Birthing Simulator Helps Train Births in Rural Minnesota

CLOQUET, Minn. (AP) — Virginia lies on her back in a hospital gown, about to have her second baby.

“She’s 39 weeks pregnant,” says Melissa Seibert, director of inpatient services at Cloquet Community Memorial Hospital. “And she couldn’t make it to the hospital in Duluth because she thinks she’s going to have her baby sooner.”

Virginia has nothing to add to the conversation, as she is not a person.

It’s a realistic childbirth simulator that can replicate a wide range of childbirth scenarios, from a caesarean section to a high-risk breech birth. The educational tool is intended to solve a vexing vicious cycle in rural health care, Minnesota Public Radio News reported.

As young people leave small communities for urban areas, fewer babies are born. And that means there are fewer opportunities for doctors, nurses and other practitioners to keep up to date with the basic and essential skills needed to give birth.

And when that happens, hospitals sometimes stop delivering babies altogether, says Dr. Charles Kendall, who has been in family medicine at Cloquet Hospital for nearly three decades.

“A lot of doctors have given up on (midwifery), either because they’ve retired, or they don’t want to do midwifery, or they don’t want to take any risks,” he said. he declared. “It’s really put a strain on rural hospitals.”

Seibert monitors Virginia’s vital signs on an iPad — heart rate, blood pressure and baby information — as she leads nursing student Kasey Enerson through a normal vaginal birth.

A plunger inside Virginia pushes the baby into the birth canal.

“And then when you really want to help get the baby out, you’re going to put your fingers under your shoulders and help the baby out,” she tells Enerson.

The simulator is used by a wide range of practitioners, from nursing students like Enerson to staff who already work at Cloquet Hospital and don’t have much practice in high-risk deliveries.

“What we don’t have are a lot of mothers who are going to hemorrhage. We don’t have a lot of moms coming in with preeclampsia,” Seibert said.

The simulator allows staff to recreate these scenarios. “Once they do this more and more, they get better,” she said.

Of the hundreds of babies Kendall has delivered, he’s seen few emergencies — and not practicing can make doctors nervous.

“You just don’t get the chance to practice them or do them. And so it makes docs — all docs, but especially rural docs — nervous about wanting to do it at all,” he said.

Based on the numbers, it’s becoming less and less likely that Kendall and her colleagues will be involved in high-risk deliveries in the future.

Twenty years ago, Cloquet Memorial Hospital welcomed up to 150 babies a year; last year only about 50 were born.

But even though volumes are low – and births don’t usually make money for hospitals – CEO Rick Breuer said it was an essential service.

“We are a large enough community and a large enough health care provider that we consider this an essential basic service that we should provide,” he said, noting that it is dangerous for pregnant women. of having to travel far for the delivery.

“The further a mother has to travel to give birth, the worse the results. They don’t keep all their prenatal appointments, there are just more bad things that can happen along the way,” Breuer said.

That’s one of the reasons Blue Cross and Blue Shield of Minnesota invested $125,000 in purchasing the simulator for Cloquet Hospital, said Karen Amezcua, senior director of vendor partnerships for the insurer. .

“Pregnant women in rural areas are 9% more likely to die or experience life-threatening complications during childbirth, compared to those living in urban areas,” she said.

BCBS believes the simulator will lead to better health outcomes for mothers and babies in rural areas, but also to better outcomes and more routine care in general, she said.

“Receiving obstetric care in communities allows new mothers and their babies to establish a long-term relationship with primary care in their local community,” Amezcua said. “Primary care promotes preventive care and early detection of disease. If we can promote access to care and early entry into the system, we can prevent your long-term health problems.

Although the simulator has so far only been used by a limited number of people, Breuer said a state grant will allow the hospital to provide training at little or no cost to a multitude of practitioners working in rural settings in the region. nurses, doctors, medical students and paramedics.

From Breuer’s perspective, preserving rural labor and delivery services everywhere is central to preserving rural health care in general.

Midwifery is a small part of what his hospital offers, he said.

“But it’s an important part. Because people who come here for OB will come here for everything else.

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