The value of perinatal care Featured

8:00pm EDT June 25, 2007

The saying that an ounce of prevention is worth a pound of cure is especially true when it comes to delivering a healthy baby at the end of a high-risk pregnancy. Diabetes, infections or other complications greatly increase a pregnant woman’s chances of delivering a premature or sick infant. Fortunately for expectant mothers and fathers, proactive care from an experienced perinatologist can significantly improve the odds of delivering a healthy baby. For employers who bear the financial burden and social responsibility of providing health and disability insurance coverage to workers, this is good news.

A perinatologist is an obstetrical subspecialist concerned with the care of the mother and fetus that are at higher-than-normal risk for complications both during the pregnancy and up to one month after delivery. A high-risk baby might be cared for by a perinatologist before birth and by a neonatologist after birth.

“One really sick baby can incur hundreds of thousands of dollars in insurance costs,” says Dr. Patrick Walsh, director of neonatal intensive care at Western Medical Center Anaheim. “So having healthy babies is good for business leaders and the community.”

“We are able to treat many of the conditions that lead to premature births,” says Dr. Nandi Wijesinghe, medical director of obstetric services at Western Medical Center Anaheim. “The earlier a patient seeks treatment, the less likely it is that the baby will have complications at birth.”

Smart Business spoke with Walsh and Wijesinghe about these concerns.

What constitutes perinatal services?

Walsh: Perinatal services are provided by a highly specialized team, including a board-certified physician and a trained nursing staff. This type of care is critical because it’s difficult for premature infants to recover, and if things go wrong at birth, they go wrong very quickly. So it’s imperative to have specially trained personnel who attend to the patient over the course of her pregnancy and who will be on the premises of the medical center ready to step in, if needed, during labor and delivery.

What should patients consider when selecting a medical center and physician for peri-natal care?

Walsh: I would evaluate the level of staff interaction and how staffers respond to your questions, because you really want to be treated like a person — not a number — and you want answers to all of your questions. Also, it’s important to ask who will be attending the delivery. You don’t want a situation where the perinatologist or an anesthesiologist is on standby waiting for a call to come to the delivery room, because time is of the essence under these circumstances. Frequently, I wait outside the delivery room door just in case I’m needed when one of my patients is delivering. Also, mothers-to-be and fathers-to-be should ask which physician will be on call just in case the mother delivers when the perinatologist is on vacation. Also, ask how the doctor will transfer the information about the case to another doctor, should delivery occur while the patient’s regular perinatologist is away.

Wijesinghe: At large medical centers like tertiary medical centers and teaching hospitals, patients frequently are cared for by a team of physicians or an intern with limited hands-on experience. It’s important to have a continuum of care, from the physician’s office all the way through delivery. I believe that patients and infants fare better with a greater level of one-on-one attention that is afforded by a private practice perinatologist.

What are the positive outcomes that result from early treatment by perinatologists?

Wijesinghe: The likelihood of a baby having complications at birth is greatly reduced when high-risk obstetrics patients are under the early care of a perinatologist. This can reduce infant morbidity and mortality rates. The best outcomes are achieved by doctors who deal with these types of complications on a daily basis.

Walsh: New knowledge and practices improve the treatment for patients with high-risk pregnancies and premature infants. Patients need to be under the care of a specialist who is constantly focused on implementing new techniques in order to benefit from the resulting improved outcomes.

How do Orange County businesses benefit from this availability?

Walsh: Newborn intensive care is one of the most expensive forms of medical treatment available. The impact of caring for a sick infant can last for years, decades or even a lifetime. So having a preventive program available locally can make a huge difference in direct costs to businesses and help employees stay worry-free and productive.

Wijesinghe: In many areas, patients have to be referred out for this kind of medical care, which further increases the cost to employers and the anxiety level for patients. In poorly managed medical situations, the welfare of the mother and the infant can be compromised quickly. When we do our job effectively, the frequency of complications is reduced, and everyone benefits. For more information about prenatal care, contact Western Medical Center Anaheim.

DR. NANDI WIJESINGHE is medical director of obstetric services at Western Medical Center Anaheim. Reach him at (714) 774-8870.

DR. PATRICK WALSH is director of neonatal intensive care at Western Medical Center Anaheim. Reach him at (714) 502-1144.