Healthy Pregnancy, Healthy Baby

Preparing for and giving birth to a child at RiverView Health is just the first stage in what can be a continuum of care where you build a relationship with your provider during your pregnancy and he or she continues to offer you and your child a comprehensive array of health services spanning all levels of intensity of care. In other words, your provider will know you and understand your history because he or she has been a part of it.

Starting or adding to your family is an exciting time! RiverView is here to go through the journey with you.

Your RiverView provider and nurses will help you learn what you need to know to have the healthiest pregnancy and baby possible. During your pregnancy, RiverView will provide you with information at each prenatal visit that is appropriate to your stage in pregnancy, and have staff available to you day and night to answer any questions. Your medical provider will see you at each appointment and after your baby is born, or more often depending on the level of support you need. Through this valuable one-to-one relationship, you will also receive caring support, education and encouragement.

“We pride ourselves on giving personal care with a hometown feel,’’ said Frieda Larson, Obstetrics (OB) Unit coordinator. “Your doctor will most likely deliver your baby. It is pretty rare for that to happen at larger hospitals.”

Begin with your Doctor

One of the first steps in your journey is to choose a provider. Choosing your doctor is a big decision.

RiverView is pleased to offer very qualified and experienced physicians. As family practitioners, they can guide you through pregnancy and birth, and continue on to care for you and your newborn after delivery.

RiverView OB services are provided by Dr. Erik Kanten and Dr. Saravana Balaraman within their family practices. General Surgeon Dr. Idatonye Afonya provides cesarean services, while Dr. Kari Wessman is available for both OB and cesarean call.

Dr. Erik Kanten has been practicing medicine in Crookston since 1988. He attended undergraduate school at Augsburg College and the University of Minnesota medical school both in Minneapolis. His residency in family practice was through the University of North Dakota in Grand Forks. Dr. Kanten sees patients at RiverView Clinics in Crookston, Fertile, and Red Lake Falls.

Medical director for the OB Unit, Dr. Kanten has been providing OB care longer than any other provider at RiverView Hospital. RiverView Nurse Gail Henre keeps track of all of the babies born with Dr. Kanten’s services in a special book she’s kept since he delivered his first RiverView baby in November of 1988. Since then, he has delivered well over 1,000 babies and counting.

Dr. Kanten is a great example of a doctor who wants to be there for his patients from birth through end of life.

“I don’t like missing a delivery. That really bothers me,’’ he stated in a video featuring his 2008 Family Physician of the Year Award from the Minnesota Academy of Family Physicians. “I try to always be there. You follow them for eight or nine months; so then to miss the big celebration, I don’t like doing that.’’

Dr. Saravana Balaraman joined RiverView Health in 2012. A graduate of JJM Medical College in Davangere, India, Dr. Balaraman served as chief resident of family medicine at Stamford Hospital, Stamford, CT, prior to joining RiverView Health. Dr. Balaraman sees patients at RiverView’s North Clinic in Crookston.

Judy Hagen, a nurse who works with Dr. Balaraman, describes him as “very attentive’’ to his patients. Education is also very important to Dr. Balaraman and he strongly advises his patients participate in RiverView’s Childbirth Classes.

Your first visit with Dr. Balaraman or Dr. Kanten should be around 10 weeks when the heart tones can be heard. The initial visit is mainly to talk about any concerns you may have, go over questions and do prenatal lab work. On the second visit, lab results are discusses and a physical exam is conducted. At 24 to 28 weeks, a blood sugar check takes place to test for Gestational Diabetes. Patients are seen every month until the 35th week when weekly appointments take place until delivery.

Childbirth Classes

RiverView holds classes for expecting parents to help them better understand what to expect during pregnancy and childbirth; and to help ease the fear of the unknown. The course includes four two-hour classes focused on the stages of labor, breathing and relaxation techniques during labor and delivery, coaching instructions and a tour of hospital rooms. The later classes focus on baby care, breastfeeding and CPR. The course instructors for all sessions are labor/delivery nurses at RiverView Health. Click here to register.

The Big Day (or Night)

Your doctor will advise you when it’s best to come to the hospital. One clear-cut rule is to come in if your water breaks, even if you aren’t having contractions. When you arrive, your obstetrics nurse will help you get comfortable and manage contractions. She watches your condition and carefully monitors the baby’s heartbeat. When your physician is not present, your nurse will keep him or her posted of your progress.

Your own physician, who has cared for you throughout pregnancy, will be your guiding hand during delivery. The only exception is when your doctor is out of town. Another family physician with OB services from RiverView Hospital would then perform the delivery.

Pain Management

They don’t call it labor for nothing. Having a baby is hard work, and part of that work is getting through the pain. There are more ways than ever to manage that pain, and you don’t have to choose just one. Your RiverView care team will work to make your labor and delivery as comfortable as possible.

Breathing and relaxation techniques are important during labor, as well as other natural, medication-free options. For pain medication, the RiverView anesthesiology team is always available with a variety of options during labor and recovery. An exciting addition at RiverView in 2015 is the implementation of epidural analgesia. This is an extremely effective and popular treatment for labor pain. It is estimated that approximately 6 out of 10 women in the United States have an epidural during their labor, with rates as high as 80-90% in many regions of the country.

“This project (epidural implementation) has been a joint effort with OB providers, Anesthesia, OB nursing staff, Pharmacy and Senior Leadership,’’ said Larson. “It could not have been accomplished without the level of teamwork that is so characteristic of RiverView.’’

The Golden Hour

Once that little bundle of joy makes its way into the world, the Golden Hour begins. Those 60 minutes after birth are very important for bonding between mother and baby. Research shows that breastfeeding and bonding are improved when there is skin-to-skin contact early on, Larson reported. “We have had a great response to this. Patients love it.’’

The American Academy of Pediatrics statistics state that babies who are held skin-to-skin immediately after birth have more stable heart rates and respiratory rates, they maintain stable body temperature and glucose levels, and they also cry less and secrete less stress hormone. These babies breastfeed sooner, longer, and more effectively and exhibit more optimal sleep patterns and growth patterns. Mothers report a sense of safety and security and exhibit greater mothering behaviors when holding their newborns this way. Keeping mother and baby together and in close contact after birth is a win-win situation for everyone.

The Gentle Cesarean

In 2014, RiverView was one of the first hospitals in the region to start keeping mother and baby together after a cesarean. The OB Unit worked with RiverView’s Surgical Services Team to ensure that mothers who deliver via cesarean section get to enjoy the same closeness with their newborns. Instead of being separated after the procedure and during the recovery period, mothers delivering at RiverView can keep their newborn with them from birth through recovery on the OB Unit.

For those having cesarean births, things also became more clear in 2015.  RiverView introduced a 2-ply blue and clear surgical drape that allows families to, at the time of baby’s birth, see the baby immediately.  The baby is now in view from the time of birth until mom gets to hold baby for the first time.

And now, in 2016, RiverView has taken it one step further and initiated skin-skin care and breastfeeding right in the operating room. Mothers who deliver via cesarean are now able to enjoy the same bonding and physiologic benefits of immediate skin-skin care and early breastfeeding that is enjoyed by mothers who deliver vaginally.

“These efforts are all a part of RiverView moving towards practicing what has been termed ‘The Gentle Cesarean’,” Larson stated.  “Thanks to coordination between the RiverView Surgical Team and the OB Unit, cesarean delivery at RiverView is now a more ‘gentle’ experience for mom, baby, and the entire supportive family.’’


No longer is it the case that a family’s first night alone with the new baby is after returning home from the hospital. The Centers for Disease Control, the World Health Organization, and the American Academy of Pediatrics all recommend a 24 hour “rooming-in’’ setup. Rooming-in is the practice of keeping mother, baby, and family together in the same room after the birth of their baby and through the remainder of the hospital stay. Newborns only leave their mothers and go to the nursery for procedures or if needing specialty observation.

Safety Features

On the long list of items that ensure the safety of each mother and child, RiverView has implemented the policy of not allowing any inductions or scheduled cesarean sections prior to 39 weeks, unless medically indicated. RiverView’s cesarean rate is currently the same as the national average, 32 percent, although it’s usually below the national average.

Once the baby is born, routine congenital cardiac screenings are conducted to identify problems as early as possible so proper treatment can begin. As required by the State of Minnesota, newborns are screened for treatable genetic conditions through a blood spot panel, congenital heart defects through pulse oximetry screening, and hearing deficits through hearing screenings.

Comfort, Atmosphere

RiverView continues to upgrade Inpatient rooms with funds donated by the RiverView Auxiliary to make each room as comfortable and esthetically pleasing as possible. A gift package is also given to each baby born at RiverView by the Auxiliary with many keepsakes to mark the joyous occasion.

The RiverView Foundation is also a partner in assuring each family is comfortable. Through the Foundation, rocking chairs have been donated and projects incorporated like the baby blanket program in which each baby born at RiverView is given a handmade blanket sewn by RiverView volunteers. The blanket program is made possible in memory of caring mothers Irene Noesen and Cheryl Steinbrink.

“Every baby born on our Unit is special to the staff and RiverView community,’’ Larson stated. “We are a community hospital and take great pride and joy in the fact that we get to be a part of bringing these new lives into the world and providing education and support to the families that welcome them.’’

For more information on childbirth services offered at RiverView Health, call 218-281-9300 or  800-743-6551.