St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Amy Loughlin and Jan Melsom
OB-GYN Associates of St. Augustine 

Not Your Traditional Hospital Birth


August 1, 2017 | View PDF

The number of women choosing an out of hospital birth experience is growing and these may be some of the reasons for this choice. It was the local community's growing desire for different birth options that prompted Flagler Hospital to develop their Low Intervention Suites (LIS). After meeting with community stake holders the development committee at Flagler Hospital proposed setting up designated rooms for families that choose to labor in a more homelike setting. While Flagler Hospital has always recognized a families right to self-determination and participation in the birth process, setting up the LIS was an outward commitment to this philosophy.

The voice of the patients that have taken advantage of the LIS helps to tell the story. Marissa commented that her desire to utilize the LIS stemmed from wanting to be unmedicated and to have midwives provide care. She felt that delivering in the hospital gave her a sense of reassurance but having the opportunity to deliver in the LIS was the best of both worlds. Marissa has delivered 3 babies in the LIS and drives by other hospitals specifically to have the LIS experience. As one of the first patients to utilize the room, Marissa has noted that by her third birth the staff had increased their comfort and expertise with this concept of care.

Joanna recently delivered her first baby in the LIS and said that the hospital and staff went above and beyond her expectations for her childbirth experience. She stated that she and her husband were attracted to the philosophy of the low intervention approach as it increased her options of being able to move around freely. After participating in a tour and taking childbirth classes Joanna made her decision to have a low intervention birth. Although a home birth or birthing center birth was considered, both Joanna and her husband felt more comfortable delivering in the hospital.

Stephanie was originally attracted to the concept of an LIS delivery because of her discomfort with and sensitivity to medications. She desired to have some control in the process. Stephanie felt there was the right balance between staff being present for her and allowing her the privacy to labor with her husband. She felt that both births that she has had in the LIS have exceeded her expectations and states that it was like delivering at home but with safety features available and none of the clean-up.

"We are there to support women in their choices and to help them accomplish their goals safely" says Kaitlin, RN. "We are giving people the opportunity to labor and deliver per their desires while still providing for any emergency situation" is why Cristine, RN thinks having the LIS is an important option. The ability to intervene does not mean providers will intervene unnecessarily. While emergencies can often be prevented, the hope with every labor and delivery is that it is clear sailing and things go as expected. When every minute counts, having a plan for a smooth transition of care from low risk to emergent is paramount. Delivery in the LIS at the hospital allows recognized emergencies for mommy or baby to be dealt with in minutes.

Women are screened during pregnancy to determine if they are safe candidates for a low intervention birth with criteria being very similar to eligibility for a birth center or home birth. Families that desire a delivery in the Low Intervention Suites are asked to participate in a class so that expectations can be expressed by the families and the staff can make sure goals are aligned. For the purpose of reporting, only the families that attend the LIS class are included in the LIS numbers.

The Low Intervention Suites are not a birth center as they are located within the hospital birth unit and location is paramount to designation. LIS recognizes the importance of physiologic birth, or watchful waiting of the normal process of labor and birth. This commitment is supported by the hospital administration, but is carried out by the nurses, Certified Nurse Midwives and Physicians that choose to offer delivery services in the Low Intervention Suites.

Since opening the doors in 2013 200 families have welcomed their newest members within the Low Intervention Suites. From March 2015 to March 2017 75% of the patients in LIS received no medical intervention during labor and 96% delivered vaginally. During this time the hospital has also seen a rise in the number of women who deliver without any regional medications (21%) including epidurals. It is our belief that the presence of the LIS and the education to the obstetric unit has increased staff awareness and comfort with using holistic comfort measures for all laboring women not just the ones who have decided to deliver in the LIS. By increasing awareness of the Low Intervention Suites Flager Hospital hopes to be a viable birth site for women who may not have otherwise chosen to deliver at a hospital.

Amy Loughlin, Nurse Midwife

My name is Amy Loughlin and I have been practicing midwifery with OB-Gyn Associates since 2007. Midwifery has been my calling since the birth of my son Griffin. As a young mother I felt that the midwife who delivered my son not only brought him into the world but helped to transition me into parenthood. Heck, if I could give birth to a baby I could surely be a mom!

I became a certified nurse midwife in 2002 after graduating from the University of Maryland at Baltimore. My first job as a midwife was in rural South Carolina working at a federally funded community health center. It was here that I learned about "being with women" which is what midwifery is all about. I also became a National Health Service Corp Recipient, a program that encourages providers to work in underserved communities.

After five years in South Carolina my husband and son, both avid surfers, asked if we could move to the coast. Our search for a small beach town brought us to St. Augustine and we couldn't be happier!

Working for OB-Gyn Associates is wonderful. We serve a varied population of families thorough different stages of life. I truly enjoy being the person to help women transition into parenthood just like I did 17 years ago. I also enjoy educating women who want to space out their families. Empowering women to care for themselves is more rewarding than I ever imagined.

Jan Sanchez, Labor and Delivery Department Manager

Janice has devoted her nursing career to caring for families during childbirth. She has worked at Flagler Hospital for 11 years and is currently the Director of Maternal Child Health.

When not at work she enjoys gardening, traveling, outdoor activities, and spending time with her 2 young adult children.


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