Your Guide. to a. Healthy Pregnancy

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Transcription:

Your Guide to a Healthy regnancy

Welcome Congratulations! Your pregnancy is an exciting and important time in your life. As your team of doctors, nurses and staff here at MetroHealth, we will do everything possible to make this a pleasant experience for you, your baby and family. We are here to listen and provide the best possible medical care throughout your pregnancy. Taking care of yourself is especially important for the health of you and your baby. This guide will walk you step-by-step through your pregnancy. It can help you keep track of your doctor appointments, write down questions, record important information and provide you with helpful educational information. While maintaining excellent and consistent prenatal care is essential, so is eating right, exercising and taking care of yourself. lease use our staff and this book to help you along the way. As you can see, MetroHealth is committed to taking care of you and your baby every step of the way. From your first prenatal visit to your first ultrasound to delivering your baby and after, we promise to provide you with the high-quality, personalized care you and your baby deserve. Sincerely, Your MetroHealth Caregivers This book belongs to: For more information on MetroHealth s birthing services, visit metrohealth.org/birthing

Your Guide to a Healthy regnancy Table of Contents regnancy & Birthing Care...1 You & Your Doctor...2 Doctor Visits Your Appointment Information eer Helpers Testing...3 Classes...4-5 Childbirth reparation Classes Breastfeeding Class Sibling Class Boot Camp for New Dads Teen Clinic Breastfeeding Clinic Doula rogram Healthy regnancy FAQs...6 Delivering at MetroHealth...7 Why It s Important to go to MetroHealth Experts in Specialized Care What to ack...8 For You For Your Baby Getting to the Hospital...9 Transportation lan When to Call an Ambulance When to Come to Labor and Delivery After You Arrive at MetroHealth...10 Getting to the Labor and Delivery Unit The Triage Area Your Baby s Arrival...11 Before Your Baby Arrives What to Expect Tips for Your Labor Support erson After the Baby Arrives...12-13 What to Expect ostpartum/mother-baby Unit Visiting Guidelines...14 Children and Siblings Safety Guidelines...15 Your Discharge Day...16 Instructions What the Baby Needs Safe Sleep for Your Baby...17 Maps...18-20 To Labor & Delivery Labor & Delivery to / from Emergency Department To Labor & Delivery from the Outpatient Obstetric Clinics Entrance & arking Details Important hone Numbers...21

From your first prenatal visit to your first ultrasound to delivering your baby, we will provide you with the high-quality, personalized care you and your baby deserve. Take an online video tour of the MetroHealth Birthing & erinatal Center! Go to metrohealth.org/birthing/videotour to meet our team of leading experts, hear one mom s amazing story and much more!

regnancy & Birthing Care By choosing MetroHealth, you and your baby will receive the highest level of care from our outstanding staff who are dedicated to providing you and your family with the best possible experience. MetroHealth s board-certified obstetricians many of whom are nationally renowned together with our entire health care team are committed to you and your baby. From your first prenatal visit to your first ultrasound to delivering your baby, we will provide you with the high-quality, personalized care you and your baby deserve. If you experience complications during your pregnancy, you ll be glad to know that the MetroHealth Division of Maternal-Fetal Medicine has the largest, most respected maternal-fetal program in the region. Nobody treats more high-risk pregnancies than we do. And nobody has our diverse range of services and specialties. For more than three decades, we have been leading the way in the treatment of high-risk pregnancies. We are one of only 14 centers in the country selected to participate in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units research networks. Because of that selection, we continue to be at the forefront of maternal-fetal care. Should your baby need more specialized care after birth, MetroHealth is equipped with a Certified Level III Neonatal Intensive Care Unit (NICU) the highest level available. This state-of-the-art unit is equipped with the most advanced monitoring technology and a team of neonatologists, perinatologists, respiratory therapists, pediatricians and neonatal nurses. They are all dedicated to giving your baby the extra care and attention he or she might need. Christie, Sam and Henry In the third month of her pregnancy, Christie found out there were problems with one of her twins. Another hospital told her only one of her children would survive. Terrified at the thought of losing one of their twins, Christie and her husband came to the high-risk pregnancy specialists at MetroHealth for a second opinion. With the expertise and compassion of MetroHealth physicians, Christie successfully delivered both Sam and Henry. While one of the twins required surgery, both are expected to lead healthy lives. MetroHealth has the largest maternal-fetal program in northern Ohio, and is a national leader in high-risk pregnancy and delivery. As one of America s 14 research centers for highrisk pregnancy, MetroHealth has pioneered treatments, including medication therapy to prevent prematurity. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 1

My Doctor / rovider is: Office hone Number: Due Date: My Appointment is at: My next Appointment is: You & Your Doctor Doctor Visits Early, frequent and regular check ups are necessary. Your doctor will need to see you at least once a month during the first two trimesters of your pregnancy. Eight weeks before your due date you will need to come in every two weeks. Four weeks before your due date you will need to come in every week. Your Appointment Information Thank you for choosing The MetroHealth System for your pregnancy and delivery. lease record the following information (on the left) to help keep your records in order. arking Reminder! At MetroHealth Medical Center s Women & Children s avilion, parking is FREE for obstetrics visits ONLY. lease bring your parking ticket with you to your appointment to be stamped. Appointments at our health center locations also include free parking. eer Helpers: Mother Nurture roject Breastfeeding eer Support helpers are available to meet with women at their prenatal visits at the main campus and offer individual education sessions about breastfeeding. eers are available to follow up with women after they give birth and remain available by phone and at weekly Breastfeeding support groups at MetroHealth s main campus.. Schedule, request and cancel appointments If you cannot keep an appointment, please call the office as soon as possible to reschedule. MyChart helps you manage your family s health care online! Ask your doctor for an access code or request a code online at metrohealth.org/mychart View test results Request prescription renewals Email your health care team with questions Access through mobile app 2 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Testing First Visit Expect tests on your first visit to the doctor or nurse practitioner s office. These may include: Blood tests to measure iron level, blood type, Rh factor, evidence of syphilis, hepatitis screening, TB and HIV (optional). Culture to check for STDs. ap test to check for cervical cancer. Urine test to check for diabetes, infection and kidney function. At All Following Visits Expect to be weighed, have your blood pressure checked and urine tested. Your doctor or nurse practitioner will listen for your baby s heartbeat and measure your abdomen. ossible Additional Tests Other testing is sometimes ordered to monitor your baby s growth and development: Testing for Down syndrome. A non-stress test (NST). An ultrasound. Alpha-fetoprotein to measure spine development. Diabetes testing. laces You Need to Know for Appointments and Tests You will probably make frequent visits to the following locations, so it will be helpful to familiarize yourselves with these places. All of these locations are conveniently located in the MetroHealth Women & Children s avilion. They include: Your Doctor or Nurse ractitioner s Office. The Blood Lab. Ultrasound. Keep track of your test results by signing up for MyChart, metrohealth.org/mychart For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 3

Childbirth Education Classes MetroHealth is pleased to offer a variety of classes to help you and your family prepare for your baby. View the current schedule for each class at metrohealth.org/birthing. Register for FREE childbirth education classes online! metrohealth.org/birthing or call 216-778-3381. Childbirth reparation Classes Our childbirth educators are certified and experienced perinatal nurses. Classes include information about labor and birth, comfort options and pain relief, coping skills for labor and birth and caring for yourselves and baby after birth. Lucian Bartosik 2011 Breastfeeding Class Learn the basics of breastfeeding preparation and feeding and pumping techniques along with newborn nutrition from our certified lactation consultants. Sibling Class This one time class is for siblings of the baby, ages 2-11. Children 12 and over are invited to attend a prenatal tour with their parents. Classes include information on how to hold and interact with a newborn brother or sister, a tour of the maternity unit and a movie about being a big brother or sister. Each child will receive a graduation diploma for their participation in the class. Boot Camp for New Dads Geared to first time fathers, this class is taught by veteran dads. You will learn how to make it through the first months of parenting and come out a competent, on the job father. This is one of our most popular classes for men of all ages. Lucian Bartosik 2011 Lucian Bartosik 2011 4 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Teen Clinic renatal care and classes geared to teens. Call 216-778-1462. Breastfeeding Clinic The MetroHealth Breastfeeding Clinic is a resource for mothers and their children to receive high quality medical care for any issue related to breastfeeding, both before and after delivery. The clinic is staffed by a nurse practitioner, a certified lactation consultant and a family physician. The clinic provides medical evaluation and diagnosis of problems associated with breastfeeding including issues such as infant weight gain, breast or nipple pain or infections, tongue-tie, medical conditions affecting breastfeeding, adoption or reestablishing milk supply. These are medical visits that are covered by most insurance. Call 216-778-3381 to register for childbirth preparation classes. For a current class schedule, ask your nurse or visit our website at metrohealth.org/birthing. We Invite You to Make an Appointment To schedule an appointment in the Breastfeeding Clinic, call 216-778-2222 The Breastfeeding Clinic is located at: MetroHealth Medical Center Women and Children s avilion, First Floor 2500 MetroHealth Drive, Cleveland, OH 44109 Doula rogram MetroHealth offers the birthing option of a volunteer doula, a woman who is trained to provide physical and emotional support for the laboring mother before, during and just after the birth. Your childbirth educator can provide more information about doula services, as doula availability may be limited. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 5

First Things First Now that you know you are pregnant, there are a few important steps to take, starting today, toward keeping your baby healthy: Let us know if you smoke or live with someone who does. Be sure to avoid ALL alcohol during your pregnancy. Even small amounts of alcohol can affect your baby. When it comes to caffeine and pregnancy, moderation is the key. Eat wisely and well, especially lots of the leafy dark green and yellow vegetables that are your best source of folic acid. Avoid foods made from unpasteurized milk (including many soft cheeses) and raw or undercooked meats and seafood. Tell your dentist and any other health care providers you see that you are pregnant. Let us know if you work in a factory or laboratory, with small children or with animals. Healthy regnancy FAQs Below are sample questions you may want to ask your doctor or nurse practitioner during your pregnancy. Circle the questions you may want to ask, or write down your own questions in the spaces below. If I have a question, who do I call and when? What are today s tests measuring? What forms do you want me to sign? What do they mean? I feel sick all the time. Is there something I can do? Am I gaining the right amount of weight? How should I change my diet? Should I take vitamins or supplements? What medicine can I take if I have a headache? Can I lie on my stomach at night? Will it hurt my baby? I m so tired. Is this normal? Is there anything I should not be doing? Is the baby facing the right way? What are the signs of labor? Who should I call if I think I m in labor? How much longer do you think it will be? What does it mean to induce labor? If I am in pain during labor, what should I ask for? What do I do if my water breaks? Who do I ask at the hospital for help with breastfeeding? Why do some women have a C-section? I had a C-section last time, will I need to have one again? I have many questions about breastfeeding, is there someone I can talk to now? Do you have pets at home? If you have a cat, please arrange for someone else to clean the litter box, as the germs carried by the waste can be dangerous. You may also need to use precautions with other kinds of pets particularly reptiles and birds. If you exercise regularly, you can continue your routine throughout your pregnancy as long as you are comfortable doing so. 6 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Delivering at MetroHealth You should be prepared for your hospital stay at least four to six weeks before your expected date of delivery. Babies sometimes come before their due date, so early preparation can be helpful. Why It s Important to go to MetroHealth Even if another hospital is closer, it s important to come to MetroHealth Medical Center when you are in labor because your prenatal records are here. MetroHealth doctors do not deliver babies at other hospitals, so your doctor will not be able to deliver your baby if you go elsewhere. In addition, if you are experiencing a high-risk pregnancy, most Greater Cleveland hospitals are not able to take care of high-risk mothers and babies. If you deliver elsewhere, you run the risk of being separated from your baby if you deliver at a hospital not equipped to handle your special needs. Our Labor and Delivery Unit has: Nine private state-of-the-art birthing suites designed to allow a woman to labor and give birth in the same room. Spacious rooms for a family-centered approach. The most progressive fetal monitoring technology and neonatal resuscitation equipment available. Obstetricians, anesthesiologists, pediatricians and pediatric nurse practitioners readily accessible 24 hours a day, seven days a week. Experts in Specialized Care Team Helps Dad Witness Birth Halfway Around the World Thanks to some creativity on the part of employees from Labor and Delivery and Information Services, a military dad stationed halfway around the world witnessed the birth of his son. James Jesionowski, who is stationed in Afghanistan, was able to watch baby Richard being born at MetroHealth Medical Center via Skype. Every delivery is a big occasion for the family, and this one definitely ranks in my Top 10, said a Geoff etranek, Assistant Nurse Manager, Labor and Delivery. Words can t express how truly grateful I am, Jesionowski says about being able to witness the birth of his son. In the event you or your newborn requires specialized medical services, feel confident that both of you will receive state-of-theart care from our trusted team of physicians: MetroHealth has one of only 14 National Institute of Child Health and Human Development Maternal-Fetal Medicine Units in the nation and has the largest maternal-fetal program in northern Ohio. Our Certified Level III (highest level available) Neonatal Intensive Care Unit (NICU) is equipped with the most advanced monitoring technology and highly skilled teams. We invite you to take an online video tour of the MetroHealth Birthing & erinatal Center! metrohealth.org/birthing/videotour Mom, Denise Horvath, introducing Dad to baby Richard. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 7

What to ack For You When you pack your overnight bag or small suitcase, the following items may be helpful: Robe and slippers. Button or wraparound robes work best. Nightgown/pajamas. If you plan to breastfeed your baby, choose nightclothes with easy access front openings. Two good support bras. If you plan to breastfeed, bring nursing bras. ersonal care items, including toothbrush, toothpaste, soap, facial tissues, deodorant, shampoo and other make-up essentials. Electrical appliances are permitted after they have been checked. Camera Cellphone charger Loose-fitting clothes to wear home For Your Baby We provide all the clothing your baby needs during your stay. You will want to include the following for your baby to wear home. (Wash all baby items before using them.) Infant car seat ractice using the car seat, taking it in and out of the car before coming to the hospital. Check the manufacturer s instructions for how to install your seat. Sleeper or other outfit Undershirt Receiving blanket Hat or cap Extra blanket, depending on the weather Diapers 8 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Getting to the Hospital Transportation lan As your delivery date approaches, be sure to have a transportation plan in place. Have someone readily available at all times to drive you to the hospital. Have another person as a back-up to drive you to the hospital. Keep the phone numbers of these people with you at all times. Make sure you and your driver are familiar with the best route to MetroHealth as well as where to park and directions to the Labor and Delivery Unit. Do not drive yourself while in labor! Know where to park and what entrance to use when you arrive at MetroHealth. arking and entrances vary depending on what time you arrive. To see a map and detailed directions, visit metrohealth.org/birthing. When to Call an Ambulance We strongly encourage you to have someone drive you to the hospital as most women have plenty of time before delivery. However, you should call 911 and ask to be taken to MetroHealth if you have any of the following symptoms: Heavy vaginal bleeding that soaks through your pants or runs down your legs. If the baby can be seen when looking between your legs. If you pass out or have a seizure. Name of Driver: hone number: Backup Driver: hone number: If you are unsure whether you should come in, please call Labor and Delivery at 216-778-4830 and a nurse or doctor can advise you on your decision. If this is your first baby, the early portion of labor typically lasts six hours. With few exceptions women have plenty of time to be driven to MetroHealth in a car. When to Come to Labor and Delivery If you are having painful, regular contractions that are coming every four to five minutes. If you are having any contractions and your due date is more than one month away. If your water breaks. If you have bleeding from the vagina that is heavier than a period. If your baby is moving less than normal. If your doctor provides you with other instructions. If you are unsure, please call Labor and Delivery at 216-778-4830. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 9

Information Needed for Registration Insurance card hoto ID Emergency contact person and phone number Social Security Number lease leave valuables at home, the hospital does not have a place to store them. Labor and Delivery: Key Facts Open 24 hours a day, seven days a week. Four to five physicians and an anesthesiologist are always available. MetroHealth is known for its high VBAC (vaginal birth after C-section rate.) We encourage photos and videos after the baby s birth, but we do not allow photos and videos during the actual birth. You may have up to three visitors of your choice (including family) at any one time. An adult must accompany children under age 16 and only the baby s siblings are allowed to visit. During times of seasonal flu or respiratory illness, visitors may be limited to protect the health of mothers and babies. After You Arrive at MetroHealth Getting to the Labor and Delivery Unit Follow the pre-planned route to the hospital. See enclosed maps for parking and locations. Follow signs to the C elevator. Exit at the second floor and follow the stork signs to Labor and Delivery. Stop at the registration desk. The secretary will greet you and help you begin the registration process. arking and entrances vary depending on what time you arrive. To see a map and detailed directions, visit metrohealth.org/birthing. The Triage Area After registration, the expectant mother (only) will go to the Triage Area, where: Your vital signs will be taken, as well as an assessment as to how far along you are in labor. You will be asked a series of medical and social history questions for documentation purposes, then one support person may join you in the Triage Area. A determination will be made as to whether or not you are in labor. Based on this determination, you will go to a Birthing or Observation Room, or return home until labor begins. 10 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Your Baby s Arrival Before Your Baby Arrives Your baby s birth will involve several people. The most important members of your team are you, your family and your labor support person. What to Expect Your nurse will ask for a brief medical history. They will assess your contractions and check your baby s heart tones with a fetal monitor. You may be encouraged to walk, sit in a rocking chair or take a shower as a way to encourage contractions and cope with labor pain. You will labor and give birth in the Birthing Room, unless you need to go to an operating room. Ask your nurse, doctor or any member of our team questions regarding pain relief options or any other questions so you will know what to expect. Our team will talk with you about your birthing options, based on your and your baby s health. Tips for Your Labor Support erson Offer the mother encouragement, wipe her brow, rub her neck or back, adjust her pillows and coach her through a difficult contraction. Designate one person to give updates. Incoming calls will not be routed to you during labor. lease let your family and friends know that we may not share any information about a patient over the phone to protect their privacy. Wear comfortable clothes. Bring snacks to keep up your energy also during labor. lease do not bring any food to the mother s room. Birthing Room Three visitors, including your support person, may be with you in the Birthing room. During sterile procedures, visitors will be asked to step outside to the waiting room. lease tell your nurse if there is anyone you do not want in the room with you. A sleep chair is available in the Birthing Room for your support person. MetroHealth has a photographer who is available to take professional photos of your new baby. For more information, please ask your nurse for assistance about this service. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 11

After the Baby Arrives What to Expect Maternal-Fetal Specialist Help with Successful Delivery of Twins Samantha s son, Ethan arrived without any complications. Her next pregnancy with twins ended in a loss at 20 weeks and another ended in an early miscarriage. She and her obstetrician, Sally Machedran, MD, turned to maternal-fetal specialist, Brian Mercer, MD, when she conceived another set of twins. I had such a good rapport with both of them and that really helped me feel comfortable. They worked very well with me and my husband, which made it easy for us to follow their instructions, recalls ierce. Once labor and delivery are behind you, it s time for you and your support person to relax and get to know your baby. Assuming there are no complications, your baby will be placed skin to skin with you for the first hour of life. This eases a baby s transition to life. If you choose to breastfeed, you will start now. Your nurse will check your blood pressure, pulse, size and firmness of your uterus and the amount of vaginal bleeding several times. Your nurse is available to assist you in feeding your baby. For security and identification purposes you, your baby and the baby s father will receive a wristband. Your baby will also receive an ankle band. ostpartum/mother-baby Unit You and the baby will be moved to the ostpartum/ Mother-Baby Unit from the Labor and Delivery Unit. The unit has 26 rooms, most of which are large enough to accommodate an additional bed for your person of choice. The ostpartum/mother-baby Unit is located on the second floor, 2B and 2C, and includes the newborn nursery. Room Service is available for 2B and 2C. Those instructions lead to the twins successfully being delivered at 37 weeks. The doctors really focused on the fact that every day (in utero) makes a difference for the babies, and they were right, ierce says. My family won t go anywhere but Metro for our care again. 12 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

For Mom Upon your arrival to the ostpartum/mother-baby Unit, a nurse will come in regularly to check your vitals signs (blood pressure, temperature, pulse, respirations), as well as assessing your pain level. At first you will need to call your nurse before you get out of bed. A typical stay on ostpartum/mother-baby Unit is usually 24 to 48 hours for a vaginal birth, and about three days for a C-section. An attending physician or resident will check on you every day, including the day you are discharged from the hospital. A pediatric provider will check on your baby every day. For Baby Upon your arrival to the ostpartum/mother-baby Unit, a nurse will come in regularly to check the baby s vital signs, assess and assist you with feeding your baby. In addition to the nurse, several other health care providers and hospital staff will be in your room to see the baby and check on various needs. These may include: your baby s pediatric provider, a lactation/breastfeeding consultant, hearing screeners, photographer if you request their services and others based on your baby s needs. During the baby s stay, there are several tests and/or procedures that may be needed. We understand it may seem like many people are in and out of the room, but these are necessary to help your baby have a healthy beginning in life. In the event that Mom is ready to go home and the baby is not, the baby will be cared for in the newborn nursery on the 2B unit. Should your baby require more specialized care in our NICU, you and your family will be encouraged to participate in your infant s care, helping to prepare you for the day you bring your baby home. ostpartum is a term that you will hear often. It s a medical term referring to the period of time (or occurring in the period of time) shortly after childbirth. MetroHealth offers single-occupancy postpartum rooms. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 13

Visiting Guidelines Visiting hours are 8 a.m. to 9 p.m. The father, guardian or person of choice needs to be over 18 years of age to have extended visits or stay overnight. In addition, the mother must also be over 18 years of age, or only the guardian may stay overnight. Family members and friends are welcome. lease ask them to be considerate of you and the other patients on the unit. Mom and baby are not permitted to leave the unit unless they are going to the NICU, therefore a lounge is available for the patient s family and/ or visitors coming in large groups. Visiting Hours 8 a.m. to 9 p.m. on the ostpartum/mother-baby Unit Important Information It is important for your visitors to wash their hands before handling your baby. If a visitor has a cold or any sign of an illness, we ask that they not visit in the hospital. There is no limit to the number of visitors who can see you, but please let your nurses know if you are feeling overwhelmed. We suggest no more than three visitors at a time. We encourage a quiet time between 1 and 2:30 p.m. to provide you with time to rest. Our doctors and nurses try to coordinate their care before and after this quiet time, and we can help arrange this for you. Children and Siblings An adult must accompany children under 16 years of age. Siblings, supervised by an adult, are welcomed. Children must have an adult with them at all times. 14 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Safety Guidelines arents, staff and visitors play an important role in keeping you and your baby safe. We use the following security measures to keep everyone safe: Staff are trained to maintain a safe and secure environment. Locked security doors control who enters the units. Visitors must pick up the phone outside the door before entering the unit. Bracelets with matching numbers for you, your baby, and father or person of choice. (You and your baby s bracelet numbers will be checked each time your baby is returned to you after being separated.) lease Follow These Guidelines: Do not sleep with your baby while in your bed or sitting up in a chair. If you are feeling sleepy or plan on sleeping, place your baby on his/her back in the crib. Babies may not be carried in the hallways. We encourage you to go with your baby to and from any procedure. Babies must remain on the inpatient unit at all times. Only give your baby to someone wearing a pink MetroHealth photo name badge. lease question anyone who wants to take your baby out of the room. Find out where your baby is going and why. Do not leave your baby alone in the room. A family member may watch the baby while you shower, walk or have a discussion with your nurse or doctor. Do not leave your baby alone on the pillow, bed, chair or anywhere else. Baby belongs in your arms or on his/her back in the crib only. Call your nurse immediately if you are unsure about anyone in your room. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 15

Your Discharge Day Instructions: A doctor will need to see you and your baby to write the discharge orders. You will receive discharge instructions either as a group in the family lounge, or one-on-one with your nurse. You will receive information regarding what to look for in yourself or your baby, when to call your doctor or nurse practitioner, and certain activities to avoid. You will receive a discharge folder that includes instructions specific to you and follow-up appointment information. Make plans for someone to help you at home during the first week after delivery, as you may still be very tired. Get as much rest as possible during your first week home. Helpful Resources for Car Seat Safety You can also visit the National Highway Transportation and Safety website (NHTSA) at nhtsa.gov/safety/ease-of-use for information on where to find a car seat inspection station and car seats. You can also call 1-866-Seat- Check (1-866-732-8243). You can watch a helpful video at safercar.gov/parents/ InstallInfant.htm to give you visual guidance on how a car seat for your newborn baby should be installed What the Baby Needs: Before leaving the hospital, make follow-up appointments for you and the baby with both your doctor or nurse practitioner, and the baby s pediatric provider. Your baby will need diapers, T-shirt, sleeper outfit, hat, blankets and any other outer clothing needed for the weather. You must be sure to have all the supplies you need for your baby at home. We do not provide clothes for you or the baby to wear home, please be sure to have your family bring in what you need to the hospital. If you need blankets or clothing items for the baby, we will be happy to contact social services to connect you with other resources. Car Seat Safety: Bring your baby s car seat for baby s ride home, make sure you have a car seat specifically for a newborn baby. ractice using the car seat taking it in and out of the car before coming into the hospital. Your nurses are not certified to install car seats so they won t be able to help you with placing your baby in your car seat or your car seat in a car. Check the manufacturer s instructions for how to install your seat. Did you know car seats have expiration dates? The heat, sun and severe cold all are hard on seat parts. Used car seats are not a good idea. lease read through the helpful information included in your discharge folder. Note the Cuyahoga County s Safe Sleep rogram, a campaign that was developed in 2009 in response to an increase in sleep-related infant deaths due to unsafe sleep environments, including sleeping with the baby. To learn more about Safe Sleep, see the following page and visit metrohealth.org/safesleep. 16 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Safe Sleep for Your Baby 5 4 Myth Babies choke when sleeping on their backs Sleeping on tummy is just as safe for a baby Fact In Cuyahoga County: Almost 20 babies die each year because of unsafe sleep conditions. (That s enough to fill an entire kindergarten class!) 1 2 Useful tips to help baby sleep Have a bedtime routine Babies tend to sleep better after feeding or baths Gently rub baby s arms and legs Keep house quiet Sing If baby wakes up, leave them alone unless they are crying Calm baby quickly if they are crying Do not play with baby, they will wake up even more When can my baby have Tummy Time? Two to three times a day When baby is awake When an adult is present Safe Sleep Tips 1. Always place baby on back for every sleep and nap. On the back: Keeps baby s mouth and nose unblocked Helps baby breathe clean, fresh air Keeps baby cool 2. Always put baby in crib. Adult beds, waterbeds and sofas do not count as cribs. 3. lace safety-approved crib near your bed or close to where you sleep. 4. Baby should ALWAYS sleep alone: Not with Mom, Dad or anyone else. 5. No toys, blankets, bumper pads or soft objects in crib. 6. Use a firm crib mattress and tightfitting sheets. 7. Sleep positioners and apnea monitors have not been proven safe. 8. Room temperature should be comfortable for a lightly-clothed adult. 9. Use light pajamas such as a one-piece sleeper. Two piece pajamas will ride up and could get in the baby s face. 10. Do not cover baby s head with anything. For more information, talk to your health care provider or visit metrohealth.org/safesleep. 7 6 What Does Safe Sleep Look Like? 1 lace your baby on his or her back for naps and to sleep at night. 3 2 Use sleep clothing, such as a one-piece sleeper, instead of a blanket. 3 Use a firm mattress in a safety-approved crib, covered by a fitted sheet. 4 Make sure nothing covers the baby s head. 5 Do not use pillows, blankets, sheep skins, or bumper pads in the crib. 6 Keep soft objects, stuffed toys, and loose bedding out of your baby s sleep area. 7 Do not allow anyone to smoke near your baby. For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 17

To Labor & Delivery lease ARK in the HOSITAL parking garage. Entrance at the Manning Towers. Take the B Elevators to the 2 nd floor. Follow the stork/baby symbols on the walls Around past the NICU, past the C Elevators Down to Labor & Delivery Reception Desk. Labor & Delivery, MetroHealth Medical Center Hamann - Second Floor 2500 MetroHealth Drive, Cleveland, OH 44109 (216) 778-4830 for labor concerns Directions to MetroHealth Medical Center From Hopkins International Airport: Take I-71 North. Exit W. 25 th Street. Turn left on W. 25 th, proceed to MetroHealth Drive. Left on MetroHealth Drive. From the West via I-90: Exit W. 25 th Street. Turn right, proceed to MetroHealth Drive. Left on MetroHealth Drive. From I-71 North or South: Exit W. 25 th Street. Left on W. 25 th Street to MetroHealth Drive. Right on MetroHealth Drive. From the South via I-77: Take I-490 to I-71 South. Exit W. 25 th Street. Left on W. 25 th Street to MetroHealth Drive. Right on MetroHealth Drive. From the South via Jennings Freeway (Route 176): Take I-480 West to Route 176 North. Exit at W. 14 th Street and follow the signs to I-71 South. Follow above directions for I-71. From the West via The Ohio Turnpike: Take Exit 151 to I-480 East to I-71 North and follow above directions for I-71. From the East via The Ohio Turnpike: Take Exit 173 to I-480 West to I-77 North and follow above directions for I-77. Valentine Avenue to 71 176 South 90 MetroHealth Drive Hospital arking Garage Hospital Entrance (first floor) arking and entrances vary depending on what time you arrive. To see a map and detailed directions, visit metrohealth.org/birthing. N to West 25th Street Cancer Care avilion Scranton Road MetroHealth Drive Rammelkamp Center A B? Take B elevators to 2nd floor Specialty Services avilion Trowbridge C West 25th Street? Women's and Children's avilion? E F Labor & Delivery 2nd floor Woodbridge to 71 Marvin Rehabilitatio n avilion Outpatient laza arking Garage Southpoint Drive Scranton Road Southpoint Drive South oint arking Garage glinda? Information Desk Elevators arking Entrance Emergency Entrance Traffic Light RTA Bus Stop 18 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Labor & Delivery to / from Emergency Department Emergency Department MetroHealth Medical Center Critical Care avilion Ground Floor 2500 MetroHealth Drive Cleveland, OH 44109-1998 arking and entrances vary depending on what time you arrive. To see a map and detailed directions, visit metrohealth.org/birthing. The Emergency Department is located on the Ground Floor of the Critical Care avilion. Cafeteria and Towers Café are located on the 1 st Floor. Information desks are located near main entrances to the medical center, i.e. Inpatient Towers (1 st Floor), Critical Care avilion near the Emergency Room (Ground Floor) and the Outpatient laza Atrium (1 st Floor). Take the B Elevators to: 5 th Floor: Surgical Intensive Care Unit (SICU) 3 rd Floor: Cardiac Intensive Care Unit (CICU) 4 th Floor: ediatric Intensive Care Unit (ICU) 5 th Floor: Medical Intensive Care Unit (MICU) Take the C Elevators to 2 nd Floor: Labor and Delivery Valentine Avenue to 71 176 South 90 MetroHealth Driv e Hospital arking Garage Hospital Entrance (1st floor) Quad ark N to West 25th Street Trowbridge West 25th Street Outpatient Clinics Atrium Outpatient Clinics Scranton Road From Ground Floor take E Elevators to 1st Floor turn right and follow signage to the C Elevators MetroHealth Driv e? E Atrium Waiting room Towers Cafe (1st Floor) F A? B C Gift Shop Inpatient Towers The Atrium Grille Cafeteria (1st Floor) From 1st Floor take C Elevators to 2nd Floor and follow the signs to Labor & Delivery (2nd floor) Woodbridge to 71 Outpatient laza arking Garage Southpoint Drive Scranton Road Waiting room South oint arking Garage Emergency Department (GROUND floor) Southpoint Drive? Information Desk Elevators arking Entrance Emergency Entrance Traffic Light Marvin The Atrium Grille (Cafeteria): 7 am - 7 pm, Daily MetroHealth Towers Café: 6 am - 11 pm, Monday-Friday Eglindale Drive RTA Bus Stop Food/Cafe For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 19

To Labor & Delivery from the Outpatient Obstetric Clinics Outpatient Obstetric Clinics are located on the Second Floor of the Women & Children s avilion. Take the bridge over to the main hospital to the E elevators : take E elevators to the 1st Floor, turn right and follow the signage to the C elevators : take C Elevators to the 2nd Floor and follow the signs to Labor & Delivery. Information desks are located near main entrances to the medical center, i.e. Inpatient Towers (1st Floor), Critical Care avilion near the Emergency Room (Ground Floor) and the Outpatient laza Atrium (1st Floor). Valentine Avenue to 71 176 South MetroHealth Driv e Scranton Road Hospital arking Garage Hospital Entrance (1st floor) Quad ark N Cancer Care avilion MetroHealth Driv e A? B Inpatient Towers West 25th Street 90 to Trowbridge West 25th Street Specialty Services avilion Atrium Women's and Children's avilion Take bridge over to the main hospital and the E elevators down to the 1st floor. Follow signs for C elevators? E Atrium Towers Cafe (1st Floor) F C Gift Shop The Atrium Grille Cafeteria (1st Floor) From 1st Floor take C Elevators to 2nd Floor and follow the signs to Labor & Delivery (2nd floor) Woodbridge to 71 Rehabilitation avilion Outpatient laza arking Garage Southpoint Drive Scranton Road South oint arking Garage Southpoint Drive? Information Desk Elevators arking Entrance Emergency Entrance Traffic Light Marvin Eglindale Drive RTA Bus Stop Food/Cafe 20 OB/GYN appointments can be made at any MetroHealth location by calling 216-778-4444

Important hone Numbers My Doctor s / rovider s Name: My Doctor s / rovider s hone Number: Department of Obstetrics:...216-778-4444 Department of ediatrics:...216-778-2222 Labor and Delivery:...216-778-4830 Department of Social Work:...216-778-5551 Social workers can provide counseling, education and referrals to community resources. Ask your doctor or nurse for a referral. Lactation/Breastfeeding:...216-778-3337 Breastfeeding Clinic:...216-778-2222 Childbirth Classes:...216-778-3381 Emergency:...911 (olice, Fire, Ambulance) For more information on MetroHealth s birthing services, visit metrohealth.org/birthing 21

Notes