Maggie McKay (Host): Getting pregnant, going through the process of nine months of change to your body, and then the big day, the actual birth of your baby. There is a lot to prepare for. Our guest today is RN and Director of Women's Services at Summerlin Hospital with UHS, the Valley Health System, to talk about the birth journey and experience and even birth trauma. Welcome, Early. It's so nice to meet you. I can't wait to talk to you more.

Early Ritter: Well, thank you. Thanks for having me.

Host: First of all, you wear a lot of hats in addition to the title that we just mentioned. You also are going back to school, you can tell us about that. And you serve as an Adjunct Professor of Nursing at a nearby college. How do you fit all that in?

Early Ritter: Well, it's quite complex and difficult, especially with a family. But I try to muster things and try to do the best I can for my career path. Women's services and women in general in their pregnancies is my passion. I really want to make sure that they have everything they need. And so, sometimes that means that we have to go back to school to ensure that physicians and nurses get the best that they can from me.

Host: And as Director of Women's Services at Summerlin, what does that involve?

Early Ritter: It's a wide variety of things. But mostly, I oversee all of things due to pregnancy, so maternity services. I oversee labor and delivery, high-risk antepartum, our postpartum units, and all things involving the baby's newborn nursery.

Host: Wow. That's also crucial in life and death. I mean, it's such an important role. What originally inspired you to choose that path?

Early Ritter: I started out my career in business, and it was healthcare, but business in relation. And I really truly wanted to branch into nursing ever since I was little. And so, I decided that I was going to do that. And later on in life in my 30s, I decided to go to the venture and go to nursing school. But with three kids at home, that was also very taxing for me. And I think the inspiration of having children of my own helped drive me into obstetrics. And I really enjoyed my birth experience with my first three, but there was also some things that were catalysts to not so good experiences that I wanted to change.

Host: And you mentioned a few things that you do at Summerlin Hospital. Can you tell us more about the Women's Services, the program, what they offer?

Early Ritter: We have a huge facility that has 16 labor and delivery rooms, four PACU beds, three ORs for our C-sections, and also anything else that needs to be taken care of in an OR setting. We have 24 postpartum rooms, 16 antepartum rooms. So, we have a huge facility. We do about 4,500 deliveries a year. We do the most in Las Vegas. And with that comes a lot of complexities with the different varieties of acuities of women that come in.

Host: Early, do you still follow the patients after their babies are born?

Early Ritter: Sometimes we do. There's a lot of educators that we have here. So, we have lactation consultants and childbirth educators. And then also, anyone that had just wanted to keep in touch with us. We'll sometimes get calls from them. And a lot of social media, you know, they'll post and they'll tag us in Summerlin Hospital. So, we do hear from them. Otherwise, there's so many that we kind of lose track of all of them.

Host: Right. Right. Well, of course, 4,500 a year, my goodness. So God forbid, if there is trauma involved in a birth, how do you help the patient deal with that?

Early Ritter: We really have done a lot in the last 10 years in the last decade to look at this very thing. And one of the major things that I have looked at was we look at moms in the facet of they have nine months to think about a delivery of a beautiful bouncing baby or babies. And what ends up happening sometimes is, as their dream unravels, when something goes wrong in a hospital setting, trauma comes into play. So, that could include postpartum depression, PTSD, posttraumatic stress disorder, anxiety, depression, unease, distress, problems with family, building relationships, not only with their family, but also with their brand new baby. And in turn, you see a lot of posting on social media about this very thing, so there becomes a distrust of our hospitals in the setting. And realistically, there probably wasn't anything that could have been done to facilitate a different outcome. However, it is in our purview that we need to look at this as nurses and make sure that these patients are empathized with, that we understand the things that they're going through. So that way, we can ensure that they're getting consent and that they're understanding what's going to happen, they're educated, and they have more of a grasp on that. We can't just assume that a mom comes into the hospital and knows exactly what's going to happen because she's read some books or got online. So, we have a huge undertaking to make sure that these moms are well taken care of, especially emotionally and mentally.

Host: Boy, isn't that the truth? You can take every class under the sun until you're blue in the face, you can read every book and you still aren't going to know until you're in it.

Early Ritter: Absolutely, yes.

Host: I think. I mean, that was my experience. I thought I knew it all. Then, I'm like, "Uh-oh, they didn't talk about this and this and this and this." Anyway, you mentioned lactation services. You are a lactation consultant, helping moms with that breastfeeding journey. Tell us about the benefits and the challenges.

Early Ritter: Well, you know, a lot of moms come in and they have this beautiful picture painted that they're going to breastfeed and they want to do that and we really want to help facilitate that dream for them. But many of them, they come in and they're tired and they just go, "Okay, give the baby a bottle." And we all know the best thing for babies is breast milk. You don't see a cow feeding a baby or you don't see a human feeding a cow. So, the best form of feed is through a mom's milk.

So, we will work with our moms and try to make it as seamless as possible. And that is exactly why I became a lactation consultant so that I could help with our lactation department and really help them flourish and grow and ensure moms get the best that they possibly can from us in terms of support and followup and all of those things. So, we have breastfeeding support groups every month here. So, it's great, it's great for moms and to try to help facilitate that for them.

Host: Yeah, that's so helpful because it can be frustrating if your baby isn't taking to it. I have to imagine, Early, that the best part of your job is seeing new life come into the world. For people who may never experience that, can you even try to describe it?

Early Ritter: It's difficult to describe because it is absolutely the most beautiful thing I've ever seen. There's two pieces of life that are just almost indescribable, and one is life and one is death. And they're completely different. But in terms of how it appears to a nurse, it is absolutely just breathtaking. I have been in a thousand births at least, if not more, on my own. And realistically, you look at each one and I always cry.

Host: Sure. How could you not?

Early Ritter: it's just watching that partner and that mom have that baby just enter the world, take its first breath. It is really beautiful. And it can also be very sad for those who have never experienced that because there's so many people struggling with that very thing, with their fertility, et cetera. So, living ambiguously through those people though can help you realize that journey, and you can see the wonders of it and it's beautiful.

Host: I bet. So Early, when you have expectant moms who are nervous, how do you ease their fears? What do you tell them?

Early Ritter: It's okay to be scared and it's okay to be nervous. I never liked to use the cliché, you know, "Oh, bunch of women have done this year after year," because their experience and their perceptions are their own. So, their fear is going to be very personal. We know that each birth is different. And so, we like to capture what helps them ease their fears. You know, if the more fear you have, the more anxiety you have and the more it hurts, right? So, we try to ensure that they're breathing and meditating and trying to get as calm as possible utilizing the people in the room to help them. Doulas always help the nurse that's with them, always can help and to ensure that they're getting what they need. We have aromatherapy that helps. Music helps. And also, the knowledge to know that we're here. We've seen it all. And we're going to take really good care of you and your baby. We're going to make sure that nothing bad happens to you. And I think that that a lot of times will help.

Host: That would be very reassuring. Is there anything else you'd like to share that we didn't cover?

Early Ritter: I just really want to make sure that women know that they're safe to come to the hospital that we really do look at everything and try to care for them just as much as if they delivered in a home setting. There's a huge push, and especially through COVID, of moms who wanted to deliver at home because they were either afraid of the hospital or they've heard things in the media or in social media that the hospital was a scary place. And I just want to reassure them out there that we are safe. We're a safe place to land for you. We're going to take really good care of you and your baby, and we're going to try to make it look just like home.

Host: Oh, that's so nice. Well, thank you so much, Early. This has been so interesting and educational. We really appreciate your time.

Early Ritter: Absolutely. Glad to be here.

Host: Again, that's RN, Early Ritter. If you'd like to find out more, please visit our website at www.valleyhealthsystemlv.com. Thank you for listening. I'm Maggie MacKay. And if you found this podcast helpful, please share it on your social channels and check out our entire library for topics of interest to you. This is Health Talk with the Valley Health System, presented by the Valley.

Physicians are independent practitioners who are not employees or agents of the Valley Health System. The system shall not be liable for actions or treatments provided by physicians.