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Legacy Mount Hood Medical Centers Birthing Center employs new tech in the care of critical newborns

by: OUTLOOK PHOTO: JIM CLARK - Pediatrician Dr. Metta Willey, left, and birthing center team leader Lorinda Schnackenberg praise the addition of Telebaby for the added level of support and expertise it provides to staff.

Will and Kim Cadwallader felt about as prepared as they could be as the due date for their third child approached.

Kim’s pregnancy had been “uneventful.” They knew they were having a son, and the family’s birth plan included daughters Reegan, 4, and Rylee, 7.

But Kim and Will had no idea their son’s first few moments of life would depend on the newest technology in newborn care.

The Gresham couple checked into the Birthing Center at Legacy Mount Hood Medical Center on Saturday, Sept. 28, for a scheduled induction. Kim had been diagnosed with gestational diabetes during her second pregnancy, and both her girls had weighed more than 9 pounds each at birth. Kim’s obstetrician felt inducing labor at 39 weeks, instead of 40, would prevent their son, Reid, from being too big for conventional delivery.

Over the course of several hours, Kim’s labor progressed normally. The 29-year-old mom-to-be wanted a medication-free labor and delivery, so she walked the halls to ease the discomfort of her contractions.

Suddenly, little Reid’s heart rate began to drop, and Kim’s hope for a natural delivery disappeared.

“They told me it was a prolapsed cord and they were going to have to do a crash caesarean,” Kim recalled. “Everything happened so quick, and this was not the way I ever thought it would be. I kept thinking, ‘This isn’t happening to me.’”

Umbilical cord prolapse is an uncommon but emergent obstetrical condition. It occurs when the umbilical cord precedes the baby in the course of delivery. Each contraction constricts the blood supply and oxygen to the baby, making rapid delivery of the child critical to prevent brain damage or death of the infant.

Kim was rushed into an operating room, where she was given a general anesthetic. Doctors used suction equipment to rescue the baby, and at 7:23 p.m., little Reid Cadwallader was born.

Because of the urgent situation, Will was unable to stay with his wife during delivery. Within minutes after Kim disappeared behind the operating room doors, nurses directed Will to the Birthing Center’s nursery.

“I saw him when they brought him in,” he said. “He was gray and not moving. There were three of them working on him, massaging his chest. I think it was mostly shocking to me. And I wasn’t expecting to see the level of technical equipment.”

Little Reid was placed in an “isolette” incubator bed, where nurses continued to resuscitate him. As Will watched, he became aware of what he called a “robot” — a mobile apparatus with a computer screen attached to the top.

“At first, I thought it was just somebody looking over their shoulder with a camera,” Will said. “Then I realized it was connected to (Reid’s) bed.”

Angels over their shoulders

In September, Legacy Mount Hood Medical Center took a giant leap into the future of medicine when it became the third hospital in the metro area to introduce the Telebaby — a high-tech link between neonatal nurse practitioners at Emanuel’s Randall Children’s Hospital and those at Mount Hood’s Birthing Center.

“Think Skype, with the best visuals,” said Stephanie Johnson, neonatal nurse practitioner. “We at Randall deal with critical care babies every day. (Telebaby) allows us to be involved from the beginning to provide an extra level of support and expertise to the wonderful care doctors and nurses provide at the other hospitals.” by: OUTLOOK PHOTO: JIM CLARK - Telebaby allows neonatal nurse practitioners at Emanuels Randall Childrens Hospital to see newborns in real time and coordinate care or transport with staff at Mount Hood.

Telebaby is indeed something straight out of the future. The device, which does sort of resemble a robot without arms, allows neonatologists at Randall to communicate with those on the front line assisting a critical newborn. A movable computer screen with remarkable clarity allows them to see the baby in real time, monitor the infant’s vital signs and mobilize a transport team if the child requires transport to Randall.

Lorinda Schnackenberg was one of the Mount Hood nurses who took care of Reid Cadwallader after his birth. Even though all doctors, nurses and staff in the birthing center are certified in neonatal resuscitation every two years, Schnackenberg said having the additional support from neonatologists from Randall allows her team at Mount Hood to remain focused on their patients.

“They can see everything we do and they always say, ‘You’re doing great,’” Schnackenberg said. “They can order lab work or meds if they’re needed, which we love. Before Telebaby, one of us would have to leave the baby to use the computer to do that. Now, we can stay with the baby.”

While pediatricians generally aren’t present at every delivery, they are notified if there is a known high risk prior to delivery or problems develop at birth. Dr. Metta Willey with Metropolitan Pediatrics was on call the night Reid Cadwallader was born. She arrived at Mount Hood shortly after the infant was brought to the nursery.

“I knew they were going to use Telebaby, and that was a huge relief to me,” Willey said. “Those first 10 minutes are so important with infant resuscitation. There’s so much that can happen. Telebaby is so great because it allows us to communicate with the people whose level of expertise with critical babies is higher right from birth.”

Telebaby also provides a faster link to Randall’s transport team, which ensures precious minutes aren’t lost for a newborn in need of advanced care. Schnackenberg cited the example of a baby born recently more than three months prematurely.

“We can anticipate what might happen and can call Telebaby before the baby is born,” she said. “The transport team arrived within three minutes after that baby was born.”

And baby makes five

Within about 10 minutes after his birth, little Reid was breathing on his own. His skin color had changed from gray to pink, and two days later, he went home with his mom and dad.

by: OUTLOOK PHOTO: JIM CLARK - Little Reid Cadwallader was born gray and not breathing after mom Kim was found to have a prolapsed umbilical cord during her labor. Now, nearly four months later, it’s difficult to imagine Reid Cadwallader was born gray and not breathing. He has more than doubled his birth weight of 9 pounds, 12 ounces, smiles happily for a newspaper reporter and photographer and shows no signs of developmental issues from oxygen deprivation.

Kim hopes to add one more member to the family, but has been advised to give her body two years to heal from her emergency caesarean section in September. Even though she admittedly “slept” through the bulk of her son’s delivery and aftermath, she gets emotional when talking about the staff who took care her and Reid.

“I think once people know that Telebaby is available, they’ll know that their baby will have a chance if there are complications,” Kim said.

“It gives you that reassurance that there is someone on the other end with that technical expertise. I owe the doctors and nurses at Mount Hood my life — they saved my son. I can’t ever say thank you enough.”

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