Clinical Component

Navigating the Clinical Component

As the OB Hospitalist, you manage labor and delivery, postpartum rounding, triage, and inpatient obstetric consults during your shift. Most patients receive their prenatal care at Care for Women's Medical Group, so they arrive with records and a care plan in place. A group physician is on backup call for every shift and comes in for C-section assists, simultaneous deliveries, or any case where you want a second physician.

Clinical Snapshot

Item Detail
Delivery Volume 120 to 150 deliveries per month
Daily Average 3 to 5 deliveries
C-Section Rate 20%
Gestational Age 24 weeks and above
Patient Risk Level Primarily low risk
Anesthesia In-house anesthesiologists, 24/7 epidural coverage
NICU Level II
EMR Cerner
APPs in Hospital None

Patient Population

Most patients are established as prenatal patients of Care for Women's Medical Group.

The group refers pregnancies with significant risk factors to other facilities during prenatal care, so the inpatient population is primarily low risk.

A smaller number of unreferred patients arrive through the emergency department.

Patients know the group works as a rotating team, so they expect to be delivered by the physician on shift.

A Typical 24-Hour Shift

Activity Typical Volume
Deliveries 3 to 5 on average; busy shifts can reach 9 or 10
Scheduled C-sections 1 to 3, usually in the morning
Rounding 8 to 10 patients
Consults 2 to 4; about half need an in-person visit
Emergency department visits About 20 to 22 per month across the service

Other parts of the shift include:

  • Reviewing non-stress test strips with the NST nurse
  • Responding to answering service calls from group patients after office hours
  • Admitting and triaging obstetric patients sent from the emergency department to labor and delivery
  • Discharging postpartum patients. Typical length of stay is 1 to 2 days after a vaginal delivery and about 3 days after a C-section.

Backup and Call Coverage

You are the in-house physician for your shift, and there is no separate call schedule. Backup coverage works as follows:

Time Backup and Surgical Assist
Weekdays before 5 p.m. Full-time surgical assistant and rotating residents are available for C-section assists. A group physician is on backup call.
Weekdays after 5 p.m. Group physician on backup call
Weekends Group physician on backup call

Every physician in the group lives within 15 minutes of the hospital.

When two C-sections are needed at the same time, the backup physician performs the second one in the main OR.

A separate laborist covers unreferred emergency department patients on weekends and some Wednesdays. When that laborist is in-house, they serve as your backup.

Labor and Delivery Unit

  • 10 labor and delivery rooms: 6 triage and early labor rooms and 4 delivery suites
  • An additional delivery room near the emergency department entrance for patients who arrive fully dilated
  • 1 dedicated OB operating room, with access to the main OR when a second room is needed

The NST area is located on the unit, with non-stress tests scheduled daily.

A new maternity unit with two dedicated OB operating rooms has been approved. Construction is expected to begin in January 2027 and be completed by the end of 2027.

Clinical Support

Anesthesiology: About 10 anesthesiologists focus on obstetric anesthesia. They are part of a large regional anesthesia group and provide epidural coverage 24/7.

Maternal-Fetal Medicine: An MFM group is available by phone 365 days a year and comes in for consults when needed.

Neonatal care: Neonatologists staff the Level II NICU. Respiratory therapists attend routine deliveries.

Specialty support: Gynecologic oncology, general surgery, and urology respond when you call for help.

Nursing: Labor and delivery nurses are the team you work with most during a shift.

Teaching

San Antonio Regional Hospital's residents rotate through labor and delivery for 3 to 4 months each year. During those rotations, residents help with postpartum rounds, notes, consults, and C-section assists on weekdays.

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