If your unborn baby is diagnosed with an abnormality, or if you require high-level pregnancy care, a specialized fetal center can significantly improve your pregnancy prognosis. The choice of a fetal center is a personal one, but your decision should be guided by fact-based evidence. Here are six things to consider as you research your options.
1. High-level, integrated prenatal and postnatal care
When choosing a fetal center, you want to look for one that offers the highest level of care with a broad spectrum of disciplines. Multiple specialists are often involved in the care of a baby with an abnormality. This care begins during pregnancy, continues after birth and, in some cases, into adulthood.
When choosing a fetal center, think about the doctors who will care for your child, how they will communicate with each other, and the level of care offered at the facility. It is critical for your doctors to communicate and work together in agreement, but their close proximity to each other is also important. Optimally, they should be at the same site with access to critical care resources.
Here at Texas Children’s, we have state-of-the-art facilities with a level IV Neonatal Intensive Care Unit, as well as a fantastic team of neonatologists and pediatric specialists. Not only is our staff located under the same roof, but the communication level between maternal-fetal medicine and pediatrics is excellent. It is, in my experience, one of the best examples of follow up, communication and teamwork I’ve seen in my career. We are one and we all participate in the care of our patients. This is something very unique about Texas Children’s. This would be important to me if I were choosing a fetal center.
2. Experience, track record and transparent reporting
When considering a fetal center, you will want to make sure the center has significant experience, an excellent track record and transparency of data. Just looking at the number of procedures a center completes can be an indication of their experience with a particular condition; however, you should also research their outcomes and survival rates. Specifically, look at how many babies the center has treated with the same or similar condition to yours. Make sure you understand the long-term outcome of their cases, as well as the survival rates.
Texas Children’s Fetal Center is one of the most experienced centers in the country with outcomes and survival rates among the best. Not only are we committed to excellence clinically, but also in our data reporting. Our Outcomes Team is dedicated to collecting, documenting and reporting outcomes of all moms and babies. This information is posted on our website so patients can see outcomes, rate of complications, survival and volumes. Comparing this data across fetal centers is one of the best ways to make a decision about your care.
3. Research and innovation
Another factor to consider in choosing a fetal center, is how research and innovation driven they are. This is an important aspect, as research and innovation are the only ways to advance in this field. Typically, an academic hospital, versus a private practice, will be more focused on research. By following patients over time, research institutions can gain a better understanding of intervention implications and provide wise patient counseling. These facilities are also innovators in the field, taking on rare or extremely complex conditions, and often setting new standards for treatment.
Texas Children’s is an academic institution, partnering with Baylor College of Medicine —research and innovation are important aspects of what we do. We don’t limit ourselves to only treating the most common conditions a baby might have. Rather, we embrace rare and uncommon cases, putting our heads together as a team of specialists to determine the best and safest solution for mother and baby. We also follow our babies and moms over the long run to better understand their outcomes and improve our protocols. I believe it is impossible to push the envelope and keep moving forward in this field if you don’t have a clinical practice hand-in-hand with clinical research.
4. Infrastructure to care for mom
The care infrastructure within a fetal center is something to carefully consider in your decision as well. With high-risk deliveries, you have to be prepared for any situation. You want to make sure the facility you choose has a comprehensive array of skilled specialists, competent anesthesiologists, the ability to assess high-risk needs, and the tools to respond in case of an emergency.
At Texas Children’s, we will assess your risk and develop a plan, but also be prepared for anything. We have specialists in every foreseeable area—from cardiology to pulmonology to critical care—on call 24/7 and ready to provide the highest level of care. Our team of anesthesiologists has vast experience managing complications, and we have operating rooms ready to go when needed. If a transfusion is necessary, we have an excellent, competent blood bank on standby. Also, our recently-opened maternal ICU for expectant moms, an uncommon amenity among fetal centers, allows us to specialize our care for mom. Everything is in-house or within reach and that significantly improves the care patients receive. Personally, I believe we provide the best care possible for moms at Texas Children’s Fetal Center.
5. Established clinical protocols
Established, evidenced-based protocols at fetal centers are absolutely imperative for proper care, especially when many specialists are involved. These pre-set, rehearsed procedures allow all physicians to respond in a homogenous, systematic and calm fashion, even in the most unexpected situation or emergency. Protocols provide great reassurance that you will be taken care of in a professional and systematic manner, regardless of who is treating you or what time of day it is.
At Texas Children’s we diligently follow evidence-based clinical protocols established by the scientific societies. We also have our own in-house protocols adapted from these. All of our physicians know what to do in every situation, ensuring consistent, quality care.
6. Personal connection and comfort
When you narrow your search to a few fetal centers that all offer equal care, then you should consider your own personal connection or comfort level. You will spend a lot of time with the nurses and physicians who take care of you, so you want to be comfortable around them, have open communication and know they support you. A center should provide resources and staff to help you navigate your journey, not just from a clinical perspective, but also physically, emotionally and logistically.
In initial consultations at Texas Children’s, when a serious condition is confirmed, we tell patients—from that moment on—we are part of their family. And we really mean this. From the doctors, to the nurses and all the other staff involved, we are there for the long haul. My patients tell me so often about the phenomenal care they receive from our nurse coordinators. I know from my own daily interaction with them that they aren’t just doing their job. They have an incredible passion for their patients and get intimately involved in their lives—the clinical plan, living situations, travel arrangements, social needs, everything and anything.
We have an excellent team of support for our patients and their families. Many patients return years later or keep in touch by calling or texting us. We love seeing how our patients and their families are doing years later. Regardless of the outcome, we are there for our patients ready to support them in any way we can. That’s what families do.