Birthing Services
Dear Editor: The recent letter to the editor from the NEST group presented one perspective but doesn’t include key information about the services provided to the residents of Sitka. We believe it’s important to give a more complete picture of perinatal care and obstetrics (OB) (birthing) services offered to our community.
First and foremost, our top priority is to provide timely, effective patient-centered care, and all prenatal patients are encouraged to develop a birth plan with their physician. We deliver care specific to a mother’s needs while recognizing that some women may require high levels of intervention during childbirth. Our model of care ensures we have the capacity to rapidly mobilize resources to address unanticipated, potentially life-threatening situations.
SEARHC and SCH have been fortunate to attract highly qualified and committed family physicians to our small, isolated community. Our physicians’ dedication to their patients, families, and community defines their lives, and the care they provide is patient-, family-, and community-centered. They provide continuity and seamless coordination of care for women before, during, and after their pregnancies and address their health in a comprehensive manner during and after their child-bearing years. Any implication that our providers put “(their) lifestyles before the needs of women” is simply untrue and demeaning to this dedicated group of physicians.
The NEST letter points out that the Alaska Native Medical Center and Providence Hospital in Anchorage, with a population of over 290,000 (32 times the size of Sitka), utilize midwives in their OB services, a model that works well in higher volume settings. These midwives also perform shift-work similar to the physicians and are not continuously on call.
SEARHC has a family practice model of OB care and fully recognizes that excellent OB care requires a team approach. Our family physicians use an evidence-based, non-interventional, patient-centered approach to OB care, and we wholeheartedly agree on the importance of a trauma-informed approach in the delivery of all health care to a vulnerable population. SEARHC employs a full-time obstetrician/gynecologist with decades of experience who assists the family physicians with complex prenatal care patients, difficult deliveries, and unanticipated complications such as cesarean sections. SEARHC provides 24-hour anesthesia service for women who desire epidurals or require urgent Caesarean sections. SEARHC also employs several pediatricians to attend deliveries when there are concerns for the baby’s well-being or to consult on unforeseen, post-birth complications. And, our OB service is staffed by OB nurses, all of whom have specific training in lactation services and some with Certified Lactation Counselor certifications.
As an organization, we have excellent OB outcomes and our C-section rates are markedly lower than the national average. Mt. Edgecumbe Hospital (MEH) is Baby-Friendly® designated and has excellent success in the initiation and support of breast feeding. We have staff available 24/7 to answer lactation questions and support mothers and have formed a community lactation support group that will meet regularly. Moreover, every delivery performed at MEH is reviewed to promote continuous learning and program improvements. Patient care is well documented in a standardized format that’s rapidly available to any physician caring for a patient to ensure coordinated care and avoid unnecessary examinations and interventions.
Finally, although the NEST letter highlighted common ground that we share, specifically the importance of high-quality, patient-centered women’s health services in our community, SEARHC has never been formally approached by NEST to meet. At most, there have been brief, anecdotal discussions with individual group members or unilateral statements made in public venues. This type of communication does not lead to meaningful dialogue. We extend an open invitation to NEST to contact us directly at 966-8417 to discuss this further.
Valerie Edwards, MD
John A Baciocco, MD CPE
Chuck Roesel, MD
Courtney Hayashi Vickery, MD
Kimberly Capp, DO
Irbert Vega, MD, FAAFP
Melody Shepherd, MD
Lisa Antonio, MD
Jason Koskinen, DO
David Vastola, MD
