How Teamwork and Rapid Mobilization Welcomed Triplets at General Leonard Wood Community Hospital
When a mother in active labor at just 28 weeks gestation arrived at the facility, GLWCH staff immediately initiated high-acuity obstetric and pediatric protocols. Recognizing that the patient's advanced labor prevented a safe transfer to a distant neonatal intensive care unit, the team transitioned seamlessly to deliver the infants on-site, showcasing the hospital’s capability to handle complex, high-risk emergencies at a moment's notice.
Upon the patient’s arrival, the Labor and Delivery team rapidly assessed the situation to establish a controlled, highly coordinated care environment.
"When she arrived with a complicated medical history and in active labor with triplets, our immediate priority was establishing a calm, structured, and precise environment," said Morgan Weller, a registered nurse. "While Heather Starnes, RN, remained at the bedside to monitor the patient and locate all three fetal heartbeats, I coordinated with our physician and prepared necessary bedside supplies. Our clinical training is designed for these exact moments, ensuring everything is positioned and ready before it is needed."
Army Maj. Alyssa J. Provagna, an obstetrician-gynecologist, led the primary medical evaluation to determine the safest course of action for both the mother and the infants.
"Our immediate clinical decision-making focused on whether a transfer was safe," Maj. Provagna said. "Once we determined that traveling by ambulance was not clinically advisable, we immediately executed our on-site high-risk delivery protocols. Our mission was clear: protect our military family and deliver these three newborns safely."
Delivering triplets at 28 weeks requires a sophisticated alignment of personnel, specialized equipment, and space management. Within 30 minutes, the hospital's surgical and respiratory teams reconfigured an operating suite to support three distinct, fully equipped neonatal resuscitation stations.
Shon Jacoby, a registered respiratory therapist, highlighted the precision of the technical setup.
"Our standard for high-risk deliveries is to assign a dedicated respiratory therapist to each premature infant," Jacoby said. "While a standard surgical suite is typically configured for a single warmer, our team systematically reconfigured the space to accommodate three units. We mapped out the floor plan, managed utility lines safely, and had the entire room fully operational and staffed in under 30 minutes."
The high-acuity nature of the delivery called for a comprehensive, multi-specialty care team. Responding to the emergency, other pediatricians, family physicians, emergency medicine providers, and nursing staff mobilized from off duty locations and other departments in the hospital to rapidly to support the operation.
"Our staff responded with incredible speed and professionalism," said Army Capt. Lydia Sickbert, a staff pediatrician. "We coordinated across departments to bring in specialized support, including Army Maj. Adam Henderson, an emergency medicine physician, and midwife Terrina Knarr, who served as the surgical assist. Extra nurses and respiratory therapists arrived ready to integrate into the team. It was a superb demonstration of collective capability."
In the operating room, Maj. Provagna and Knarr performed the cesarean section, supported by three distinct resuscitation teams poised at their respective stations.
"The procedure flowed with exceptional organization," Maj. Provagna noted. "Every staff member had a defined role, communication was continuous, and each baby had a dedicated team waiting to receive them the moment they were born."
The successful delivery highlights the deep commitment of GLWCH’s medical staff to providing exceptional care for military families.
"Events like this showcase the vital role of Labor and Delivery," Weller said. "Our team proved we are fully trained, equipped, and ready to manage the most complex, high-risk scenarios."
Starnes reinforced that pride: "The seamless care this family received is a testament to the caliber of our staff. Seeing everyone align so rapidly and perform so flawlessly makes me incredibly proud to be part of this hospital team."
Following the successful delivery, all three infants were stabilized by the GLWCH clinical team and safely transferred to a higher acuity hospital for continued specialized care.
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