The dream started in 2004. Dr. James Hamilton, practicing obstetrics in Kilmarnock, attended quarterly meetings in Richmond for 3 years—not missing a single meeting, and participated on the state OB task force. Juliana Fehr, Jessica Jordan, Dr. Hamilton, and Dr. Kahler were on the state OB task force formed by Governor Warner. Later in 2005, when the hopes of a women’s hospital had completely failed, they looked to a new solution. Dr. Juliana Fehr, professor at Shenandoah University, appeared before the Virginia Board of Health asking that two OB pilot projects be approved and supported; the model using certified nurse midwives utilized in a birth center model of care. Independent birth centers and hospital birth center models have been created and providing services in the U.S. for decades. There are now over 400 birth centers throughout the U.S.
In 2004 the Family Maternity Center of the Northern Neck, Inc. was incorporated. Its mission and vision was to provide delivery services and pediatrics to those living in the northern neck of Virginia. The project has changed several times in its inception but has never wavered in its intent. Dr. James Hamilton, Medical Director, Jessica Jordan, RN, CNM, Clinical Director and Shirley Dodson-McAdoo, President, CEO, are its founding staff.
Kristi Duryea, formerly employed by RGH in the maternity department, had the first meeting at her home. The first fundraiser occurred when Kristi and Cindy Booth Clark baked dinner rolls from a recipe of Cindy’s Uncle Joe. They sold them and made $300.
In January 2005, the Virginia General Assembly passed HB 2656: “Pilot programs for obstetrical and pediatric care in underserved areas,” thus offering improved access to obstetrical care and inpatient maternity services. In August 2005, a group of nurse-midwives, physicians, health department representatives, and residents of two affected communities developed a plan for the pilot projects. The Virginia General Assembly of 2006 and 2007 appropriated funds of $150,000 to hire project coordinators, provide task force development, and marketing and education expenses for two areas; $75,000 each for the Northern Neck and Emporia. From 2004–2008, eight rural hospitals have closed delivery services in Virginia.
In September 2006, Shirley Dodson-McAdoo was hired as project coordinator for The Family Maternity Center of the Northern Neck. Since that time, a work plan was developed to provide direction with deliverables and goals identified to establish a birth center in the Northern Neck. Shirley Dodson-McAdoo has been successful in organizing the efforts of state and local supporters and moving forward with implementation of the Virginia’s Board of Health’s recommendations to the OB pilot project. As project coordinator, she has organized community support, completed a 501 C3 application, updated health care needs of under-served targeted population, completed an American Association of Birth Center application, attended a “How to Start a Birthing Center” conference, established a consistent advisory council, and has participated in the development of CNM protocols (Certified Nurse Midwives), the emergency protocols and an informal memorandum of agreement with local facilities and physicians.
The OB pilot project plan is based on evidence-based research that shows birth centers to be safe, cost effective facilities where pregnant women or those planning to be pregnant receive their prenatal care and low-risk women deliver their babies by Certified Nurse Midwives which are NPs with a specialty in midwifery. The birthing center, FMCNN, will implement a Certified Nurse-Midwife’s Model of Care. CNMs will provide collaborative care with a board certified obstetrician as medical director. They will provide essential health screenings, education, and continuity of care to maximize outcomes. They will deliver care in a cost-effective manor and give pregnant women the option of receiving care in their own community. This facility will provide much needed care for those unable or unwilling to travel 60–90 minutes to the nearest delivery facility. At present, many expectant mothers are traveling to Richmond, Newport News or Williamsburg for delivery services. Those wishing for a more natural delivery experience are arranging stay over at their own expense.
FNCNN will be an accredited birth center by the American Association of Birth Centers (AABC). Protocols have been developed based on national standards with criteria for risk assessment and a mechanism for collaboration and referral; including Level III Perinatal Centers and telemedicine with Virginia Commonwealth University Health Systems (VCUHS/MCV) as needed. Once the birth center is accredited by CABC; private pay, Medicaid and other health insurance reimbursement will be arranged and accepted. It is anticipated that the birthing center will be self sufficient for their operating expenses in conjunction with grants from both public and private funding agencies within three years of operation.
According to Dodson-McAdoo, The Family Maternity Center of the Northern Neck, Inc. is a greatly needed facility that will provide prenatal care and education to women who are pregnant or plan to become pregnant. Lack of prenatal services leads to preterm deliveries, low birth weight, and unreliable dating which is crucial in making appropriate treatment options. The goal is to provide prenatal care and women’s healthcare to all women in the Three Rivers District. Networking and collaboration with organizations such as social services, Three River District, health family resources, health start programs, and healthy beginnings initiatives will be done. The Center will provide care to all women regardless of their ability to pay; a variety of reimbursement programs will be developed so that no one will be denied care. The Center will provide space for WIC and social services for added convenience to our customers. Dodson-McAdoo stated, “It is our belief that healthy mothers have healthy babies.”
Low-risk women can have healthy babies in our community around family and friends. Research has shown that not all women need go without liquids throughout their labor nor be restricted to bed rest. A calm supporting environment that is prepared for emergencies and which provide the safest environment possible is our goal.
I spoke with Shirley Dodson-McAdoo CEO, to find out her focus on this project.
Q: What is your background?
A: I consider myself a critical care nurse who went on to get my masters. I worked at Blue Cross and Blue Shield and helped develop the Case Management Model.
Q: How did your life begin this journey towards the position of CEO of the birthing center?
A: I moved to this area in 1996 and worked as a consultant and project manager until 2006. In 2006, while working as a nurse practitioner at MCV, I did my women’s health residency with Dr. Hamilton.
Q: What special needs did you see for developing the Maternity Center?
A: This area has a high infant mortality rate. One study found that midwives make a great difference. So I began examining models of birthing centers and clinics. FNCNN was incorporated in 2004 following Dr. Hamilton’s involvement in the task force. In September 2006, I worked on a nonprofit status. Land was donated in 2009 and now we are breaking ground.
Q: What is your vision for the future of FMCNN?
A: We are required by accreditation standards to provide the safest environment possible and have safety drills. Education will be a major part of what we do. There will be a large education room providing researched-backed education both for the mothers and families. Attendance at classes is required for 6–10 weeks. Everything from nutrition to parenting skills will be offered. Laundry facilities are available as a convenience to the mothers.
Q: What is your philosophy for the center?
A: One mother and one baby at a time.
Jessica Jordan, RN, MS, CNM
Midwife for the Family Maternity Center of the Northern Neck
Q: What is your background?
A: I have been a midwife for 15 years and moved to the Northern Neck in February 2009 from Richmond. I have worked in a hospital setting and wanted to work in a birthing center.
Q: What is your vision for the maternity center?
A: I want to see babies being born naturally without medical intervention; not induced and without drugs, in a setting where they can move around. Women in labor have reduced discomfort in the warmth of tubs, by lessening gravity and promoting relaxation. Hospitals differ in that moms and babies are sometimes separated. At the birthing center they will never be apart. Bonding and breast feeding is facilitated with that.
Q: What is your future hope for the center?
A: That 90% of women will receive prenatal care in the first trimester. We would like to develop more programs including English as a 2nd language and nutrition. We would like to see the center handle 100 births in a year’s time.
Q: How can you get the word out?
A: I will speak to groups on our goals and word of mouth, one woman at a time.
Q: Why is it called the Family Maternity Center?
A: We hope to provide childcare and education. Childcare will be available for women who come in for classes and appointments. We have a stork squad, a volunteer group already formed that will assist with that. Speaking of volunteer groups, the “Knit Wits” have already made 22 blankets for the babies.
Dr. James Hamilton, OB, Medical Director
Q: How long have you been in the Northern Neck?
A: Twenty-seven years. I was a resident at MCV and drove over the bridge and knew I wanted to live here. I was in a practice with Dr. Summers for a year, then solo for six years, joined by Dr. Vogel for 15 years and now have had a single practice for five and a half years.
Q: When did you see the need for this facility?
A: In February of 2004, RGH closed its maternity department because of increasing costs and insurance issues. A maternity center is insured differently and the cost is considerably less.
Q: What are your goals for this center?
A: I want to create attractive accessible care with an overall concern for patient safety. We will be partners with VCU (Virginia Commonwealth University) medical center as a tertiary referral center. We will practice telemedicine with full time video communication through telephone and data links with VCU for high-risk patients. In the case of complications, we will utilize ambulance transfer and will have a helipad available for transfer. VCU is 15 minutes away by helicopter. We will be supplying prenatal care for all patients, delivery for low-risk—the rest will go to VCU.
Q: What would you like to see in the future?
A: I would like the maternity center to grow in an orderly fashion with supply meeting demand in approximately three years, bringing the births up to around 100 per year. Two or three midwives and a medical director would be ideal.
Judy Ripley, Landscape Design Consultant
I became involved with this project six months ago. I began meeting with Shirley Dodson-McAdoo and saw her vision. She felt she needed a plan to develop the space and with the building being environmentally friendly, she asked for a plan to match. She requested that the developed plan be constructed over a period of years, due to funding concerns. I had a different focus.
First I wanted the site disturbance plan to exceed the zoning requirements for the protection of our natural resources. John Tippett, Executive Director of the Friends of the Rappahannock, an environmental group, kindly agreed to review those plans. Then I began the process of how to fit the landscape design to the architecture, function and feel of the facility.
The low impact of carefully executed landscape will be shown in the retention basin and surrounding entrance area, planted and augmented to look like a dry river bed, with plants that can take both wet and dry conditions and do the job of filtering the run off.
Open spaces will be planted in wildflower seeds along with annual rye. A path will be cut to allow persons to wander among the flowers and utilize a seating area. Low-maintenance plantings, needing only a weed whacker and watering, will be installed both as foundation plantings and in a break/picnic area.
A memory border of trees and shrubs will evolve along one edge of the property with trees donated to celebrate the babies born in the center.
A birthing garden with privacy fencing will feature a fountain and beautiful glazed pots filled with seasonal interest. The pots will be on wheeled-bases allowing ease of watering, over wintering within the facility, and movement to the pergola for picnics. An original wrought iron sculpture will be hung in the garden area to commemorate the many donors to the project. Merchants serving the Northern Neck have donated approximately 80% of the landscape design. Generosity started with the donation of the land and continues.
This is a special community that cares!
The Family Maternity Center of the Northern Neck is located on Route 3, just before Devil’s Bottom Road,
Lancaster, Virginia. Expected opening will be in April 2010.