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By Lauren Giella
Senior Reporter
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As cities across the country experience population shifts, local infrastructure must adapt. In areas where the population is rapidly growing, no institution can attest to the boom in population quite like the local maternity hospital.
Newsweek recently published its 2024 ranking of America's Best Maternity Hospitals, in partnership with Statista. The list recognizes the top 404 maternal health facilities in the country to help expecting parents find the right hospital to deliver their child.
The ranking was determined by three central pillars: a national online survey of health care professionals and hospital managers, nurses and midwives, a patient experience survey and various hospital quality metrics. In total, 236 hospitals received four ribbons and 168 hospitals received five ribbons, the highest rating for this ranking.
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According to Statista, 100 new hospitals were featured on this year's ranking. Of those, 33 facilities debuted on the list with five ribbons. One of those five-ribbon debut hospitals was Huntsville Hospital in Huntsville, Alabama.
Huntsville is one of the fastest growing cities in the state of Alabama. The city had the biggest population jump from July 2021 to July 2022, according to U.S. census data. Huntsville added about 3,300 people over the course of the year—more than twice as many people as the next closest city. In the last few years, Huntsville has overtaken Birmingham and Mobile as the most populated city in the state with about 235,000 residents in 2023, according to data published by the city.
Within the Huntsville Hospital Health System is the Huntsville Hospital for Women and Children, which features a range of pediatric, women-focused and maternal services. The hospital serves northern Alabama and southern Tennessee, acting as a regional referral center for many specialized services in women's health and pediatric care.
According to Huntsville Hospital for Women and Children's Vice President of Operations Elizabeth Sanders, the hospital has the highest birth volume of any hospital in the state of Alabama and is on track to surpass over 5,000 deliveries within the year.
"I'm proud of where the hospital has come, and it does have a high volume, but it's always focused on quality and patient safety," she told Newsweek.
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Nichole Shockley got her first nursing job in the Huntsville health system 17 years ago. After moving into an educational role, she now has served as the director of the labor and delivery unit for 14 years. She told Newsweek that she can't imagine working anywhere else.
"We are a higher-level-of-reliability organization that is consistently focused on our community and what we can do to make sure that we deliver the highest quality and safe, good care to everyone that's in our community," Shockley said. "We are our community and so the care that we're providing is to our families and friends. We want to make sure that it is the absolute best around."
Huntsville Women and Children has many accommodations that are unique to the region, Shockley said. This includes the region's only obstetric emergency department, which was one of the first in the state of Alabama, that allows patients to get quick, safe, high-quality care by board-certified OB-GYNs.
"We have an obstetrician in-house all the time," she said. "That way if something were to happen that was unexpected or in an emergency situation, we always have somebody right there to be able to help back us up and make sure that we can respond quickly."
The hospital's Level III neonatal intensive care unit (NICU) cares for newborns with any complications immediately after birth, and the 11-bed high-risk antepartum unit works with maternal fetal medicine specialists to care for mothers.
The number one reason for the hospital's success, Shockley said, is the "incredible" staff.
"It always goes back to the dedication and the passion of the people that are caring for these patients," she said. "I've never in my life been around more intelligent, hilarious, hard-working individuals who truly come in every single day wanting to do everything that they can to be able to get the highest-quality care."
The labor and delivery unit is a fast-paced, high-acuity place, Shockley said. It, therefore, takes staff who are driven and passionate about the work they do to run smoothly.
"We always emphasize that you got to be quick on your feet, you got to be a fast thinker, you got to be a critical thinker, you have to really, really, really care about your patients," she said.
Between the employees at the NICU, the neonatal nurse practitioners and neonatologists, staff are prepared to deliver quick care for any expected or unexpected complication that may arise. There are also specialists who can apply up-to-date research and vast experience to provide the best, evidence-based care.
Huntsville is also part of the Alabama Perinatal Quality Collaborative, which connects mothers and babies with key health and community stakeholders, shares opportunities for education and training, and advances quality and safety of care through collaborative cooperation, evidence-based practices and equitable approaches to care, according to the Alabama Public Health website.
That partnership, paired with an OB simulation lab, allows physicians to focus on those low-frequency yet high-acuity situations that impact mothers, like maternal hypertension and maternal hemorrhage.
"We have an opportunity to practice [those situations] and have all of the interventions we need to do at the forefront of our mind," Shockley said.
The staff at Huntsville Women and Children are not only well trained and dedicated to their work, but they take the initiative to improve their own work environment and improve hospital operations.
Huntsville Women and Children recently joined the American Association of Critical-Care Nurses' Healthy Work Environments National Collaborative, which guides and supports health care organizations in transforming their work environments, according to the AACN website. By joining this collaborative, Shockley said the unit is working to become a more cohesive and collaborative team to provide safer and higher-quality care to patients.
The labor and delivery unit also has a staff-run culture committee to "ensure everyone that's part of our team feels supported, mentored, that we are consistently equitable and inclusive and that everyone feels supported," Shockley said. These initiatives not only help improve patient experience, they also help staff get through both the good and bad days on the job together.
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For the ranking, the patient survey portion considered several factors, including cleanliness, communication with staff, care transition, communication about medication, discharge info, quietness and staff responsiveness.
At Huntsville, Shockley said the patient experience is the highest measure of success.
"I have two babies of my own—I have a 6-year-old and a 3-year-old—and I would not have thought of going anywhere else, speaking as a mother not just as a nurse," she said. "I know that at Huntsville Hospital for Women and Children, we have absolutely everything that we could possibly need in order to be able to take care of not only those expected things that come along with childbirth, but those unexpected things that you don't ever really want to come into the situation."
Shockley said maternal care patients have more of a choice when it comes to bringing their baby into the world and should be empowered to use their voice and understand all of the options.
"I think maternity care is a different type of health care," she said. "In general, there's much more patient-centered and patient-driven care."
Delivering the best care relies on mothers feeling safe enough to voice their concerns or questions, she said. That's why the nurses and staff are focused on sitting down with patients and taking the time to build a rapport.
At the beginning of each nurse's shift or when they get a new patient, Shockley tells them to take five minutes to sit down with the patient and introduce themselves, get to know the patient and understand her hopes, dreams and birth preferences for this journey.
"That helps build that relationship with your health care team and ensures that whenever those scary moments come up, [when] you have a question or concern or you're worried about something or afraid that something is going on, you feel much safer being able to speak about it," she said.
The staff at Huntsville understands that maternity care does not start or end with the birth of a child. That's why the hospital provides several opportunities for pre- and post-birth education for mothers and fathers.
The community outreach program offers maternity and pregnancy classes as well as a "daddy bootcamp" for fathers to practice changing diapers and other tasks they'll need to help with when their baby arrives. The hospital also offers free postpartum lactation support and donor milk usage.
"It's something that we take pride in being able to offer so that we know that everybody is armed with as much education and as much support as possible so that they can leave our facility home and take care of whatever they need to as a new family," Shockley said.
After a baby is born, many women struggle with postpartum depression and anxiety, Huntsville Vice President of Operations Elizabeth Sanders said. According to CDC research, one in eight women who recently gave birth experiences symptoms of postpartum depression. While the hospital doesn't treat outpatient postpartum depression or anxiety, they recognized the need for more support.
"You may get a lot of help at the very beginning, but then there are a lot of emotions that come from the postpartum standpoint," Sanders said. "So we have started a support group where they can get together, they can go on walks, they can just build that camaraderie in those relationships. I think it helps for people who are new to our area. It helps for people who may not have that support here but also people who have it and they just need additional support for what they're going through right now."
Overall, every decision Huntsville Hospital for Women and Children makes is for the patients. With a growing population, the staff understands the need to provide high-quality services for the region.
"Something that is so vital to us is that although we are very busy and we have a booming population, every single patient that comes into our doors has to feel like they're the only patient," Shockley said.
This also comes at a time when maternity care services across the country are closing due to low staffing, Shockley said. Huntsville Hospital for Women and Children has worked in recent years to expand outpatient and midwifery services and open their doors to surrounding communities.
"We have to be a presence in our community," she added. "We really try to make sure that that door is very open for everyone in our community to be able to come to us and feel safe to be able to voice some questions and know that we're always there as that support."
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