EXPECTING PARENTS

EXPECTING PARENTS

Family focused care at Guam Regional Medical City is a comprehensive approach to preparing and supporting each family. This care begins with preparing you even before the arrival of your baby, with prenatal care, information and educational programs, for siblings and other services to ensure that you are well prepared for your new addition. And, after the birth, the nurses caring for you and your baby become familiar with your specific needs and provide information and education that will serve your family long after you go home.

Your Checklist

The obstetrical admitting packet you received contains an admitting forms that should be filled out and returned in a timely manner so that we may prepare for the birth of your child. Along with general information, the forms also request information about your followup Pediatrician , special requests and insurance coverage.

Important points about insurance:

Be aware that insurance plans differ regarding lengths of stay for obstetric care. Check your insurance provider for their policy on length of stay. Guam Law allows a hospital stay of 48 hours for vaginal birth and 96 hours for cesarean birth.

Please understand that you are ultimately responsible for payment of any service not covered by your insurance or any copayments required. Please contact your insurance provider to become familiar with these costs.

Please know that no one is refused care at The Guam Regional Medical City for lack of the ability to pay. If you have any questions about your ability to pay for your stay, call our Revenue Management Department at (671) 645-3595. They will investigate resources that may be available to you through government and private agencies.

The hospital’s pre-admission’s staff may also contact you prior to admission for additional information or notify you of any estimated charges.

Selecting a Pediatrician

Your baby must be examined by a pediatric care provider before being discharged from the hospital If you have not already selected a pediatric care provider, your obstetrician or nurse practitioner can help you select one. You may also call your health insurance company for a list of providers.

Parent and Childbirth Education Classes

Parent and Childbirth Education The birth of your baby is an exciting experience, and we offer a number of options that allow you to participate fully and to be as prepared as possible. Our labor and delivery department staff offers various childbirth preparation programs and refresher courses, as well as breastfeeding, infant care and infant CPR classes. Please inquire with our nursing staff about this or call 645-5685.

Health Care Proxy/Living Will

We often receive inquiries from patients and their families about health care proxies or living wills, which are legal documents that define an individual’s feelings about the extent of care they wish to receive under extenuating circumstances. For further information, call 645-3591/2 or visit www.grmc.gu. You must have these forms filled out prior to coming to the hospital

Planning for Your Stay Items to Bring

During your hospital stay, we will provide you with sanitary pads and panties, and diapers for your baby.
Bring only essential items, such as:

•Maternity nursing bra

•Personal toiletry articles

•Nightclothes, bathrobe, slippers

• Eyeglasses

• MP3 Player

• List of current medications

• Small amount of money for newspapers

• Clothing for the baby to wear on the day of discharge

• Personal items for the Father or partner’s overnight stay

Do not bring:

• Large amounts of cash

• Please, do not bring any jewelry. For your safety, it is important to remove all jewelry prior to coming to the hospital. It can cause injury and could get lost within bedding, etc.

• Medications, if your obstetrician does not specific instruct you otherwise, then bring them to the hospital.

For your baby:

When you are ready to leave you may dress your baby in the clothes you brought from home. Baby clothes should be washed in a mild detergent first, rinsed well and should include:

• Stretch suit or “onesie”

• Booties • Hat

• Two small receiving blankets (for support in the car seat)

• Additional blanket, depending on the outside temperature

• Infant car seat

Arriving at the Hospital
Emergency Entrance

For women in labor, you may use the emergency entrance on the South side. For more information on parking, please refer to our Patient Guide .

Obstetrical Admitting

When you arrive at the hospital in labor, enter through the main lobby, a customer relations partner will escort you to the elevators. Take the elevators to the fourth floor to the Labor and Delivery department. The Nursing and Admissions staff will work together to make all the arrangements necessary for a swift and comfortable admission to the hospital.

Labor and Birth

After you have been admitted, you will be: •Assessed for labor in the triage area and then admitted to a private labor and birth room which features special lighting and equipment, including a birthing bed, rocking chair and television •moved to an obstetrical operating room located on the second floor of the IMU only if you are having a cesarean birth or complicated birth.

If you are having a scheduled cesarean section, you will be admitted to a private room in the maternity unit. This will be the same room that you will return too after your surgery to recovery until you are discharged from the hospital. Your baby will join you after your recovery from the Operating room.

Obstetric Anesthesia Services

The Obstetric Anesthesia Service provides specialized care 24 hours-a day,(space) 7 days-a-week. There are many nonmedical techniques that exist that can help you during labor, including:

• breathing and relaxation techniques

• warm showers

• massage

• position changes If you plan on having an epidural anesthesia during labor we recommend that you call our Anesthesia Department at 645-4966/77 to get to meet one of our anesthesiologist.

Partner/Support Person

The Guam Regional Medical City is committed to providing a safe and supportive birthing experience for expectant mothers in a family-focused care setting. We understand that, for some patients, sharing the birthing experience with family and friends provides additional special support. We encourage participation of the partner, and an additional support persons with the consent of the patient and provided there is enough room for the nursing staff to care for the patients. Sibling participation is encouraged. However, there should be a responsible adult to care for the sibling(s) while in the labor and delivery room.

For a cesarean birth only one person is allowed in the operating room and recovery room. You should discuss your plans with your obstetric care provider. Visitors are encouraged to stay at home until the birth of the baby. There is a waiting area located near the entrance of the labor and delivery patient rooms. Refer to the visitor policy in the GRMC Patient Guide for additional details.

Nursing Staff

A registered nurse will be assigned to your care, providing you support throughout your delivery. You may take photographs or a videotape of the birth, please ask the staff before including them. Should your labor be complicated or premature, you will be initially assessed and may be transferred to our special antenatal unit for women with problem pregnancies. There you will be assigned a nursing staff who will coordinate your care with the medical and nursing staff.

Neonatal Intensive Care Unit (NICU)

It is reassuring to know that if your baby needs intensive care, the Guam Regional Medical City Neonatal Intensive Care Unit is led by a U.S. Board Certified Neonatologist and a team of experienced, medical professionals in this specialty area. Premature infants and other newborns with various health difficulties stay in the NICU for expert care and observation. Family focused care and developmentally supportive nursing care are practiced in the NICU, and parents are encouraged to touch, hold, feed and care for their babies to the extent tolerated by the baby’s health. The unit has family rooms located adjacent to the NICU where families can spend time with their babies once they are stable. A number of supportive programs for families are provided.

Postpartum Care

After a brief recovery period in the birthing room, mom, baby and partner will be brought directly to a private patient room- you will not need to be separated from your baby at any time under normal circumstances. We encourage you to keep your baby in your room at all times. However, a nursery is available for medical observation or, if you request, to care for your baby for a short period.

During your stay you can:

• review basic care and safety with your nurse

• attend daily classes on topics including breastfeeding and bathing your baby

Newborn Tests and Vaccinations

Screening tests and vaccinations will be based on requirements of the Guam Department of Public Health and your pediatric health care provider. Your infant will be screened for jaundice, heart disease and various metabolic disorders prior to discharge.

Hearing Screening

As part of our standard of care, your baby will receive a hearing screening test before being discharged from the hospital. For more information on screenings, read the Newborn Screening brochure in your admitting packet for additional information.

Circumcision

Circumcision is the surgical removal of the foreskin of the penis. The decision regarding circumcision is a personal one, and parents are encouraged to discuss this decision with their obstetric and pediatric health care providers. You will need to sign a surgical consent form for circumcision before the procedure. And, if you are interested in a religious (ritual) circumcision, our staff will be happy to help you arrange the type of service you prefer. Please plan the service as early as possible so that a convenient time may be arranged for the hospital and your family. At your wishes, your own rabbi religious leader may be invited to say the prayers and perform the circumcision (or a member of our staff will be happy to perform the circumcision). Written information about circumcision is available by calling Parent and Childbirth Education Department at (671) 645-5685.

Additional Services

All internal phone numbers can be connected using the last four digits from your bedside phone. External phone numbers require dialing nine and the seven digit telephone number.

Care Coordinator/Social Work

Social workers are available to help with personal and family problems related to illness, housing, health benefits and in come, and can provide counseling, evaluation and referral to a community agency. The Care Coordinator meets with all patients to review the discharge process, discuss home care options, and assist with any discharge planning. Contact your nurse or obstetric care provider to reach a social worker who is on-call for emergencies.

Interpreter Services
(671) 645-5500

We are committed to communicating clearly and thoroughly with all patients about the care we provide. Informing your doctor in advance about your language or hearing needs will help make you more comfortable. If you need an interpreter while in the hospital, your nurse or doctor can arrange for this service at no cost for you.

Lactation Consultant Number
(671) 645-5500

Your nurse will assist you with breastfeeding. In addition, certified lactation consultants are available for inpatient bed side consultations for diagnosis and treatment of problems and special situations related to breastfeeding. Please ask your nurse about additional supplies, such as nursing bras and breastfeeding support equipment

Customer Relations

(671) 645-5500 ext. 3700/1 Patient/Family Relations staff will help you communicate concerns, complaints, suggestions and compliments regarding your hospital stay and provide you with information on hospital policies, procedures and services.

Phone Numbers At-a-Glance
GRMC Main Number

(671) 645-5500

Birth Certificate Information

(671) 645-3581-4

Social Services

(671) 645-5510

Financial Counseling

(671) 645-3595

Childbirth Education

(671) 645-5685

Lactation Support/Breast Pump Rental

(671) 645-5500

Newborn Intensive Care Unit

(671) 645-3970/4970

Notary Public

(671) 645-5500 ext. 3700/1

Obstetrical Admissions Office

671) 645-3592/1

Obstetric Anesthesia Service

(671) 645-4966/77

Customer Relations

(671) 645-5500 ext. 3700/1