Complete Maternal Health
Dr. Theresia Neill provides an overview of maternal health in rural areas, such as where she practices medicine in northwest Kansas. A complete maternal health package goes beyond prenatal and postpartum care; it also includes services such as physical therapy for the expectant mother, taking care of her mental health needs, providing education on infant feeding, including lactation consulting, and so much more.
Featured Speaker:
She obtained her Doctor of Medicine at the University of Kansas School of Medicine in Salina, then completed her residency through the Smoky Hill Family Medicine Residency program. In September 2020, she began working as a physician at Norton County Hospital, where she practices full-scope family medicine and obstetrics.
Theresia Neill, MD
Dr. Theresia Neill grew up on a dairy farm near Severy, Kansas. She graduated from Butler Community College, then received a dual bachelor’s degree from Kansas State University in human nutrition and kinesiology, with a secondary major in gerontology.She obtained her Doctor of Medicine at the University of Kansas School of Medicine in Salina, then completed her residency through the Smoky Hill Family Medicine Residency program. In September 2020, she began working as a physician at Norton County Hospital, where she practices full-scope family medicine and obstetrics.
Transcription:
Complete Maternal Health
Evo Terra (Host): Rural hospitals, such as Norton County Hospital, focus on innovation when it comes to providing high quality obstetric care. While it rural hospitals are often smaller and more limited in provided services compared to hospitals and larger cities, there are many benefits to welcoming a baby in a rural hospital where people often know the patient as a fellow neighbor, community member and friend.
Dr. Theresia Neill is a Family Practice Physician at Norton County Hospital in Norton, Kansas, where she takes care of patients of all ages. Additionally, she is an obstetrics provider who delivers babies. From the plains of rural Northwest Kansas to you, this is Health in the Heartland presented by Norton County Hospital, where medical experts aim to empower health at any stage of life. I'm your host Evo Terra. Thanks for joining me Dr. Neill.
Theresia Neill, MD (Guest): Thanks for having me. I appreciate it.
Host: Now, some people might automatically assume that larger hospitals have much more to offer than small rural hospitals when it comes to maternal health. What are some of the advantages of seeking out maternal health from a rural setting?
Dr. Neill: So, I think that there are quite a few advantages to staying close to home whenever you're planning to have your baby. We are obviously close to home. So, instead of driving an hour and a half or more to the closest facility that you're only a few minutes away, maybe even just down the street.
One of the other benefits is that all the other providers here with me are Family Practice. My two other partners are Family Medicine physicians as well. And so, we get to treat everybody, including the mom and maybe other children in the family and then the newborn, whenever it comes along. And so, I do think that that is a huge advantage because there's a great continuity of care with that. But also it's keeping everything in the community. It's community support for people who are very community minded, this tends to be pretty important aspect for them.
Host: Yeah, family is certainly important, but let's talk for a few moments about the ways your hospital has made some improvements, including some additional equipment that benefit expecting mothers.
Dr. Neill: Yeah, so prior to us coming here, so me and my partner started in September and prior to us coming here, they had to stop doing deliveries and obstetrics services, because we simply did not have enough providers to provide that coverage. And so one of the biggest things that we wanted to get back was delivering babies at Norton County Hospital.
And that was important for us. And so we really took our time and tried to think of different things that we could do to offer the most benefit and the most support to our new moms and babies. And so a couple of the things that we really focused on at the beginning was making sure that we were delivering in a safe environment and that was having a lot of the technology that we needed.
And so, one of the things that we initially got were new infant warmers, and these allow us to do multiple different things, like keep baby warm after delivery. But also if baby has some jaundice and we need to do some bilirubin lights after delivery, then that same infant warmer allows us to do that as well.
We do offer some physical therapy services for mom prior to delivery. And it's something that one of our physical therapy assistants has special training in. And so she can talk to mom and get an idea of previous deliveries, what went well, what didn't go well and see where we need to focus our physical therapy efforts as far as strengthening, or maybe different exercises or even after delivery, figuring out how to move best, even just rolling out of bed if you've had a Cesarean section, or topics like that, those are different things that would be discussed with your physical therapy consult whenever we do that. One of the other things that we've focused on recently and that we've had good donor support for was new obstetric beds.
And so some of our beds were getting a little bit older and so, we've been getting some funds to get a few new beds, to make mom more comfortable during the delivery. One of the other things that we've also done is that we are planning on getting a new technology later this fall that will allow us to monitor moms and babies, even when we're outside of the room. And so say I have a mother laboring upstairs and I have to see a patient down here in clinic. I can pull up the screen and I can see how baby's heart rate is doing right from my computer.
And so that's one of the things that we've really been focusing on getting up and started. And that's taken a little bit more time just cause there is so much technology involved, but we're excited to have that soon.
Host: I want to circle back to the OB physical therapy that you're offering now at Norton County Hospital for just a moment. My son was born a few, let's make it three, decades ago. It was nothing like that for my wife. My granddaughter was born just three years ago and I don't remember anything about OB physical therapy. Can you talk a little bit about why that's important?
Dr. Neill: Yeah. So, one of the reasons that it is important is because a lot of women will have pelvic pain after delivery. Or sometimes they have pelvic pain before delivery and it can be associated with different muscles that are tighter than others, or maybe one of their ligaments is having more pain or maybe they just need to exercise more in their hips or their pelvis. And so, if we can get them as much pain-free and strong before delivery, then that will help with recovery after delivery, or maybe moms who have had previous C-sections, but, we have to do another C-section. If we can focus on getting them stronger and their abdominal muscles stronger before delivery, then that can help with the recovery after as well. But even the exercises that can be tailored to that specific person, it can help keep them pain-free after delivery.
Host: Yeah. keeping mom nice and healthy and happy is, is a good idea. An aspect of that today is mental health. So, what are some of the ways you're improving mental health outcomes for new moms?
Dr. Neill: So, again, a pro for family medicine is that we deal with a lot of different people through a lot of different stages in their life. And so one part of that is dealing with mental health issues in almost every patient that we see, it's not just isolated to one group of people or the other.
And so we're very comfortable with prescribing medications if we need to, if we know that we need to get them to different therapy options, then that is something that we're very comfortable with, even just coordinating care. And so that can be a huge benefit for mom, especially if it's something that we need to do on an urgent basis, rather than waiting a few weeks, if we have those connections already in place.
One of the things that we have been involved in recently is a project called Kansas Moms In Mind. And it's a program that focuses on mental health before, during and after pregnancy. And this program also gives us access to different consultants, especially on an emergent or urgent basis. But even if we have questions about a medication, whether or not that is okay in pregnancy or with breastfeeding, then we have those services available to us to find out those answers.
Host: Great. Let's talk for a moment about something I also know the hospital offers and that's lactation consulting. How does this in-house service enhance the overall care that's provided?
Dr. Neill: Breastfeeding can be a very important part yet frustrating part after delivery. It's so worth it, but it can require a lot of troubleshooting. So, we have a lactation consultant in house. She's one of our nurses and she's had special training in breastfeeding and helping assisting mom with breastfeeding. And so near delivery near the time of delivery, about 37, 38 weeks, we usually set up a consultation with her. And so, she can get an idea of any previous experience mom has, answer any questions that mom has, and just kind of get those jitters out of the way before delivery. And so right after delivery, one of the things we try to focus on, as a breastfeeding and baby friendly hospital, is that we really try to focus on that golden hour.
And so, that initial hour after delivery is really focused on getting mom and baby to bond. And if mom desires to breastfeed, then we start the breastfeeding process at that point. So, we try and get baby to latch and that will help with overall milk supply and help milk come in. Well one of the ways that our lactation consultant can help with that is if she's in the hospital at that point, then she can come in and help with that initial care. But she'll also, even if she's not in the hospital, we can always call and talk to her as a provider or even the nurse who's taking care of the patient. And the lactation consultant will be in and within 24 hours after the delivery, after mom has had some time to figure out what's working, what's not working and just help troubleshoot, especially if baby's having some problems latching or like with weight gain or anything like that. It just offers a little bit more comprehensive care for those moms who are wanting to breastfeed.
Host: This all sounds like very comprehensive care. I know also free car seat installation is another benefit to patients at Norton. Are there any other services you want to add about maternal care in rural settings?
Dr. Neill: One of the other services that we offer is a 3-D ultrasound during the third trimester, maybe about 28 or 30 weeks. That way we can get a nice little picture of baby, if he or she is cooperating with that. You kinda touched on the car seat installation. So, we'll usually do that about the 37 week mark so that we know that baby's going home in a safe vehicle and that mom and dad don't have to necessarily worry about that afterwards.
Again, with family medicine, we get to focus on a lot of different kinds of care. But one of those is that is that newborn care and that newborn period, we know mom throughout the pregnancy and we know how delivery went and any issues that mom was struggling with right after delivery. And so whenever we follow up with newborn care, it's usually within a few days after leaving the hospital. And it's great because we already know what's going on. We know may have been frustrating mom so we can check in, see how those things are doing. If mom's having a rough time, we can talk with her during that visit and we can still focus on the newborn during that visit too. And so, that's one of the great things about us being family medicine and one of the reasons that we love family medicine so much.
Host: Sounds like mom, baby, dad, and everybody else is well taken care of up there at Norton. Thank you very much, Dr. Neill.
Dr. Neill: You're very welcome. Thanks for having me.
Host: Thanks for listening to Health in the Heartland. You may find out more about Norton County Hospital online at ntcohosp.com. I have been your host Evo Terra. Take care of yourself and others. Be well.
Complete Maternal Health
Evo Terra (Host): Rural hospitals, such as Norton County Hospital, focus on innovation when it comes to providing high quality obstetric care. While it rural hospitals are often smaller and more limited in provided services compared to hospitals and larger cities, there are many benefits to welcoming a baby in a rural hospital where people often know the patient as a fellow neighbor, community member and friend.
Dr. Theresia Neill is a Family Practice Physician at Norton County Hospital in Norton, Kansas, where she takes care of patients of all ages. Additionally, she is an obstetrics provider who delivers babies. From the plains of rural Northwest Kansas to you, this is Health in the Heartland presented by Norton County Hospital, where medical experts aim to empower health at any stage of life. I'm your host Evo Terra. Thanks for joining me Dr. Neill.
Theresia Neill, MD (Guest): Thanks for having me. I appreciate it.
Host: Now, some people might automatically assume that larger hospitals have much more to offer than small rural hospitals when it comes to maternal health. What are some of the advantages of seeking out maternal health from a rural setting?
Dr. Neill: So, I think that there are quite a few advantages to staying close to home whenever you're planning to have your baby. We are obviously close to home. So, instead of driving an hour and a half or more to the closest facility that you're only a few minutes away, maybe even just down the street.
One of the other benefits is that all the other providers here with me are Family Practice. My two other partners are Family Medicine physicians as well. And so, we get to treat everybody, including the mom and maybe other children in the family and then the newborn, whenever it comes along. And so, I do think that that is a huge advantage because there's a great continuity of care with that. But also it's keeping everything in the community. It's community support for people who are very community minded, this tends to be pretty important aspect for them.
Host: Yeah, family is certainly important, but let's talk for a few moments about the ways your hospital has made some improvements, including some additional equipment that benefit expecting mothers.
Dr. Neill: Yeah, so prior to us coming here, so me and my partner started in September and prior to us coming here, they had to stop doing deliveries and obstetrics services, because we simply did not have enough providers to provide that coverage. And so one of the biggest things that we wanted to get back was delivering babies at Norton County Hospital.
And that was important for us. And so we really took our time and tried to think of different things that we could do to offer the most benefit and the most support to our new moms and babies. And so a couple of the things that we really focused on at the beginning was making sure that we were delivering in a safe environment and that was having a lot of the technology that we needed.
And so, one of the things that we initially got were new infant warmers, and these allow us to do multiple different things, like keep baby warm after delivery. But also if baby has some jaundice and we need to do some bilirubin lights after delivery, then that same infant warmer allows us to do that as well.
We do offer some physical therapy services for mom prior to delivery. And it's something that one of our physical therapy assistants has special training in. And so she can talk to mom and get an idea of previous deliveries, what went well, what didn't go well and see where we need to focus our physical therapy efforts as far as strengthening, or maybe different exercises or even after delivery, figuring out how to move best, even just rolling out of bed if you've had a Cesarean section, or topics like that, those are different things that would be discussed with your physical therapy consult whenever we do that. One of the other things that we've focused on recently and that we've had good donor support for was new obstetric beds.
And so some of our beds were getting a little bit older and so, we've been getting some funds to get a few new beds, to make mom more comfortable during the delivery. One of the other things that we've also done is that we are planning on getting a new technology later this fall that will allow us to monitor moms and babies, even when we're outside of the room. And so say I have a mother laboring upstairs and I have to see a patient down here in clinic. I can pull up the screen and I can see how baby's heart rate is doing right from my computer.
And so that's one of the things that we've really been focusing on getting up and started. And that's taken a little bit more time just cause there is so much technology involved, but we're excited to have that soon.
Host: I want to circle back to the OB physical therapy that you're offering now at Norton County Hospital for just a moment. My son was born a few, let's make it three, decades ago. It was nothing like that for my wife. My granddaughter was born just three years ago and I don't remember anything about OB physical therapy. Can you talk a little bit about why that's important?
Dr. Neill: Yeah. So, one of the reasons that it is important is because a lot of women will have pelvic pain after delivery. Or sometimes they have pelvic pain before delivery and it can be associated with different muscles that are tighter than others, or maybe one of their ligaments is having more pain or maybe they just need to exercise more in their hips or their pelvis. And so, if we can get them as much pain-free and strong before delivery, then that will help with recovery after delivery, or maybe moms who have had previous C-sections, but, we have to do another C-section. If we can focus on getting them stronger and their abdominal muscles stronger before delivery, then that can help with the recovery after as well. But even the exercises that can be tailored to that specific person, it can help keep them pain-free after delivery.
Host: Yeah. keeping mom nice and healthy and happy is, is a good idea. An aspect of that today is mental health. So, what are some of the ways you're improving mental health outcomes for new moms?
Dr. Neill: So, again, a pro for family medicine is that we deal with a lot of different people through a lot of different stages in their life. And so one part of that is dealing with mental health issues in almost every patient that we see, it's not just isolated to one group of people or the other.
And so we're very comfortable with prescribing medications if we need to, if we know that we need to get them to different therapy options, then that is something that we're very comfortable with, even just coordinating care. And so that can be a huge benefit for mom, especially if it's something that we need to do on an urgent basis, rather than waiting a few weeks, if we have those connections already in place.
One of the things that we have been involved in recently is a project called Kansas Moms In Mind. And it's a program that focuses on mental health before, during and after pregnancy. And this program also gives us access to different consultants, especially on an emergent or urgent basis. But even if we have questions about a medication, whether or not that is okay in pregnancy or with breastfeeding, then we have those services available to us to find out those answers.
Host: Great. Let's talk for a moment about something I also know the hospital offers and that's lactation consulting. How does this in-house service enhance the overall care that's provided?
Dr. Neill: Breastfeeding can be a very important part yet frustrating part after delivery. It's so worth it, but it can require a lot of troubleshooting. So, we have a lactation consultant in house. She's one of our nurses and she's had special training in breastfeeding and helping assisting mom with breastfeeding. And so near delivery near the time of delivery, about 37, 38 weeks, we usually set up a consultation with her. And so, she can get an idea of any previous experience mom has, answer any questions that mom has, and just kind of get those jitters out of the way before delivery. And so right after delivery, one of the things we try to focus on, as a breastfeeding and baby friendly hospital, is that we really try to focus on that golden hour.
And so, that initial hour after delivery is really focused on getting mom and baby to bond. And if mom desires to breastfeed, then we start the breastfeeding process at that point. So, we try and get baby to latch and that will help with overall milk supply and help milk come in. Well one of the ways that our lactation consultant can help with that is if she's in the hospital at that point, then she can come in and help with that initial care. But she'll also, even if she's not in the hospital, we can always call and talk to her as a provider or even the nurse who's taking care of the patient. And the lactation consultant will be in and within 24 hours after the delivery, after mom has had some time to figure out what's working, what's not working and just help troubleshoot, especially if baby's having some problems latching or like with weight gain or anything like that. It just offers a little bit more comprehensive care for those moms who are wanting to breastfeed.
Host: This all sounds like very comprehensive care. I know also free car seat installation is another benefit to patients at Norton. Are there any other services you want to add about maternal care in rural settings?
Dr. Neill: One of the other services that we offer is a 3-D ultrasound during the third trimester, maybe about 28 or 30 weeks. That way we can get a nice little picture of baby, if he or she is cooperating with that. You kinda touched on the car seat installation. So, we'll usually do that about the 37 week mark so that we know that baby's going home in a safe vehicle and that mom and dad don't have to necessarily worry about that afterwards.
Again, with family medicine, we get to focus on a lot of different kinds of care. But one of those is that is that newborn care and that newborn period, we know mom throughout the pregnancy and we know how delivery went and any issues that mom was struggling with right after delivery. And so whenever we follow up with newborn care, it's usually within a few days after leaving the hospital. And it's great because we already know what's going on. We know may have been frustrating mom so we can check in, see how those things are doing. If mom's having a rough time, we can talk with her during that visit and we can still focus on the newborn during that visit too. And so, that's one of the great things about us being family medicine and one of the reasons that we love family medicine so much.
Host: Sounds like mom, baby, dad, and everybody else is well taken care of up there at Norton. Thank you very much, Dr. Neill.
Dr. Neill: You're very welcome. Thanks for having me.
Host: Thanks for listening to Health in the Heartland. You may find out more about Norton County Hospital online at ntcohosp.com. I have been your host Evo Terra. Take care of yourself and others. Be well.