No matter what maternal or fetal complications may arise during pregnancy, labor or delivery, the Kienzle Family Maternity Center at Crouse Health has the technology, infrastructure and expertise to provide expedient, high-level, compassionate care.
For referring physicians throughout the region, the comprehensive maternity services at Crouse serve a two-fold purpose: Many physicians in Central New York rely on Crouse to provide a safe, comfortable and close-to-home birth experience for patients with low-risk pregnancies. Providers at 18 affiliate hospitals in upstate New York also consider Crouse — the state-designated Regional Perinatal Center — a destination for consultation and referral when complications, such as preeclampsia or preterm labor, impede safe pregnancies and deliveries.
“Our care team is a family, and we want our patients to feel as though they are a part of it. Many referring physicians may fear that their patients are going to get an impersonal care experience, but that’s the opposite of what happens here. Even though patients are coming to an institution that delivers more babies than any other hospital in upstate New York, we care for them like they’re our wives, sisters or daughters.”
— Stephen Brown, MD, board-certified OB-GYN at Crouse Health and Partner at CNY Women’s Healthcare
An Extensive History of Maternity Expertise
Crouse’s history and unparalleled leadership in the care of women and infants dates back 130 years to the founding of Syracuse Women’s Hospital and Training School for Nurses, a precursor to today’s Crouse Health. The hospital’s position at the forefront of regional obstetrical care goes back more than 40 years. In 1975, the New York State Department of Health began regionalizing perinatal care, which includes the care of critically ill mothers and infants, as well as healthy newborns. Within each region, hospitals receive a designation indicating the level of care they can provide. The hospital with the capabilities to provide the most sophisticated level of care, education and support is designated as the Regional Perinatal Center, according to the New York State Department of Health.
“By defining regional perinatal centers within hospitals, the state’s philosophy was to put our most critically ill moms and babies in one central location,” says Joan Dadey, MSN, RN, Director of Women and Infants Services at Crouse. “The state believed this structure would improve the outcomes for mothers and babies, which has indeed been the case.”
Crouse has served as the Regional Perinatal Center for Central New York since the inception of regionalization and was one of the initial eight designated regional perinatal centers in the United States. Known as the Central New York Regional Perinatal Program, the center operates in conjunction with State University of New York (SUNY) Upstate Medical University and Neonatal Associates of Central New York and serves a 14-county region that extends north to the Canadian border, south to the Pennsylvania border, and east and west approximately one traveling hour in each direction.
“Most regional perinatal centers are integrated into a university or university-based hospital,” says Robert Silverman, MD, Chair of Obstetrics and Gynecology for Crouse and SUNY Upstate Medical University. “Our program is a unique combination of private and public models. We provide 24/7 services, including the diagnosis and treatment of in utero fetal disorders and birth defects, consultations about comorbidities, such as hypertension or diabetes, and answering questions about pregnancy, labor and delivery.”
“Because we offer high-risk as well as low-risk obstetrical services, we have the ability to instantly involve specialists and take care of problems as they arise. For women who are referred to Crouse Health, this capability offers a level of comfort and security that very few institutions can match.”
— Robert Silverman, MD, Chair of Obstetrics and Gynecology for Crouse Health and SUNY Upstate Medical University
Multidisciplinary High-risk Patient Management
When a physician at one of the 18 affiliated hospitals in the region sees a patient who is at high-risk for complications, the physician can place a call to a Crouse provider. Together, the physicians determine if the woman can be safely cared for in her own community setting or if a transfer to Crouse for inpatient or outpatient treatment is necessary.
Women are referred to Crouse for reasons including multiple gestation and severe maternal complications, such as preeclampsia, preterm labor, placental abruption and other placental abnormalities. Patients who have medical conditions unrelated to pregnancy, such as Crohn’s disease, heart or lung problems, and obesity, may also be referred to Crouse for management, Dr. Silverman says.
“We are also the regional center for pregnant women who are considered morbidly obese,” Dr. Silverman says. “This is a condition that’s poorly recognized, but one that can cause a variety of maternal and fetal complications, including a higher risk of birth defects, Cesarean section delivery and stillbirth. If a patient is in need of advanced support, transport is arranged and she is brought by ambulance to Crouse’s Kienzle Family Maternity Center, where an OB-GYN and anesthesiologist are on call 24 hours a day.”
Crouse is also the only hospital in the region with the New York State Department of Health’s highest-level designation for neonatal intensive care units (NICUs). The Walter R.G. Baker NICU is a 57-bed facility located on the ninth floor of the Kienzle Family Maternity Center. The center has an in-house neonatologist on site 24 hours a day and serves a daily census averaging 55 patients. Advanced, life-saving technologies in place in the NICU include extracorporeal membrane oxygenation and therapeutic hypothermia.
Infants with congenital abnormalities, prematurity or who have experienced an adverse event, such as meconium aspiration during birth, may be appropriate for NICU care. When an infant requires transfer to the Baker NICU, a dedicated team of providers travels to the affiliate facility, stabilizes the child and accompanies the infant to Crouse, allowing them to manage any concerns that may arise during transport.
Mary Thompson, CNM, nurse midwife with Crouse Health’s Kienzle Family Maternity Center
Dedicated Care for Low-risk Pregnancies
Nearly 4,000 babies are delivered at the Kienzle Family Maternity Center every year — more than any other hospital in the region. The majority of women who seek care at Crouse have healthy pregnancies and uncomplicated deliveries. Each room in the Kienzle Family Maternity Center is decorated to provide a comfortable, home-like atmosphere. Portable monitors are used to allow women to ambulate during labor, and a variety of comfort measures, including epidurals, intrathecal analgesia and massage, are available as part of a laboring mother’s care plan.
“We pride ourselves on our high level of nursing care,” says Sara Madison, MSN, RN, BC, Nurse Manager of Labor and Delivery at the Kienzle Family Maternity Center. “All the nurses who provide care for patients have received fetal monitoring education, as well as newborn resuscitation training, and we are equipped to manage any situation that may occur.”
Joan Dadey, Director of Women and Infants Services at Crouse Health, and Sara Madison, Nurse Manager of Labor and Delivery at Kienzle Family Maternity Center
“Even during low-risk deliveries, unexpected complications can arise. Crouse Health’s team of physicians and the 400 staff members of Women and Infants Services — many of whom are registered nurses with tenures exceeding 15 years — can respond to both expected and unexpected challenges any time of day and any day of the week in a seamless fashion.”
— Joan Dadey, MSN, RN, Director of Women and Infants Services at Crouse Health
New mother, Adriane Ingallinero, and her baby.
Because unexpected complications can develop quickly during labor, Crouse has developed an obstetrics emergency safety training program with protocols that are reviewed annually. Physicians and nurses also participate in sessions in which they practice responding to emergency situations that may arise during seemingly routine deliveries, such as postpartum hemorrhage, shoulder dystocia and fetal heart deceleration. If necessary, the team can convert to a C-section delivery within 30 minutes, and neonatologists are available to offer immediate support as needed. At all times, an attending OB-GYN, anesthesiologist and neonatologist are on-site.
“We are part of a team, and we are all able and willing to work together as a team during an emergency or crisis situation,” says Stephen Brown, MD, board-certified OB-GYN at Crouse. “Having the ability to practice emergency protocols with the entire integrated team is just one of the measures that ensures we respond quickly and appropriately to obstetrical emergencies, and enables us to provide the best care to new mothers, infants and families in Central New York.”
For more information about the full spectrum of maternity and obstetric services available at Crouse, visit crouse.org/babies.