A New Beginning

A New Beginning Your personal guide to mom and baby care

Breastfeeding Resources • Lactation Consultations • Advice Line — Atlanta and Forsyth: 404.303.3329, Cherokee: 770.224.1970 • For our free online breastfeeding course and additional information go to: northside.com/breastfeeding

Mom-Me Connection The choice to breastfeed your baby is very rewarding but may be challenging at times. We are dedicated to providing you with the highest quality information and assistance to help you breastfeed. Our Mom-Me Connection allows nursing mothers a weekly opportunity to connect for socializing, support, and problem-solving, with a Board Certified Lactation Consultant as the facilitator. Topics include: building/maintaining milk supply, feeding at night, preparing for back to work, etc. Open to moms and their babies (birth to crawling). Visit our website: northside.com/Support-Groups for updated information on location addresses and meeting times. Or call 404.303.3329 for additional information.

When to Call 911 for Mother

Make sure to tell 911 you had a baby

• Difficulty breathing (Severe shortness of breath)

• Seizures

• Chest pain, tightness or pressure

• Thoughts of hurting herself, baby or others

• Unresponsive

• One-sided muscle weakness or paralysis (Slurred speech)

Always follow mother’s hospital discharge instructions!

A NEW BEGINNING Your Personal Guide to Mom and Baby Care

Welcome and congratulations to you and your family! Thank you for choosing Northside Hospital to experience one of the most important times of your life. We pledge compassionate support, personal guidance and uncompromising standards as you start your New Beginning with baby. Have this guide available while you are with us. Your nurses will refer to it often while educating you about both you and your newborn’s care. A New Beginning is yours to take home and refer to when you have questions or concerns. The information in this book does not replace advice given to you or your baby by your health care providers. YOUR NORTHSIDE HEALTHCARE TEAM

Digital Companion to Your Book

Looking for a fun way to learn new things? The CCI Scan + Play app is a FREE tool that makes it fast and easy to watch helpful videos on several interesting topics in this book. You can also use the app to enjoy more great interactive features:

BREATHING EXERCISES Stress reduction and relaxation are very important throughout your pregnancy and childbirth journey. Use breathing exercises in our app to help reach calm and focus.

STICKERBOOK Embellish your special moments with Stickerbook. Whether announcing the gender of your baby or just capturing a sweet moment, our beautiful hand-drawn stickers are a great addition to your photos.

EDUCATIONAL VIDEOS They say a picture is worth a thousand words. That’s why we added several educational videos to enhance your learning experience as you read this book. All video content is medically accurate and up to date with the latest medical standards.

HOW TO USE APP

FIND Look for the purple Scan + Play icons throughout this book.

SCAN Use the CCI Scan + Play app to scan the purple icons.

PLAY Sit back, get

DOWNLOAD Visit customizedinc.com/ ScanAndPlay and download the CCI Scan + Play app or scan this icon.

comfortable, and enjoy your video!

VIDEOS IN THIS BOOK

TABLE OF CONTENTS

YOUR HOSPITAL STAY Congratulations!.....................................................................................7 Welcome to Family Centered Care.......................................... 8 Communication...............................................................................8 Visitors................................................................................................ 9 Visitor Parking............................................................................... 9 Nutrition............................................................................................ 9 Your Rights and Responsibilities............................................. 10 Your Clinical Care................................................................................13 What to Expect from Your Clinical Care.................... 13 Be an Active Participant in Your Care...................................13 Nurse Bedside Shift Report................................................. 13 Postpartum Medications...............................................................14 Your Responsibilities.................................................................. 14 Medications While in the Hospital................................. 14 Medications Brought in From Home........................... 14 Medications When You are Discharged.................... 14 Differences Between Allergies and Side Effects....................................................................................15 Postpartum Medication..................................................................16 Postpartum Pain..................................................................................17 Managing Your Pain is Important................................... 17 Communicating Your Pain.................................................... 17 Scheduled Pain Medications.............................................. 17 Important Safety Information....................................................18 Falls............................................................................................................18 Preventing Infections........................................................................18

Hand Hygiene........................................................................ 18, 72 Uterus Changes...................................................................20, 34 Postpartum Perineal Care........................................... 21, 35 The Bottom Line on Hemorrhoids......................22, 36 Cesarean Birth Care..................................................................33 Postpartum Emotions............................................................42 Edinburgh Postnatal Depression Scale................... 48 Rest and Sleep............................................................................. 56 Jaundice.............................................................................................76 Baby Behavior...............................................................................86 Shaken Baby Syndrome.......................................................88 Skin-to-Skin..................................................................................... 92 Umbilical Cord Care................................................................. 94 Diapering..........................................................................................96 Swaddle............................................................................................. 97 Safe Sleep.........................................................................................99 Bathing Your Baby................................................................... 101 Milk Production.........................................................................106 Feeding Cues...............................................................................108 Breastfeeding Positions......................................................... 111 Breastfeeding Latch................................................................ 112 Burping Baby...................................................................... 113, 136 Hand Expression.........................................................................116 Formula Preparation.............................................................. 142 Car Seat Safety............................................................................155

V100.0173 Copyright 2000, 2019 by Customized Communications, Inc. All Rights Reserved Updated: 9/2015, 8/2016, 3/2018, 9/2019, 6/2022 Arlington, Texas | 800.476.2253 www.customizedinc.com | cci@customizedinc.com A New Beginning: Your Personal Guide to Mom and Baby Care is for general reference purposes only and cannot be relied upon as a substitute for medical care. You and your baby should have regular checkups with your health care provider. You should also consult with your health care provider about any special questions or concerns.

CHAPTER 1 Vaginal Delivery

CHAPTER 3 Emotional Changes

Emotional Highs and Lows...........................................................41 Emotional Changes....................................................................42 Postpartum Blues........................................................................ 42 12 Tips for Dealing with the Baby Blues..............................43 Perinatal Mood and Anxiety Disorders...............................44 Symptoms of Perinatal Mood and Anxiety Disorders [PMADs]...............................................45 Perinatal Mood and Anxiety Disorders: Is This Normal?..................................................................................... 46 PMADs are Treatable.................................................................46 Partners Can Experience Postpartum Depression Too...............................................46 Postpartum Post-Traumatic Stress Disorder (PTSD).............................................................. 47 Postpartum Psychosis............................................................. 47 Edinburgh Postnatal Depression Scale............................. 48 Edinburgh Postnatal Depression Scale Questionnaire...................................................................................... 49 Postpartum Support International.......................................50 You’re Planning to Go Home.......................................................51 Your Hospital Discharge................................................................52 Discharge Planning Starts When You Arrive........52 Before You Leave the Hospital..........................................52 Baby’s Discharge..........................................................................52 Important Questions to Ask About Your Discharge..............................................................52 Expected Physical and Emotional Changes at Home....................................................53 Cesarean Incision.........................................................................53 Activity...................................................................................................54 Discomfort & Pain........................................................................54 Family Planning & Resuming Sex...................................54 Emotions & Mood Swings.....................................................54 What You May Expect Over the Next Few Weeks........................................................................ 55 My Plan for Help at Home the First Few Weeks........... 56 Help Your Family Transition................................................ 56 Eat Healthy to Keep Up Your Energy................................... 59 Set Realistic Expectations and Be Flexible..................... 59 Heart Disease.......................................................................................60 Positive Lifestyle Changes....................................................60 Gestational Diabetes..................................................................61 High Blood Pressure...................................................................61 Delivered Before 37 Weeks...................................................61 Postpartum Preeclampsia....................................................61 Warning Signs of Postpartum Preeclampsia..................62 CHAPTER 4 Mom’s Discharge

Physical Changes.................................................................................19 Postpartum Changes Beyond the First Day................... 20 Uterus.................................................................................................... 20 Involution and After-Birth Pains..................................... 20 Vaginal Discharge (Lochia).................................................. 20 Showering...........................................................................................21 Perineum.............................................................................................21 Bladder.................................................................................................22 Hemorrhoids....................................................................................22 Fluid Shifts and Swelling.......................................................22 Bowel Elimination.......................................................................23 Breast Engorgement.................................................................24 Muscle and Joint Discomfort.............................................25 Skin Changes...................................................................................26 Eye Hemorrhages........................................................................26 Varicose Veins..................................................................................26 Hair Loss...............................................................................................26 Cesarean Delivery...............................................................................27 Bed Rest .............................................................................................28 Urinary Catheter............................................................................28 Deep Breathing Exercises.....................................................28 FAQs about Catheter-Associated Urinary Tract Infection....................................................................29 Cesarean Pain...................................................................................... 30 Managing Your Initial Post-Operative Pain........... 30 Managing Your Post-Operative Pain as You Recover.............................................................................. 30 Getting Out of Bed for the First Time..........................31 While Out of Bed, You Are at Risk for Falling........32 Gas............................................................................................................32 Your Cesarean Incision............................................................33 Showering..........................................................................................33 Postpartum Changes Beyond the First Day....................34 Uterus.....................................................................................................34 Involution and After-Birth Pains......................................34 Vaginal Discharge (Lochia)...................................................34 Perineum............................................................................................35 Bladder.................................................................................................36 Hemorrhoids....................................................................................36 Fluid Shifts and Swelling.......................................................36 Bowel Elimination.......................................................................37 Breast Engorgement.................................................................38 Muscle and Joint Discomfort.............................................39 Skin Changes.................................................................................. 40 Eye Hemorrhages....................................................................... 40 Varicose Veins................................................................................. 40 Hair Loss.............................................................................................. 40 CHAPTER 2 Cesarean Delivery

TABLE OF CONTENTS

CHAPTER 5 Warning Signs For Mother & Baby

OB Inpatient Warning Signs...................................................... 63 POST-BIRTH Warning Signs....................................................... 65 When to Call 911 & When to Call Your Baby’s Health Care Provider.......................................................67

CHAPTER 6 Your Baby’s Hospitalization

Never Shake a Baby......................................................................... 88 Late-Preterm Babies....................................................................... 89 Feeding Tips for Late-Preterm Babies.......................90

Your Baby’s Care................................................................................. 69 Hospital Routines.............................................................................. 70 Baby’s Clinical Care Team.................................................... 70 Baby’s Clinical Care Routines............................................ 70 Choosing Your Baby’s Health Care Provider...........71 Newborn Identification and Security ....................................71 Newborn Identification...........................................................71 Hospital Security Measures..................................................71 Preventing Infections.......................................................................72 Hand-Washing is Important...............................................72 When Mother is Ill and Contagious..............................72 Cold Sores...........................................................................................72 Preventing Newborn Falls............................................................72 Northside Hospital Circumcision Process.........................73 If You Choose to Circumcise Your Baby Boy.........73 Newborn Pain Management......................................................73 Routine Newborn Procedures and Medications..........74 Apgar Score...................................................................................... 74 Erythromycin Eye Ointment............................................... 74 Vitamin K............................................................................................. 74 Hepatitis B.......................................................................................... 74 Other Newborn Medications......................................................74 Dextrose Gel..................................................................................... 74 Tylenol.................................................................................................... 74 Important Newborn Health Screenings............................75 Jaundice...................................................................................................76 Risk Factors for Jaundice.......................................................76 Signs & Symptoms of Jaundice........................................76 Types of Jaundice.........................................................................76 Screening and Testing for Jaundice......................................77 Treating Jaundice...............................................................................77 Feedings..............................................................................................77 Phototherapy...................................................................................77 Blood Sugar and Car Seat Screening for High Risk Newborns.................................................................78 Welcoming Baby!................................................................................79 Baby’s Appearance...........................................................................80 Birthmarks...............................................................................................82 Baby Senses........................................................................................... 83 Your Baby’s Behavior....................................................................... 84 Sleep Patterns..................................................................................... 84 Tips for Waking a Sleepy Baby......................................... 84 Crying or Fussing............................................................................... 85 Temperament................................................................................ 85 Crying.................................................................................................... 85 Ways to Soothe a Fussy Baby............................................ 85 Overstimulation.................................................................................. 86 What is Colic?........................................................................................87 Coping with Colic.........................................................................87 Period of PURPLE Crying.......................................................87 CHAPTER 7 Getting to Know Your Baby

CHAPTER 8 Caring for Your Baby

Learning About Your Baby............................................................91 How to Pick Up and Hold Baby................................................92 Skin-to-Skin Contact.................................................................92 If Baby Gags or Chokes.................................................................. 93 How to Use a Bulb Syringe..................................................93 What to Do If Baby Gags or Spits...................................93 Umbilical Cord..................................................................................... 94 Wet Diapers........................................................................................... 95 Bowel Movements............................................................................ 95 Diaper Changes.................................................................................. 96 How to Change a Diaper...................................................... 96 Diaper Rash...................................................................................... 96 Dressing and Swaddling...............................................................97 Rooming-in............................................................................................ 98 Safe Sleep............................................................................................... 99 ABCs of Safe Sleep........................................................................... 99 Tummy Time.......................................................................................100 The Power of Play............................................................................100 Bathing Your Baby........................................................................... 101 Tub Bathing Baby..................................................................... 102 Cradle Cap...................................................................................... 103 Nail Care............................................................................................ 103 Caring for a Circumcision.......................................................... 103 Plastibell Circumcision Procedure............................. 103 Other Circumcision Procedures................................... 103 Caring for an Intact Penis.......................................................... 103 Taking Baby’s Temperature...................................................... 104 Only Digital Multiuse Thermometers are Recommended for Newborns............................. 104 How to Take an Axillary Temperature...................... 104 How to Take a Rectal Temperature........................... 104 Welcome to Your Breastfeeding Journey....................... 105 Physiology of the Breast...................................................... 106 Milk Production.......................................................................... 106 Colostrum........................................................................................ 107 Exclusive Breastfeeding...................................................... 107 How Do I Know My Baby is Ready to Breastfeed?.... 108 Newborn Tummies Are Very Small!.................................... 109 Cluster Feeding.................................................................................. 110 Breastfeeding Positions................................................................. 111 Latch-On.................................................................................................. 112 Signs of a Proper Latch-on.................................................. 112 Baby-Led Latch............................................................................. 112 Burping..................................................................................................... 113 How Do I Know My Baby is Getting Enough to Eat?................................................................. 114 CHAPTER 9 Breastfeeding

Cleaning Feeding Supplies......................................................... 141 By Hand............................................................................................... 141 By Dishwasher............................................................................... 141 Extra Sanitizing............................................................................. 141 Storing Supplies........................................................................... 141 Preparing Formula for Your Baby......................................... 142 For Powdered Formula......................................................... 142 For Liquid Concentrate......................................................... 142 For Ready-to-Feed Formula.............................................. 142 Frequently Asked Questions about Making Formula Types of Water for Mixing Formula ...................................... 143 Frequently Asked Questions about Making Formula Heating, Storing, and Milk Storage Guidelines ..........144 Cronobacter Infection...................................................................145 Frequently Asked Questions....................................................146 Formula Feeding Logs.................................................................. 147 Taking Your Baby Home...............................................................151 Planning to Take Baby Home Starts at Birth................152 While You’re in the Hospital.............................................. 152 Important Questions to Ask About Your Baby......................................................................... 152 Get All of Your and Your Partner’s Questions Answered ............................................................. 152 Choosing a Car Seat.......................................................................153 Get Your Car Seat Inspected............................................153 General Rear-Facing Car Seat Installation Tips............................................................................153 Used Car Seats.............................................................................153 Car Seat Instructions and Safety Information..............154 How Long Should Baby Stay in a Rear-Facing Car Seat?..................................................154 Baby’s Car Seat...................................................................................155 Before Your Baby is Discharged....................................155 Can Hospital Staff Put My Baby into the Car Seat?.......................................................................155 Hot Car Safety.....................................................................................156 Look Before You Lock....................................................................156 Arriving Home....................................................................................157 Pets........................................................................................................ 157 Siblings................................................................................................ 157 Baby’s First Doctor’s Office Visit .............................................158 Immunizations...................................................................................159 Recommended Immunizations, Birth–6 Months.................................................................................. 160 CHAPTER 11 Baby’s Discharge

In the Early Days.................................................................................115 Breastfeeding and Formula Supplementation.................................................116 Expressing Breast Milk...................................................................116 Hand Expression..........................................................................116 How to Hand Express..............................................................116 Breast Pumps and Hands-On Pumping...........................118 Pre-owned Breast Pumps...................................................118 Frequency of Expressing.......................................................118 Collection of Breast Milk.......................................................119 Storage of Breast Milk.............................................................119 Thawing or Warming Breast Milk..................................119 Cleaning Your Breast Pump Parts....................................... 120 Washing By Hand......................................................................120 Dishwasher......................................................................................120 Optional Step................................................................................120 Store Safely......................................................................................120 Cleaning Rental Pumps........................................................120 Returning Rental Pumps.....................................................120 Care of the Breasts........................................................................... 121 Sore Nipples.................................................................................... 121 Engorgement................................................................................. 121 Growth Spurts................................................................................ 121 Frequently Asked Questions about Breastfeeding What You May Feel While Breastfeeding, Breastfeeding a Preterm Baby .............................................. 122 Frequently Asked Questions about Breastfeeding Others Feeding Baby, Pacifier Use ...................................... 123 Frequently Asked Questions about Breastfeeding Breast Surgery, Taking Certain Medications ................ 124 Frequently Asked Questions about Breastfeeding Artificial Sweeteners, Alcohol and Caffeine, Mother’s Diet While Breastfeeding ......................................125 Marijuana and Breastfeeding..................................................126 Breastfeeding Logs.......................................................................... 127 Feeding Your Baby a Bottle.......................................................135 How Do I Know My Baby’s Ready to Eat?.............. 135 What Are Proper Bottlefeeding Techniques?.... 135 Paced Bottle Feeding............................................................136 Burping Your Baby..........................................................................136 How Much Should My Baby Eat?.......................................... 137 Formula Feeding Your Baby.....................................................138 Choosing Formula for Your Baby..................................138 Formula Comes in 3 Forms...............................................139 Formula Package Safety......................................................139 How Is Formula Regulated?..............................................139 Unsafe Milk Options.................................................................139 Homemade Formulas............................................................139 Imported Formulas................................................................. 140 Counterfeit Formulas............................................................. 140 Choosing Bottles and Nipples for Your Baby............... 140 CHAPTER 10 Formula Feeding

TABLE OF CONTENTS

CHAPTER 12 Your Experience

Your Patient Experience...............................................................161 We Value Your Insight and Comments....................161 Press Ganey Survey Sample......................................................162

CONGRATULATIONS! Welcome to the Women’s Center at Northside Hospital. While you are here, you and your baby will be cared for by a team of medical and nursing professionals that specialize in maternity and newborn care. This chapter has useful information to help you feel more comfortable during your stay.

YOUR HOSPITAL STAY

7

Your Hospital Stay

Welcome to Family Centered Care

When you arrive at the Family Centered Care Unit, you and your family will be greeted by a mother-baby nurse. The nurse’s goal is to help you recover from the birth, assist with feedings, and provide education about post-delivery and newborn care. Each FCC room is equipped with an individual temperature control, television, and phone. It also has a daybed for your support person and a bassinet with all of the supplies needed to care for your baby.

COMMUNICATION You may use the telephone in your room any

time during the day or night. • Dial “9” to get an outside line.

• To allow you to rest, no incoming calls will come through between 9 p.m. and 9 a.m. • You may use your cellphone. • We cannot charge any long-distance calls to your hospital bill. • Please use a calling card if you wish to call outside the Atlanta, Cherokee, or Forsyth areas.

Main Hospital Numbers: • Atlanta: 404.851.8000 • Forsyth: 770.844.3200 • Cherokee: 770.224.1000

8 A New Beginning

NUTRITION Our goal is to provide you and your baby with optimal nutrition during your hospital stay. Meal selections are based on the orders of your physician. A catering associate will come to your room daily and offer you choices from the menu. If you have any questions about your dietary orders, please ask your physician. Family members are also welcome to bring you food, as long as it adheres to your dietary orders. Pantry: You’ll find coffee, ice water, and juice in the pantry, as well as a microwave and refrigerator. Use orange labels located on top of the refrigerator to label food with your name, room number and date. Food in the pantry refrigerator is discarded after 3 days, so you must relabel any items on the third day that you want to keep. Guest Meal Voucher: Our guest meal voucher program will allow friends and family to enjoy a meal of their choice with their loved one. How to get a meal voucher: Visit the cafeteria cashier and purchase a $3 guest voucher, or at the Atlanta campus, you can visit the Lotus Blossom Café (also known as the coffee shop) in the Atrium. How to order a guest meal: When a catering associate comes to the room to get the patient’s meal order, present the voucher and order the guest meal too. The meals will be delivered at the same time for your convenience. What comes with the $3 meal voucher: The voucher entitles you to a full patient meal (chef selection either #1 or #2 for that meal), or you can use it for the $3 face value in the cafeteria.

VISITORS Please discuss Northside’s current visitation policy with your nurse because it is subject to change. You may invite one adult as your support person to be with you 24 hours a day. This person is welcome to spend the night with you in your room. This is a great opportunity for your support person to ask questions and learn how to best help you at home. VISITOR PARKING Atlanta: Available in the PINK parking deck across from the Women’s Center on Hollis Cobb Drive (per hourly fee). Daily parking passes can be purchased at the kiosk in the parking garage. Cherokee & Forsyth: Available at no charge in the open lot in front of the Women’s Center.

9

Your Hospital Stay

Your Rights and Responsibilities

Your well-being and healing are our primary concern. We believe that a positive hospital experience is a responsibility that is shared by you and your health care provider.

YOUR RIGHTS

You have the right to request and receive information on patient rights, responsibilities and ethics. You have the right to considerate, respectful care and compassionate medical care, regardless of your race, religion, national origin, any disability or handicap, gender, sexual orientation, gender identity or expression, age, military service, or the source of payment for your care. You have the right to have a family member or representative of your choice and your own physician promptly informed of your hospital admissions. You have the right to an identified surrogate decision-maker, as allowed by law, when you cannot make decisions about your own care, treatment, and service. You, your family, and/or surrogate decision maker have the right, as appropriate and as allowed by law, to be involved in care, treatment, and service decisions, including the assessment and treatment of your pain. You have the right to request an environment that preserves dignity and contributes to a positive self-image, including room accommodations as available, reasonable and medically appropriate. You have the right to request privacy and confidentiality as reasonable and appropriate under the circumstances. You have the right to visitors, subject to clinically necessary, reasonable, restrictions established by the hospital and you have the right to refuse visitors. You have the right to have a support person, who may be different from your surrogate decision-maker, who can exercise your rights to receive or refuse visitors when you are unable to communicate. You have the right to communication that you understand, including qualified medical interpretation services and other reasonable accommodations, free of charge, if you have special communication needs due to vision, speech, hearing, language, or cognitive barriers or impairments.

10 A New Beginning

You have the right to telephone and mail services, as reasonable, available, and appropriate within the hospital, setting and patient population. You have the right to request, in a timely manner, the name of the physician(s) and other practitioners responsible for all aspects of your care, treatment, and services. You have the right to know information about any relationship of the hospital and staff to other health care and educational institutions, as it relates to your care. You have the right to request consultation with another physician or specialist, including a pain specialist. You and, when appropriate, your family have the right to be informed about the care you receive, including treatment, services, and anticipated and unanticipated outcomes. You or your surrogate decision-maker have the right to accept or refuse medical or surgical treatment to the extent permitted by law, including forgoing or withdrawing life-sustaining treatment or withholding resuscitative services, in accordance with law and regulation. You have the right to execute, review, and revise an advance directive, and, upon admission, receive information on the extent to which the organization is able, unable, or unwilling to honor advance directives. (The existence or lack of an advance directive does not determine an individual’s access to care, treatment, and services.) You have the right to access, request amendment to, and receive an accounting of disclosures regarding your own health information as permitted under applicable law, including current information concerning your diagnosis, treatment, and prognosis (Health Information Portability & Accountability Act 1996). You and your family have the right to consultation to assist in resolving any ethical issues, concerns, or dilemmas regarding your care, treatment, and services. You have the right to receive pastoral care and other spiritual care services while you are a patient in this hospital. You have the right to be considered as a candidate for organ/tissue/eyes donation. You have the right to have your wishes concerning organ donation honored, within the limits of the law or organizational capacity. You have the right to reasonable personal safety while you are a patient in this hospital, including access to protective services, as allowable by law and as reasonable under the circumstances. You have the right to be informed of hospital rules and regulations that apply to you as a patient and to speak to a Patient All patients have the right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff. Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, staff member, or others and must be discontinued at the earliest possible time. You have the right to freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment, and services. You have the right not to be transferred to another facility or organization, except in an emergency, without your consent to the transfer, including a complete explanation and alternatives to a transfer. (The other facility and you must accept the transfer.) You have the right to informed consent for certain care, treatment, and services provided to you, and the right to refuse participation in research programs and recording and filming for internal and/or external purposes. You have the right to rescind consent for care, treatment, and services provided, including your participation in research programs and recording or filming for internal and/or external purposes. You have the right to receive an itemized and detailed explanation of hospital charges for services rendered and to be provided with financial counseling, free of charge as appropriate. Northside Hospital strives to provide satisfactory care; however, if you have a concern that you feel was not satisfactorily addressed, you have the right to contact a Patient Relations representative. You also have the right to file a concern with the Georgia Department of Community Health. You may reach them at 404-656-4507 or by mail at 2 Peachtree St. NE, Atlanta, GA 30303. Patient safety concerns can be reported to The Joint Commission: At www.jointcommission.org , using the “Report a Patient Safety Event” link in the “Action Center” on the homepage By fax to 630-792-5636 By mail to Office of Quality and Patient Safety, The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL 60181 Relations Representative to have complaints, suggestions for improvements, or concerns heard. All patients have the right to be free from physical or mental abuse and corporal punishment.

11

Your Hospital Stay

YOUR RESPONSIBILITIES

In order to create a partnership that will improve your care, we ask that you give careful consideration of your responsibilities to: Provide, to the best of your knowledge, accurate and complete information about your health history, current condition, and current medication and adverse reactions.

Ask questions if you do not understand any aspect of the care, treatment, or services provided for you.

Cooperate with your doctor, nurse, and other caregivers.

Follow the recommended treatment plan.

Request pain relief when pain first begins and immediately report when pain is not relieved.

Report changes in your condition or anything you think might be a risk to you.

Ask the doctor or nurse what to expect regarding pain and pain management.

Take responsibility for the outcome if you decline or refuse the recommended treatment.

Communicate your wishes regarding end-of-life decisions, including advance directives, with your family, physician, personal attorney, and spiritual adviser.

Discuss your wishes regarding organ/tissue/eye donation with your family, physician, personal attorney, and spiritual adviser.

Show respect and consideration of others.

Follow the hospital’s policies and regulations.

Fulfill the financial obligations of receiving care, including accepting financial responsibility for any consultations with physicians or specialists, including pain specialists.

Request interpretation services when necessary.

12 A New Beginning

Be an Active Participant in Your Care

We believe that you need to be an active and full partner in your care. To help prevent medical errors: • Be sure all the health care professionals involved in your care have important information about you. • Ask your partner or family member to stay with you while you’re in the hospital to be your advocate (someone who can help get things done and speak up for you when you cannot). • Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. • If you have a test, don’t assume no news is good news. Ask for results of all tests. • Learn about your condition or treatments. Use this book as a reference. NURSE BEDSIDE SHIFT REPORT When your nurse goes off duty — between 7 to 7:30 a.m. and 7 to 7:30 p.m. — they will introduce the next nurse who will be caring for you and your baby. The two will meet at your bedside for 5-10 minutes and share important information about you and your baby’s care. Take this opportunity to share your goals and expectations for the upcoming shift. Listen

Your Clinical Care

WHAT TO EXPECT FROM YOUR CLINICAL CARE Your physician has written specific orders for your care. These orders may include: • Assessment of you and your baby’s body. • Lab work specific to you and your baby’s condition. • Type of diet and level of activity. • Medications specific to your diagnosis. • Consultations with other health care professionals, including lactation specialists. What to Expect After Delivery • Your vital signs will be taken at least once per shift — or more frequently, depending on your diagnosis and physician’s orders. • Your activity level will depend on your condition. Most patients can get out of bed and walk after delivery if they are stable. • Vaginal deliveries may take a shower daily if you are stable. Our staff will be happy to help with your hygiene needs. Cesarean deliveries may shower depending on your type of incisional dressing. • If your physician orders lab work, a technician will collect the specimens needed. Please discuss all lab results and questions you may have with your physician. • During your stay, a nurse “leader” will stop to visit you to discuss your hospital experience. You may ask to speak to them to discuss questions or concerns any time during your hospital stay.

You are an important part of your health care team. Listen to your nurses’ report to ensure that they have complete and timely information. Speak Up Ask any questions or raise any concerns you may have. If you do not understand a medical term, feel free to ask them to explain. Participate and Ask Questions Your involvement helps us ensure that you receive the high-quality, individualized care you deserve.

13

Your Hospital Stay

Postpartum Medications

MEDICATIONS WHEN YOU ARE DISCHARGED

Your physician will review all your medications — those you took before the birth and those prescribed after — to prevent any negative drug interactions. Your nurse will also review each of the prescribed medications you will be taking at home and give you written instructions on their use. Make sure you ask any questions you have and discuss any concerns.

YOUR RESPONSIBILITIES • Make sure all your health care providers know about every medication you are taking. This includes prescription and over-the counter medicines and dietary supplements such as vitamins and herbs. • Make sure your health care providers know about any allergies and adverse reactions you have had to medicines. • Ask for clarification if you can’t read the physician’s handwriting on any prescription. • Ask your health care provider to explain your home treatment. Your obstetrical provider will prescribe all medications based on your medical history, if you have a history of any drug allergies or reactions, your type of delivery, and clinical condition. Your nurse will review all these medications with you. Review the medication table on page 16 and ask questions about each medication prescribed. Your nurse can provide more detailed written information about your medications. Let your nurse know anytime you have concerns, questions, or are unsure about your medications. It is important that you understand your medications and are comfortable taking them. MEDICATIONS WHILE IN THE HOSPITAL

Questions to ask before taking a new medication

• What is the name of the medicine and what is it for? • How and when do I take it? • How long do I take it? • Will this work safely with other medicines I’m taking? • Is it safe for me to take this if I’m breastfeeding? • What food, drinks, activities, and dietary supplements should I avoid while taking it? • When should I expect this medicine to begin to work, and how will I know if it is working? • Are there any side effects , what are they, and what do I do if they occur? • What symptoms do I need to be sure to report? • What should I do if I miss a dose? • What is the most important thing I should know about this medication? • Where can I get written information about this medication?

MEDICATIONS BROUGHT IN FROM HOME

The use of any home medications (prescribed, over-the counter, herbs, or vitamins) is discouraged during your hospital stay. This policy helps decrease the risk of any prescription and drug-to-drug interactions. Please have your support person take home any medications you brought to the hospital.

DO NOT TAKE a new medicine until...

• You have ALL your questions answered • You have discussed your history of allergies and medication side-effects

14 A New Beginning