-sized anatomical human models called manikins, Lucy and her baby, Hal, are part of SimCOACH, an educational operating room on wheels owned by Palmetto Health Systems and the University of South Carolina Medical School and leased for two years by the South Carolina Department of Health and Human Services for $1.1 million. It will visit all 45 of the state’s birthing hospitals to offer training with a goal of reducing the number of Caesarean sections performed on first-time mothers. The truck is scheduled to visit Georgetown Memorial Hospital later. Monty Robertson of the state Department of Health and Human Services said Lucy is a $75,000 machine that will save millions in medical costs. “She births, cries, bleeds, the whole nine yards,” he said. “Our main goal is to improve the health of moms and babies throughout the state.”

Mary Ernst of MUSC’s outreach educational department is Lucy’s voice. She watches from a control room and speaks into a microphone. “Am I going to die?” she asks during the simulation of a shoulder dystocia, where the baby’s shoulders are wider than the birth canal, and postpartum hemorrhage.

Cassandra Minzler, Waccamaw Community Hospital’s labor team leader, said the training started with a regular vaginal delivery without complications and proceeded to difficult births producing a baby needing full resuscitation. Nurses carefully weigh Lucy’s blood loss in order to recognize hemorrhage. “We want to improve our quality of care so we can improve the quality of care for the community,” Minzler said. The simulation is videotaped and reviewed immediately in the truck. “The best learning environment is a controlled environment,” Minzler said. “When you learn to do it in a controlled environment, you will respond better when it gets chaotic.”

Nurse Beth Marion said the experience allowed the participants time to ask questions during the procedure. “We can ask what do you recommend we do differently,” she said, “or we can go back and watch to see what we did wrong that we can do better next time.”

Dana Kiser, Waccamaw Community Hospital’s director of Women’s and Children’s Services, said the training would benefit those caring for babies too. In addition to nurses working in the delivery room and nursery, obstetricians and pediatricians took part and worked with the fetal medicine and neo-natal staffs of MUSC along with a member of the helicopter crew that transports newborns. When infants need more care than Waccamaw Community Hospital can provide, they are airlifted to MUSC. “Infants in distress with that type birth experience have to have special care and immediate monitoring,” Kiser said. “The doctors rearranged their schedules to take part. It’s that important.”

Waccamaw Community Hospital has emphasized procedures and facilities for new mothers and infants and was certified as the state’s first “Baby Friendly” hospital and the first accredited as a “Child Birth Center of Excellence.” Kiser said Waccamaw has fewer C-sections than the national or state averages. “We are very proud of that,” she said. “We are going through these scenarios so we can be better equipped to meet those emergencies. Thankfully, they don’t happen every day, so the more practice we get, the better.”

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