Approximately 5,000 pregnant patients per year give birth to their babies at UnityPoint Health–Meriter Hospital (UPH Meriter) in central Madison, the largest number of any Wisconsin hospital with birthing services. Newborns delivered at UPH Meriter are cared for by a dedicated team of outstanding newborn hospitalists led by Elizabeth Goetz, MD, MPH, professor in the Division of Neonatology and Newborn Nursery.
Goetz has been involved with the nursery since her residency with the Department of Pediatrics in 2005. Beyond being board-certified in pediatrics, Goetz is also an International Board-certified Lactation Consultant (IBCLC). She was appointed the medical director of the newborn nursery in 2011.
Goetz noted that historically, general pediatricians started their days early seeing newborns and children admitted to the hospital before beginning their days in clinic. The last 20 years have seen a shift away from this model with the evolution of the hospitalist mode that moves the care of hospitalized newborns and children away from general pediatricians to trained hospitalists working within hospitals. “This process started at the UW in 2004,” Goetz explained, “when two of the general pediatricians, Bonny Whalen, MD, and Katie Kelley, MD, started a rounding service in the newborn nursery that also provided newborn education to pediatric residents.”
During her residency, Goetz worked with Whalen on breastfeeding research. “When Dr. Whalen moved to Dartmouth [New Hampshire] at the end of my third year of residency,” Goetz said, “it seemed a natural fit for me to start rounding on newborns in the Meriter Newborn Nursery.”
Thus, in 2005, Goetz began as a clinical instructor working half days in the nursery. “As the value of having a pediatrician present in the nursery became clear, our duties quickly grew,” Goetz recounted. “More and more general pediatricians requested that the ‘Newborn Team’ round on their babies in the mornings. We also started attending high-risk deliveries not expected to need NICU admission. During that period, Meriter and the UW were growing as tertiary referral centers, and we had more babies whose primary providers were not in Madison.”
Thus, the structure of what is now the established work of the newborn nursery hospitalists’ team within the department’s division started to take shape, accelerated by the slow, then quite rapid increase in the number of newborns associated with the UW and Meriter.
From 2005 to 2015, the newborn nursery team expanded the number of newborns being cared for to include all newborns with a UW pediatrician, all newborns with no identified pediatrician, and all newborns from communities outside the Madison area. In 2017, all newborns assigned to UPH Pediatrics and Family Medicine were added to the team’s service. In 2018, Group Health Cooperative transitioned its birth services to Meriter Hospital, increasing delivery volumes from approximately 3,500 per year to now over 5,000 births per year, making UPH Meriter the largest birthing hospital in the state. Finally, Associated Physicians added their newborns to the team’s service in 2020.
This enormous increase in the number of newborns associated with UPH Meriter meant the newborn nursery team needed to grow. The years from 2017 to the present eventually saw seven new people join and stay with the group.
Nicole Baumann-Blackmore, MD, now professor in the Division of Neonatology and Newborn Nursery, transitioned in 2017 from UnityPoint Health to the UW Newborn Hospitalist team. She is also a board-certified lactation consultant (IBCLC) and uses her skills in the newborn nursery to promote the most effective breastfeeding for newborns and their families. She has developed a breastfeeding medicine elective for pediatric residents.
The team added Jasmine Zapata, MD, MPH, assistant professor, Division of Neonatology and Newborn Nursery, in 2018, with an affiliate appointment in the Department of Population Health Sciences. Zapata has served, since 2021, as the chief medical officer and state epidemiologist for community health within the Bureau of Community Health Promotion of the Wisconsin Department of Health. She works to guide health promotion, planning, and policy efforts. Zapata is also co-chair of the Wisconsin Maternal Mortality Review Team.
In 2019, the team added two new members, Beth Smith, MD, associate professor, and Rachel Petro, MD, assistant professor, both in the Division of Neonatology and Newborn Nursery. A clinician with many interests who was previously a nurse, Smith works as a Neonatal Resuscitation Program (NRP) instructor and also participates in the Fresh Beginnings program educating expectant parents undergoing treatment for opioid use disorder. Petro is also an NRP instructor, providing education to health care professionals. In addition, she teaches residents and medical students. Her clinical interests include stabilization of newborns post-delivery, neonatal hyperbilirubinemia, and routine newborn procedures.
Kathryn (Katie) Stadler, NNP, joined the team in 2020 as a newborn nurse practitioner when the demands of COVID-19 protocols caused rapid and major shifts in clinical care. In 2021, Oresta Rule, MD, assistant professor, joined the Newborn Nursery team. In addition to her work in clinical care, Rule is invested in medical education and serves as the course director for the pediatric intern preparatory course. She also has a strong interest in research and nutrition and is leading a grant-funded study on the use of donor human breast milk in the healthy-term breastfeeding population.
The most recent addition to the newborn team, in 2024, is Sammi Tyler, DO, clinical instructor in the Division of Neonatology and Newborn Nursery. Tyler uses osteopathic manipulative medicine (OMM) to support breastfeeding mothers and newborns, using hands-on therapy to increase the body’s ability to move and function to ease pain, calm the nervous system, and for newborns, to relieve pressure from the compression of the birth process. Tyler spends one day per week at an Integrative Health Clinic.
On a typical day in the nursery, team members are rounding on 20 to 25 newborns, attending multiple deliveries, performing minor procedures, and doing prenatal consults for families with minor fetal complications. It is a fast-paced environment with most families spending 24 to 72 hours in the hospital. During this short but critical period, families must recover from the birthing process, establish breast or formula feeding, learn the basics of newborn care, and prepare to take their new baby home. To safely provide high-quality care, the newborn hospitalists team is present in the nursery during daytime hours seven days a week.
Clinical education is also a central activity in the Newborn Nursery. Medical students, pediatric interns on their core nursery rotation, and senior residents doing elective rotations in newborn care and breastfeeding medicine all do clinical rotations at UPH Meriter. For many students and residents, this is their first encounter with newborns. Preparing future physicians to provide expert newborn care is a point of pride for the newborn hospitalist team.
In addition to clinical care and education, the newborn hospitalist team is engaged in many research and academic activities. “For the last 20 years we have strived to make the UW Department of Pediatrics and the Meriter UPH nursery leaders in newborn care in the state of Wisconsin,” Goetz explained. “In addition to focusing on the highest quality clinical care and medical education, we have led state initiatives in care of newborns at risk for neonatal abstinence syndrome (NAS) and opioid withdrawal syndrome (OWS), establishment of critical congenital heart disease (CCHD) screening, and birthing equity. We currently are working on the use of donor human breastmilk in term breastfeeding infants, and we have state funding to make recommendations regarding screening practices for congenital cytomegalovirus.”
“It has been an absolute privilege for me to spend my career improving the care of newborns and families in Wisconsin,” Goetz said. “I am so fortunate to have been part of such a supportive educational academic department, to work in a hospital that values and supports high-quality medical care, and to work with such an amazing team of newborn hospitalists!”