Despite the division's successes in research and education, patient care remains the committed focus of our residents, fellows, nursing staff, and faculty members.  The "Parkland Way" of patient care delivery is a nationally-recognized and award-winning philosophy which has resulted in measurable success.  This year the divisions of Maternal Fetal Medicine and Gynecology were applauded again as U.S. News and World Report named Parkland Hospital's gynecologic and maternity services as among the nation's "Ten Best".   Other clinical accomplishments include almost 16,000 infants delivered under the division's umbrella of care and rates of stillbirth, very-low-birth-weight infants born, and cesarean deliveries all below the national average. 

      
     Our patient care achievements stem in part from our ability to effectively assess and match patients to the medical professionals able to provide the necessary level of care.   Management of the nation's largest maternity volume begins in our triage unit where each pregnant women who presents to L&D is individually evaluated.  From triage, laboring women are transferred to 1 of 3 L&D units, each designated to care for a specific level of medical acuity.  Our L&D with the highest acuity level  is staffed by faculty and residents; the lower acuity units by faculty, residents, and certified nurse midwives.

     Certified nurse midwives (CNMs) play an integral role in managing our volume of obstetrical patients.  CNMs in conjunction with managing physicians perform approximately 40% of our deliveries.  The CNM training program at Parkland Hospital, one of only 50 such programs nation-wide, assists in providing a ready supply of certified nurse midwives for our service. 
 

     Similarly, postpartum recovery care is triaged.  Medical staff members provide immediate postpartum care in two recovery rooms, each staffed to manage different levels of problem severity.  Altogether our Parkland facilities provide a total resource of 30 labor rooms, 8 LDRs, 7 delivery rooms, 7 operating rooms,  7-bed recovery room and 5-bed critical care unit. 

    
    



     Additionally, St. Paul University Hospital has served as a resource for delivery services for patients in our system for more than 30 years.   In 2002-2003, almost 2,000 patients under our umbrella of care were delivered at St. Paul Hospital.

   



     Although sound obstetrical fundamentals drive our care, our division has additional services such as 24-hour in house language translation, LDR rooms, rooming-in option for mothers and their newborns, in hospital lactation counselors, community-based prenatal classes, and electronic centralized fetal monitoring.   Our well-developed bereavement program extends one-on-one case-management  to parents from the moment that a fetal death has been identified, through the medical search for the cause of their loss, to assimilation back into our Community Women's Health Care clinic system.

     A second component to our patient care achievements comes from our ability to cast a broad health care net out into the Dallas community.  We strive to reach out and to remove many of the barriers to early prenatal care such as geography and language.  Faculty members, residents, and nurse practitioners staff 9 community clinics that offer daily prenatal care.  Translators and bilingual health care workers bridge language and cultural barriers.  In addition to the neighborhood-based clinic concept, our "MomMobile" provides pregnant patients free transportation to their clinic appointments.  As a result, 97% of women delivering at Parkland Hospital have received antenatal care prior to giving birth.

     
     Our triage philosophy carries over into prenatal care.  Women identified as having a pregnancy complication are appointed to one of several specialty clinics that our maternal-fetal faculty and residents staff.  Individual clinics, each specialized to manage a specific pregnacy complication meet weekly.  These clinics manage problems such as diabetes, multiple fetuses, genetic abnormalities, hypertension, infectious disease, preterm labor, and postterm gestation.  In addition to our specialty clinics, the 30-bed High Risk Pregnancy Unit within Parkland Hospital is dedicated to the care of maternity patients who require hospitalization and treatment for complications such as preterm labor, pregnancy induced hypertension, preterm rupture of membranes, and placenta previa.  Patient volume from this ward and clinics feeds our thriving clinical research projects.

     Our division serves not only Dallas county, but also serves as a referral source for complicated obstetrical cases for a surrounding 30 county area.  Several maternity patients are transported by ambulance or care-flight helicopter annually.

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