Prenatal Guide

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					          Prenatal Guide




We Welcome You
              Welcome from the President              1
         Preparing for Your Hospital Stay             2
                               Interpreter Services
                      Childbirth Education Classes
                                Childbirth Options
                                        Anesthesia
                               Antenatal Care Unit
Neonatal Intensive Care Unit/Special Care Nursery
                Choosing a Pediatric Care Provider
                             Parenting Newsletter
                                           Website
                                        CarePages

                    Arriving at the Hospital          4
                                  When to Arrive
                                   What to Bring
                                         Parking
                               Admissions Forms
                              Cord Blood Banking

                             During Your Stay         6
                                     Visiting Hours
                                Patient Information
                      Length of Your Hospital Stay
                                    Hospital Safety
                Participation in Research Programs
                        Women & Infants Auxiliary
         Use of Video and Photography Equipment
                 Smoke- and Tobacco-Free Campus

                Baby Care Reference Guide             8
                                     Rooming-In
                      Treatments and Vaccinations
                                   Car Seat Safety

          Legal and Business Information              10
                                Basic Daily Charge
                                 Itemized Charges
                               Insurance Coverage
                              Financial Counseling
                                    Consent Forms

                                  Campus Map          12
                         Telephone Directory          BC
                           Dear Patient,

                           Established in 1884, ours is a history rich in caring
                           for women and their babies. Our mission is to
                           provide you, your baby and your family with the
                           best possible care.

                           We don’t have to look far to realize why we do this -
                           a glance into a labor room, where a couple will soon
                           celebrate a new arrival, a peek into an incubator at
                           a precious face yawning and stretching, the joy of
                           watching a new family head home together. These
                           are moments that say “This is why we do what we
                           do.” Hospital employees experience such moments
                           every single day.

We know the birth of a baby is a very special occasion, and we are honored
to be a part of it. We have created this book to help you prepare for your stay.
Once you are here, we will give you a Guide to Patient Services which contains
information about cafeteria hours, telephone and television service, and various
programs to meet your emotional and spiritual needs as a patient and a parent.
We want to help you prepare for the birth of your baby and offer a full range of
pregnancy and parenting classes. For more information or to arrange a tour of
the hospital, call Health Education at (401) 276-7800. A virtual tour is available
at www.womenandinfants.org.

Our goal is to exceed your expectations. We believe that caring for you means
including your family in the process. It’s our patient- and family-centered
approach to health care.

If you have concerns or suggestions, we’d love to hear them. Please call the
Patient Representative at (401) 274-1100, ext. 4968. You may be randomly
selected to receive a survey at home asking your opinion of Women & Infants.
Please let us know what we are doing well and where we can improve our
care for you and your family.

We look forward to caring for you and wish you a pleasant stay at
Women & Infants Hospital.

Sincerely,


Constance A. Howes
President and Chief Executive Officer




                                                                                     1
                                                             Interpreter Services

                                                             Childbirth Education Classes
    Preparing for Your                                       Childbirth Options
    Hospital Stay                                            Anesthesia

     Interpreter Services                                    Antenatal Care Unit
     Women & Infants serves patients from many
     different cultures. We want to communicate              Neonatal Intensive Care Unit/
     with you in the language in which you are
     most comfortable.                                       Special Care Nursery
     If you prefer to communicate through an inter-          Choosing a Pediatric Care
     preter, please tell us. The hospital will provide
     an interpreter at no cost. Sign language inter-         Provider
     preters are available for the hearing impaired.
                                                             Parenting Newsletter
     Childbirth Education Classes
     Women & Infants offers many classes taught
     by experienced, certified childbirth educators          Website
     who can answer your questions and help you
     prepare for childbirth.
                                                             CarePages
     Classes are offered at various times and
     locations, including our main campus in Providence and Centers for Health Education in East
     Greenwich, Woonsocket, Swansea, South Kingstown and North Attleboro. If you have not
     received a registration form, visit www.womenandinfants.org or call Health Education at (401)
     276-7800, ext. 100.

     Childbirth Options
     Alternative Birthing Center (ABC)
     The ABC offers a cozy setting that can include older children and others. Located in our Labor/
     Delivery/Recovery unit on level 2, the ABC offers minimal hospital intervention but maximum
     assurance of safety. It features a comfortable bedroom where the birth takes place.

     After you deliver in the ABC, you can:
         • Recover for four hours there, and transfer to a mother-baby unit.
         • Recover for six to 12 hours there, and go home once you and your baby meet discharge
             criteria. This early discharge includes a home visit from a nurse who will assess you
             and the baby and offer support.
     For more information, call the ABC at (401) 274-1122, ext. 1830.

     Labor/Delivery /Recovery Rooms (LDRs)
     The LDRs offer you a place to labor, deliver and recover in one room, with your birth partner at
     your side. We have 19 LDRs with the latest technology and one whirlpool tub room on level 2.

     Cesarean Birth
     There are three operating rooms on level 2 if you                         2007     2006      2005
     need a Cesarean birth. Your partner can stay with      Total              32.3%    32.2%     31.2%
     you during the birth unless there is an emergency.     Primary            22.7%    23.2%     22.2%
     We also offer a recovery room for Cesarean births.     Repeat             86.3%    86.1%     83.8%
     Rhode Island state law asks that we outline our
     Cesarean birth rates for the past three years.
2
Anesthesia
Members of the Department of Anesthesiology want to make sure you are informed about your
options to make the best decision for you. They know some women want medication to help
relieve their discomfort and others may not. They can help you decide which option is best for
you and will be on hand during your delivery even if you choose not to have anesthesia.

You can learn more about anesthesia in childbirth through childbirth education classes. Visit
www.womenandinfants.org or call Health Education at (401) 276-7800, ext. 100.

Antenatal Care Unit
Sometimes, women with high-risk pregnancies are hospitalized before delivery to monitor their
health and the health of their unborn baby. Those women are cared for in our Antenatal Care Unit in
the new South Pavilion. The unit provides comprehensive inpatient care in an effort to achieve the
best possible outcome for mother and baby. The rooms are larger with private bathrooms. The unit
also features an amenities suite to pamper women spending weeks on bed rest. There is exercise
equipment, a washer and dryer, and a hairdressing sink and massage table for appointments.

Neonatal Intensive Care Unit/Special Care Nursery
We operate the largest single-room neonatal intensive care unit (NICU) in the country, offering
outstanding care for 1,300 premature and sick babies each year. The single-room layout, which
is on two floors in the hospital’s new South Pavilion, offers the latest technology and most
advanced care in a quieter, more private setting for families.

Our team includes: care managers, neonatal nurse practitioners and nurses, neonatal-perinatal
fellows, neonatologists (pediatricians with additional training in newborn care), nutritionists,
occupational therapists, pharmacists, respiratory therapists, and social workers.

The unit offers plenty of space for families, with lounges on each floor, a full kitchen, shower
facilities for parents, and a two-story family resource center that includes computers, a 16-foot
salt water aquarium, and brightly-lit seating areas.

Choosing a Pediatric Care Provider
You must choose a pediatric care provider – a family practitioner, pediatrician or nurse prac-
titioner – before you are 35 weeks pregnant. To help you choose someone, we developed a
brochure “Choosing a Pediatrician.” For a copy or the name of a pediatric care provider, visit
www.womenandinfants.org or call our Physician Referral Health Line at 1-800-921-9299.

Tell your physician/midwife and the hospital when you choose a provider for the baby so
we can call him/her when the baby is born. If your pediatric care provider does not come to
Women & Infants, our team of doctors will care for your baby.

Parenting Newsletter
As you prepare for the birth of your baby, we have an e-newsletter that can help. The Parent
Review is our free weekly parenting email newsletter for expectant and new parents. To sign
up, go to www.womenandinfants.org.

Website
Our website (womenandinfants.org) offers information about hospital services, a pregnancy
planner, a virtual tour of our birthing facilities, an updated listing of educational programs and
support groups, information about health care providers and clinical trials, a health encyclopedia,
and access to My Personal Health Record, a secure way to keep track of your health information.

CarePages
CarePages is a free, personal, private web page service. You can build a page to help you stay
connected with family and friends before, during and after hospitalization. The service allows you
to email updates about your health. Your friends and family can support you through messages,
virtual gifts and more. Go to www.womenandinfants.org and click on CarePages to start your own.

                                                                                                      3
                                                            When to Arrive

                                                            What to Bring
    Arriving at the
                                                            Parking
    Hospital
                                                            Admission Forms

     When to Arrive                                         Cord Blood Banking
     If you think you may be in labor, call your
     doctor/midwife, who may tell you to come to
     our Emergency Triage unit to be checked. Call
     our Admitting Office at (401) 274-1122, ext.
     1422, to let them know you are on your way.

     If you are in active labor, you will be evaluated by a physician or midwife and may then be
     transferred to the Labor/Delivery/Recovery room area. Patients in Emergency Triage are seen
     according to their medical need, so those with the most serious problems are seen first.

     What to Bring
     During your stay, Women & Infants will provide hospital gowns for you and clothing for your
     baby. You may also want to bring:
         •   Toothbrush and toothpaste
         •   Deodorant
         •   Shampoo
         •   Soap
         •   Nightgown
         •   Robe
         •   Slippers
         •   Shower shoes
         •   Breastpads
         •   Comfortable bras and underpants
         •   Clothing for you and the baby to wear home and for baby’s first photo

     For your peace of mind, never bring large sums of cash, credit cards or other valuables such
     as jewelry and personal electronic devices such as cell phones and ipods. The hospital cannot
     store your valuables and is not responsible if they are lost.

     Parking
     Patients with an emergency may park near the Emergency Triage entrance. After you are
     admitted, please have your partner move the car to the visitor parking lot.

     The visitor parking lot is located opposite the Emergency Triage entrance of the hospital. There
     is a nominal fee for parking in this lot. Patients and visitors with a United Health card with an
     anchor in the upper right hand corner, a white Rhode Island medical card with an anchor in the
     center, a Neighborhood Health Plan card, or a state welfare card are eligible for free parking.
     The cards must be displayed when requesting free parking.

     When you are being discharged, we offer free valet parking at the main entrance. Valet
     attendants can also check the installation of your infant car seat. Valet parking is available
     from 7:30 am to 4:45 pm, Monday through Friday.



4
Admission Forms
Admitting staff will ask you to verify the personal and financial information submitted by
your health care provider. You must also sign admission forms and provide:
    •   Positive identification, such as a license
    •   Your insurance card(s)
    •   Name of the pediatric care provider
    •   Consent for first portrait of your baby

You may also provide copies, if you have them, of a Living Will (written document stating
your wishes for withholding or withdrawing medical care or treatment if your condition
becomes terminal) or Durable Power of Attorney (written document that appoints someone
to make health care decisions for you). You can get these forms through the Admitting Office,
(401) 274-1122, ext. 1422. Contact your attorney with any legal questions.

Cord Blood Banking
If you are interested, you can donate your cord blood to a public cord blood bank. It will be
processed, tested, frozen and stored at no cost to you. Public cord blood is made available to
patients anywhere in the world through the National Marrow Donor Program and other inter-
national networks. When a donor is needed, the cord blood is quickly shipped to the patient
for transplant without delay. For information about public cord blood donation, please call
the Rhode Island Blood Center at 401-248-5768 or email cordblood@ribc.org. Patients may also
choose to donate their cord blood to a private cord blood banking program. Please have the
appropriate materials when you deliver, and we will make every attempt to collect the sample
from the cord for you. You would then be responsible for sending this to the bank.



                                                                                                 5
                                                                   Patient Information

                                                                   Length of Your
    During Your Stay                                               Hospital Stay

     Patient Information                                           Visiting Hours
     While you are in the hospital, your family
     and friends can call (401) 274-1122, ext. 1374
     to learn if you are a patient here. Due to the                Hospital Safety
     Patient Privacy Act, we do not give out specific
     information regarding your care or condition.
     If do not want any information released, tell
     your doctor or primary nurse.
                                                                   Patient Representative

     Length of Your Hospital Stay                                  Women & Infants Auxiliary
     Hospital stays are relatively short. This is not dic-
     tated by you or the hospital, but by your medical
     condition and health insurance plan. Discharge
     time is by 11 am. Arrange transportation in
                                                                   Use of Video and Photography
     advance so you will be ready to go home.                      Equipment
     Visiting Hours
     For the safety and comfort of our patients, hos-              Smoke- and Tobacco-Free
     pital policy limits visitors to four people at a
     time during regular visiting hours. All visitors,
                                                                   Campus
     except brothers and sisters of the new baby,
     must be 14 years of age or older.
                                                                   Participation in
     We encourage visits from family and friends,                  Research Programs
     but our primary concern is that you get the
     care and rest you need to recover. Please limit
     visitors to the following times:

           Maternity Units
           Baby’s father/your significant other........ 24 hours a day
           Brothers/sisters of the new baby .......... 12 noon to 8 pm (with a sibling visitor sticker)
           Grandparents ........................................... 12 noon to 8 pm (after first visit)

           Neonatal Intensive Care Unit/Special Care Nursery
           Parents/grandparents ............................. Follow unit guidelines
           Brothers/sisters of the new baby ........... Through the Kids’ Klub

           Labor Room
           No visitors are allowed except your significant other/father of the baby or coach.

     To help keep our patients healthy, please ask your visitors to stay home if they have any symptoms of a cold or
     diarrhea, or have recently been exposed to chicken pox, measles, mumps, rubella or the flu.

     Overnight Visitors
     If the father of your new baby or your significant other wants to spend the night, the chair in your
     room reclines. Nurses can provide blankets and pillows, but not toiletries. In addition, the showers
     in the room are for patient use only.

     Ask your visitors to wash their hands – with soap and water if their hands are visibly dirty or with
     alcohol-based hand gel – before hugging you or touching your baby.

6
Hospital Safety
The hospital follows measures to protect patients’ safety during procedures and surgery.
Examples include:
    • Having staff identify each patient by asking the name and checking the identification
      bracelet
    • Having staff ask what procedure you are having
    • Having staff mark the procedure/surgery site
    • Possibly giving you antibiotics before a procedure or surgery to prevent infection

Handwashing is the best way to prevent passing colds or infection. Everyone, including chil-
dren, should wash their hands thoroughly when visiting. Use an alcohol-based hand gel like
Purell. Dispensers are located throughout the hospital. If your hands are visibly dirty, use soap
and water to clean them.

Electronic devices are generally prohibited in the hospital so we can maintain a safe
environment for all our patients. Patients are not allowed to bring most portable electric
appliances – heating or cooking devices, electric fans, portable air conditioners, and coffee
pots – to the hospital.

Patient Representative
To help promote patient- and family-centered care throughout your hospital experience,
Women & Infants offers a patient representative who acts as a liaison between you, your
family, hospital staff and administration. The patient representative addresses your rights,
concerns and complaints, answers questions, and lets you and your family know about the
services that are available to you. Contact the patient representative at (401) 274-1122, ext. 4968.

Women & Infants Auxiliary
The Women & Infants Auxiliary offers the following services:
    • Baby’s first photo
    • Gift shop
    • Nursing Moms, Etc., a store for nursing mothers and newborns

All proceeds generated from these services are donated to the hospital. If you would like more in-
formation, call the Auxiliary Office at (401) 274-1122, ext. 2029, or visit www.womenandinfants.org.

Use of Video and Photography Equipment
At the request of our medical staff, we cannot let you use video and audio equipment in the
Alternative Birthing Center, labor/delivery/recovery rooms, operating rooms, and circumci-
sion room during delivery or a medical procedure. You can use such equipment during labor
and after the birth or procedure. Still photography is allowed at any time.

We ask that you respect the privacy of other patients. Please do not videotape or take still pho-
tos of babies in the nursery or through the nursery window.

Smoke- and Tobacco-Free Campus
Health care facilities have a responsibility to promote healthy practices. Women & Infants
Hospital is a smoke- and tobacco-free campus. Smoking and the use of tobacco are not allowed
in hospital buildings, grounds, parking lots and off-site facilities occupied by Women & Infants
employees, or 50 feet from entrances to the buildings.

Participation in Research Programs
As a Brown University teaching hospital, Women & Infants is involved in important medical
education and research programs, and you may be asked to participate. The hospital’s Insti-
tutional Review Board reviews all studies. You will be asked for permission before you are
involved in any research activity, and you have the right to say no.



                                                                                                       7
                                                              Rooming In

                                                              Feeding Your Baby
    Baby Care
                                                              Treatments and Vaccinations
    Reference Guide
                                                              Car Seat Safety

     Rooming-In
     At Women & Infants, we recommend rooming-in, the practice of keeping your baby in your
     private hospital room with you for your entire hospital stay. This is a healthy choice for new
     families. It gives you time to become more confident as you provide all of the baby’s care while
     help is readily available if needed. Evidence has also shown that breastfeeding goes more
     smoothly, you will sleep just as well, and the transition home will be easier with rooming-in.

     Feeding Your Baby
     The American Academy of Pediatrics recommends that all newborns be breastfed for the first
     six months. There are many benefits to breastfeeding. For you, benefits include: faster return to
     pre-pregnancy weight; lower risk of breast, ovarian or cervical cancer; lower risk of osteoporo-
     sis later in life; and a cost savings. For your baby, the benefits include: fewer ear or respiratory
     infections; less diarrhea; increased intelligence; and less risk of obesity, diabetes, childhood
     cancers, allergies, asthma, and sudden infant death syndrome (SIDS).

     All nurses and certified nursing assistants on the mother-baby floors are trained to help you
     breastfeed. If your nurse thinks it is necessary, she will schedule a visit for you with a
     certified lactation consultant either in the hospital or once you go home. Visit our website
     (www.womenandinfants.org) for tips, or you can call the Warm Line at 1-800-711-7011.

     Treatments and Vaccinations
     The following treatments are part of your baby’s routine care in the hospital:
         • Eye drops or ointment is placed in your baby’s eyes within one hour of birth to protect
           the eyes from infection.
         • A vitamin K injection is given shortly after birth to improve the baby’s blood clotting
           ability. Without it, some babies can bleed the first few weeks.
         • A Hepatitis B vaccination is given as a single dose in the hospital, followed by a shot at
           two, four and six months of age. It is important to finish the series for complete protec-
           tion against this virus, which can cause liver problems and even cancer later in life.

     If you have any questions about these treatments, you can discuss them with your pediatric
     care provider before delivery.

     Car Seat Safety
     A car seat is the single most important piece of baby equipment but, unfortunately, most of
     them are not installed properly. You should learn how to install your baby’s car seat before
     coming to the hospital. Some of our valet attendants and security personnel are certified to
     install and check your baby’s car seat when you are discharged.




8
9
                                                              Basic Daily Charge

                                                              Itemized Charges
     Legal and Business
                                                              Insurance Coverage
     Information
                                                              Financial Counseling

      Basic Daily Charge                                      Consent Forms
      The basic daily charge, which begins the day
      you are admitted, includes room, meals, the
      availability of our medical staff, and nursing
      care. Depending on the length of your stay, there
      is no charge for the day you are discharged.

      Itemized Charges
      Your account will also reflect separate charges for care and services not included in the basic
      daily charge, including:
          •   Laboratory tests
          •   Medication
          •   Special examinations (x-ray or EKG)
          •   Special medical supplies
          •   Use of operating and labor/delivery/recovery rooms
          •   Blood transfusions
          •   Anesthesia supplies

      The professional fees of your health care provider, radiologist and anesthesiologist are not in-
      cluded in your hospital bill. You may want to ask your health insurer if these fees are covered.

      Insurance Coverage
      Based on information from your health care provider, we try to verify your insurance coverage
      before you are admitted. You are responsible for following your policy. Some policies want to
      pre-approve or certify all hospitalizations or require that you call when you are admitted. If
      you do not follow the policy rules, your insurance company may not pay your bills. If you are
      admitted for an emergency, a financial counselor will contact you during your stay to make the
      necessary arrangements.

      Financial Counseling
      Many insurance plans apply your co-payments and deductibles, or exclude coverage of certain
      services for you or your baby. In such cases, a financial counselor will contact you about your
      financial responsibility. You are expected to make advance payment based on your estimated
      responsibility for things that are not covered by your insurance plan.

      You may qualify for full or partial free care based on your income. If you have questions about
      payments, call our financial counselors weekdays from 8 am to 4:30 pm, and from 7 am to 3:30
      pm on weekends and holidays, at (401) 274-1122, ext. 1588 or 1335.




10
Consent Forms
Your health care provider will talk to you about your treatment, discussing advantages, disad-
vantages and alternatives. You will be asked to sign a consent form stating you understand and
agree with the procedure. If you do not understand the information you are given, ask your
provider to explain.

You will be asked to sign consent forms at the time of admission and for some procedures per-
formed on your newborn. Emergency treatment will still be given even if a consent form has not
yet been signed. If your infant is admitted to the Neonatal Intensive Care Unit or Special Care
Nursery, you will need to sign a separate consent for treatment.




Our goal is to exceed every patient’s expectations.
To assist us, please share any concerns and suggestions with us at any time by calling
(401) 274-1122, ext. 4968 to speak with the patient representative. In addition, a hospital administrator
is on-call 24 hours a day to assist you by calling the hospital operator. The Rhode Island Department
of Health also has a concern line you may call at (401) 222-2566.

If you have a complaint under the Americans With Disabilities Act, please submit that complaint
in writing to the Risk Management Department at Women & Infants or call (401) 274-1100 and
ask to speak with the Risk Management Department.

Women & Infants is accredited by The Joint Commission (TJC). This hospital continuously
strives to provide the highest levels of quality and safety in all that we do. We encourage you to
discuss any concerns or issues you may have about your care or service with us directly so we
may resolve them as quickly as possible. You may also contact The Joint Commission directly at
www.jointcommission.org, complaint@jointcommission.org, or (630) 792-5000 or (800) 994-6610.

In accordance with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Section 504 of the Rehabilitation
Act of 1973, as amended (29 U.S.C. S794), and the Age Discrimination Act of 1973, as amended (42 U.S.C. 6101 et
seq.), Women & Infants Hospital of Rhode Island does not discriminate on the basis of race, color, national origin, age or
handicap in admission or access to, or treatment in, its program or activities. In addition, the hospital’s president has been
designated to coordinate the efforts of Women & Infants Hospital of Rhode Island to comply with the U.S. Department
of Health and Human Services regulations (45 C.F.R. Parts 80, 84 and 91). For further information concerning the
regulations and grievance procedure for resolution of complaints alleging discrimination, contact Women & Infants
Hospital at 401-274-1100, ext. 1104. Hearing-impaired persons may call (TTY) 401-831-0381.*

* The hospital has made arrangements with the Greater Rhode Island Chapter, American Red Cross, to share its 24-hour TTY service.


                                                                                                                                    11
12
13
Telephone Directory
The main hospital number is (401) 274-1100. These are some of
the numbers you may find useful. If you are calling from out-
side of the hospital, dial (401) 274-1122, and then the four-digit
extension. If you are inside the hospital, you can dial the four-
digit extension.



Admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1422
Baby Prints (pictures) . . . . . . . . . . . . . . . . . . . . . . . 1740
Business Office . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1419
Food and Nutrition Services . . . . . . . . . . . . . . . . . 1528
Gift Shop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1549
Medical Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1486
Neonatal Intensive Care Unit. . . . . . . . . . . . . . . . . 1216
Nursing Moms, Etc. . . . . . . . . . . . . . . . . . . . . . . . . . 1749
Pastoral Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1659
Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . 1374
Patient Representative. . . . . . . . . . . . . . . . . . . . . . . 4968
Security. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1635
Service Response Center
 (food, room temperature, etc.) . . . . . . . . . . . . . . . 1111
Warm Line . . . . . . . . . . . . . . . . . . . . . . . . 1-800-711-7011
WIC Program/Nutrition Services. . . . . . . . . . . . . 2768

				
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