Cleveland Clinic Indian River Hospital is in the midst of a year-long, $7-million renovation of its labor, delivery and mother/baby rooms.
“Our goal is to be able to provide the highest level of care for all deliveries, with the exception of a high-risk diagnosis that takes them out of our hospital to a higher level of care in other hospitals in the surrounding areas,” said Dr. George Fyffe, chair of Obstetrics and Gynecology.
“We are focusing on family centered care, where family members are allowed to be there for the delivery and visitation after the birth. We even allow one person to be in the delivery room during a C-section delivery. We want residents of our community to feel comfortable going to deliver their babies and feel confident that they’re going to have good outcomes.”
“We started the renovation on Sept. 9,” said Mary Volsky, nurse manager for Women’s Health at Cleveland Clinic Indian River Hospital. “We have significantly great care, but our aesthetics have been less than stellar. We are making changes to provide better family-centered care. One of our challenges was to provide space for family participation. Our postpartum patient rooms are going to be one and a half times the size they are now, and they will be completely remodeled, providing enough space for Mom and the entire family.”
Cleveland Clinic Indian River Hospital has received a Florida Blue Distinction award for maternity care from the Florida Hospital Association in recognition of its commitment to reducing the rate of episiotomies, C-sections and elective deliveries.
“We are trying to reduce the number of C-sections for several reasons,” explained Dr. Fyffe. “One reason is that the more C-sections a patient has, the greater risk for complications in their future pregnancies. Two is their post-delivery experience. If they are able to deliver vaginally, it’s less painful in terms of recovery. It takes less time for them to recover and be back to normal. And three is that the patient spends less time in the hospital with a vaginal delivery.”
“We know that maternal mortality in the United States is higher than in many other countries,” Volsky interjected. “By promoting primary vaginal delivery, we improve the overall maternal mortality and morbidity rates by decreasing the frequency of cesarean delivery.”
Indian River Hospital also participates in the 39-week initiative, which ensures that no elective labor inductions are done prior to 39 weeks of gestation. The 39-week initiative was launched 2012 as the first effort of the NICHD National Child and Maternal Health Education Program to raise awareness about the risks of elective deliveries before 39 weeks of pregnancy.
“We know that approximately 18 percent of babies born before 39 weeks end up in the Neonatal Intensive Care Unit, which is very expensive care,” said Dr. Fyffe. “This 39-week initiative is very important because it not only helps us ensure that when the mom delivers, the baby will be with them and will also go home with them.
“Sometimes if we deliver those babies before 39 weeks, the babies end up with medical conditions like diabetes or other conditions that may lend itself to the lung of the baby not being completely mature; 39 weeks is a full-term pregnancy which allows enough time for the baby’s organs to develop completely.”
Indian River Hospital has an obstetrician in the hospital 14 hours a day. About a dozen OBGYN doctors are divided into inpatient and outpatient teams. The inpatient doctors stay on labor and delivery along with the midwife to provide continuous care for 24 hours for patients who are in labor, or if they have an emergency situation or need a consult. The outpatient team are physicians in the office that provide outpatient obstetrics and gynecologic care.
“Several years ago, a lot of hospitals established something called an OB hospitalist,” Dr. Fyffe explained. “These are doctors like me who have been in practice for a long time, who decided they don’t want to run back and forth to the hospital, they just provide continuous care and labor delivery.
“It’s a shift in surgical care that has expanded throughout the country. It’s like being an emergency room physician. You do your 24- or 12-hour shift and go home. And just like in an emergency room, there is always a physician there and the patient doesn’t need to wait for their OBGYN doctor to come from wherever they may be. This allows for immediate response to any obstetrical emergencies or other issues.”
There is also a midwife on the floor every day of the week, 24 hours a day. They manage the patient during their labor and delivery with the provider readily available to step in or help whenever it’s needed.
“Our midwives do most of the non-high-risk deliveries,” said Volsky. “It’s a more personal, intimate experience to have the same caretaker with you from the time you go into labor to the minute your newborn arrives. If a problem arises, the physician will be there.”
High risk pregnancies are always handled by the physician.
“For example, if you came in pregnant with preeclampsia, the physician and the midwife will manage your care, but most of the care will be managed by the physician, “Dr. Fyffe said.
“Of course, twin gestations and premature births are also managed by the physician.”
Expectant moms also have access to their own personal doula — a non-medical professional who provides continuous physical, emotional, and informational support to a mother before, during and shortly after childbirth, to help her achieve the healthiest, most successful delivery possible.
Indian River Hospital partners with Indian River County Healthy Start Coalition to offer affordable, and in some cases free, access to certified doulas through the G.R.O.W. Doula Program which supports, educates, and empowers pregnant women to take control of their health.
Renovations of the labor and delivery rooms along with a dedicated cesarean section surgical suite is slated for completion by the end of 2025, according to the hospital.
Dr. George Fyffe graduated from Rutgers New Jersey Medical School and completed a residency at Bronx Lebanon Hospital Center. His office is located at Indian River Partners in Women’s Health, 1050 37th Place, Vero Beach, 772-770-6116.
