One place where there is no shortage of fertility is Northern Westchester Hospital’s (NWH) Labor & Deliver unit, where in just the first four months of the year, the Mount Kisco hospital welcomed 19 sets of multiples, surpassing last year’s total of 18. There have been three more sets since, with approximately 21 more anticipated by August.
Said Navid Mootabar, M.D., chair of obstetrics and gynecology at Northern Westchester Hospital, https://nwh.northwell.edu/ part of Northwell Health: “I can’t really give an exact reason why the boom, but I can tell you most of the patients are natural twins, not from fertility treatments. I can also tell you that in my practice, I have had many patients transfer to NWH with twins, because they didn’t feel comfortable with their own doctors being able to handle a high-risk pregnancy, or they wanted a better NICU (neonatal intensive care unit). NWH has more experienced/convenient maternal fetal medicine services, and our practices do vaginal delivery of twins where other practices may only do c(cesarean)-sections.”
Meanwhile, Phelps Hospital in Tarrytown has launched Northwell Health’s Maternal Outcomes (MOMs) Navigation program, an initiative designed to improve maternity by providing resources, education and social support to high-risk patients throughout their pregnancies and postpartum experiences. Led by a multidisciplinary team of experts, the program aims to decrease preventable illness and death in medically complex patients, including those suffering from diabetes, high blood pressure, heart and kidney disease and blood clots, as well as those experiencing socioeconomic risks and mental health issues.
The decision to introduce the program at Phelps Hospital follows successful implementation at three other Northwell Health hospitals – Long Island Jewish Medical Center, Huntington Hospital and South Shore University Hospital. The program’s effectiveness is detailed in a study published last year in the American Journal of Obstetrics and Gynecology, which demonstrated that the navigation program led to a 20% reduction in rehospitalization for any reason within a month of discharge after delivery. The program also significantly decreased the incidence of rehospitalization by 56% due to severe maternal health problems.
Also of note was the decrease in rehospitalization by Black women, underscoring the program’s potential to address racial disparities in maternal care outcomes. According to the Centers for Disease Control and Prevention (CDC), Black women in the United States are three times more likely to die from a pregnancy-related cause than white women. The CDC cites multiple contributing factors, including variations in health-care quality, underlying chronic conditions, structural racism and implicit bias.
“The findings from the Northwell Health study underscore the critical importance of comprehensive postpartum care navigation in improving maternal outcomes,” said Karen Murray, M.D., chair of obstetrics and gynecology at Phelps Hospital. “By introducing the Northwell MOMs Navigation Program at Phelps, we are aligning with evidence-based practices and reaffirming our commitment to providing equitable, high-quality care to all mothers in our community.”
A key feature of the MOMs Navigation program is that it identifies participants based on their medical diagnoses, which are coded in their electronic medical charts. This is implemented to counter unconscious bias, which is one of the factors that may lead to poorer outcomes for Black and African American mothers. While physicians can still make referrals to the program, enrollment in the program is initiated based on the medical chart codes, independent of referrals. Other notable benefits of the program include a 24/7 nurse on-call system and a dedicated nurse care manager for postpartum navigation, ensuring that patients have immediate access to nursing assistance at all times.
The program was funded by three individual donors, who collectively contributed $500,000 to keep it operational for three years.
“We support the MOMs program, because we want to see improvements in the care of mothers and their babies here in Westchester consistent with our previous work in other countries,” said Loretta London and Roger London, M.D., two of the donors. “We hope the program will identify, engage and serve the members of the community that Phelps serves and help drive sustainable improvements in the care of prospective moms and their children.”
