By JULIE MINDA
"Suites feature spa-like décor … soothing colors and soft lines … serene environment …"
While the description may fit a fine hotel, it comes from the website of a $7 million birthing center that opened in the spring at Provena Covenant Medical Center in Urbana, Ill. That facility is among a growing number of maternity services in the ministry offering beautiful private birthing rooms with open family visiting hours, room service, high-speed Internet and movie channels — amenities in tune with the expectations of parents who are accustomed to curating their consumer experiences and expect to shape one of the main events of their lives.
"There is a desire for a more personal touch and a family-centered experience" among most parents-to-be, said Cindy Reno, interim director of maternal child health at Provena Covenant. "It's about the environment — we want to help make the birth process as comfortable and homelike as possible."
Sara Oddan-Karamanis, clinical supervisor of obstetrics at Mercy Gilbert Medical Center in Gilbert, Ariz., said research on clinical outcomes also factors strongly into design decisions and how and what services are offered. For instance, she and other ministry experts said, research shows private rooms are safer because they reduce infection risk; and amenities that reduce stress such as massages and whirlpool tubs promote relaxation and can make for a less stressful — and therefore safer — birth.
Safety and outcome research also impacts design in neonatal intensive care areas. The replacement NICU opening next year at Providence Alaska Medical Center in Anchorage will have single rooms to promote mother-baby bonding and lighting conducive to fragile newborns' sleep patterns, said Kate Mohr, executive director of the children's hospital. The NICU is part of a replacement birthing center, which opens this month.
Betsy Block, consumer specialist at the Women and Family Center at Exempla Lutheran Medical Center in Wheat Ridge, Colo., summed up, "We're balancing the regulations and safety needs with patients' needs, wants and styles."
Choosing a location
In all but the most rural communities, women have a choice when it comes to where to deliver their baby because most obstetricians are privileged at multiple hospitals and defer to their patients' preferences.
Celeste Phillips, founder, principal and president of the Phillips and Fenwick consulting firm, has consulted on maternity care with over 700 hospitals, including ministry campuses. Her research shows that women's top priorities in selecting a birthing hospital include the availability of private rooms, having a place for their partner to rest and having the option for their baby to remain in the room with them throughout their hospitalization — all features that are common in modern family birthing units.
Dr. Robert Atlas is chair of the obstetrics and gynecology department at Mercy Medical Center Baltimore, which opened a $41 million birth center this summer as part of a larger facility replacement. He said that when evaluating competing facilities women heavily weight outcome data — for instance, they'll look for a facility with low rates of caesarian section and low rates of early induced deliveries.
Additionally, said Brad Imler, president of the American Pregnancy Association, women now want lots of options when it comes to birthing decisions. Those may include whether they'll be delivered by a doctor, or a midwife; whether they'll labor in a bed, using a sling, or in a tub; which medications or therapies they may choose to control pain; and who can be present for the birth — both in the room, and, in some cases, via a video link.
While medical factors are top considerations for patients and doctors, the importance of aesthetics and amenities can't be discounted, said Exempla's Block. Oddan-Karamanis said Mercy Gilbert's patient surveys confirm that room appearance matters to patients. Mercy Gilbert and its birth center opened six years ago.
Pleasing the providers
With women's hospital choice tied to their obstetrician's admitting privileges, hospitals have to please clinicians too.
Atlas said that he's found that obstetricians are drawn to facilities that make it easy for them to do their job and that treat them and their patients well. This can mean providing access to clinical support not available at all facilities, such as midwives and in-house attending residents. He noted that increasing numbers of physicians want to be more integrally tied to the hospital — most Mercy physicians now have some level of employment agreement with the hospital, he noted. As employed physicians, they get support for their administrative work from Mercy, and that frees up their time to focus more on patients.
Imler of the pregnancy association said many physicians are attuned to their patients' desires to have a greater say in their birthing experiences, and he's found that pleasing obstetricians is a matter of ensuring the hospital can provide options to suit many different patient preferences.
Phillips said that many obstetricians want informed patients who read pregnancy books, pull research from the Internet and asks lots of questions, because in general, these are the same women who have private insurance, which reimburses better than Medicaid. "So, physicians are happy to come on board with a hospital offering lots of options, because their payer mix can improve, and they want those patients for a lifetime. You need long-term paying patients to sustain your practice," Phillips said.
Atlas said paying attention to such business considerations is particularly important at a facility like Mercy in Baltimore, which delivers more babies than any other hospital in Baltimore. Medicaid is the payer for about 60 percent of its patients.
Jan Spale, director of Maternal Child Services at Saint Francis Medical Center in Grand Island, Neb., said providing the same high-quality birthing services and options to all women, regardless of their background and means, speaks directly to the ministry's mission. She added this is particularly true with the ministry's focus on family wellness — helping a family have a healthy baby can start a family on this path.
Sr. Patricia Talone, RSM, CHA vice president of mission services, said many of the ministry's founding sponsors started their ministries focusing on women's services. With the U.S. ranked 47th worldwide in infant mortality — and with the poor and vulnerable most at risk for poor outcomes — it remains a needed focus, she said.
Return business
Birth center experts in the ministry said maternity services are usually an at- or near-break-even division at most hospitals. But, when viewed as a reputation builder and entry point for other services, birth centers can take on a new level of importance.
According to information from Phillips, U.S. women spend more than $43.3 billion annually on female-specific conditions, including childbirth, and so there is an incentive for hospitals and health networks to retain them as patients. Reno noted that mothers are normally the primary decision makers on family health care. A good birthing experience can earn personal loyalty and generate positive word-of-mouth marketing.
Atlas said the birthing centers hold a strong potential to enhance a hospital's reputation during a significant moment in a family's life. The family, he said, "is looking at how they're treated. If we can show off (what Mercy is about), patients will see this and will come back."
Ministry birthing centers offer mission-based services to mothers
Staff in Catholic hospitals' birthing centers attend not only to the physical needs of mothers and their babies, but also to their spiritual and emotional needs, according to ministry birth center experts.
At Mission Hospital in Mission Viejo, Calif., births are treated as a sacred moment. Braham's "Lullaby" wafts from the hospital intercom system after each delivery and chaplains bless newborns upon families' request. At Mercy Gilbert Medical Center in Gilbert, Ariz., chaplains are available to the maternity department around the clock to assess and address patients' needs; and the hospital broadcasts prayers daily throughout the facility over the intercom system. Catholic hospitals commonly provide grief and spiritual support to maternity department patients and spouses.
Mission Hospital also conducts postpartum depression screenings on every new mother prior to discharge, notifying her physician of any concerns and following up with the patient by phone. Mothers can participate in a free weekly postpartum support group at the hospital.
Ministry facilities provide holistic support to mothers and families that are struggling financially with their transition into parenthood. Providence Alaska Medical Center in Anchorage, Alaska, for example, offers social worker assistance to mothers who need help identifying resources such as governmental aid. The social worker makes sure the mother has received information on how to care for her child, and that the parental home is safe for a baby. The social worker follows up by phone with the mother after her discharge.
Options abound at ministry birth centers
Among the ministry facilities that have invested heavily in improving birthing facilities and options for expectant parents are:
- Exempla Lutheran Medical Center, Wheat Ridge, Colo. The family birthing center opened in December 2010 has spacious rooms that accommodate family members and other visitors. The team members in the center aim to individualize families' experiences at the birthing center, and offer options for mothers such as whirlpool tubs for pain relief and a boutique with breast-feeding supplies. "Extras" include the opportunity to record the baby's first cry for posterity, the option to have a party for siblings to make them feel important and homemade chocolate chip cookies daily for new moms.
- Mercy Gilbert Medical Center, Gilbert, Ariz. The Lund Family Birth Center opened six years ago with the opening of Mercy Gilbert. The staff encourage families to be involved in the birth experience, including allowing immediate family members to attend the birth if the mother wishes. Among the in-room comforts available to new parents and their families: couches, TVs with menus that enable new parents to select movies or vies educational videos. Patients use the TV remote page housekeeping or change the temperature in the room.
- Mercy Medical Center, Baltimore. The Family Childbirth and Children's Center opened earlier this year as part of a hospital replacement. It is a secure unit, with locked doors. The center concentrates on teaching new parents how to feed, bathe and care for their babies' health. Some of the education is video-based. Birthing suites have views of the Baltimore skyline, and patients can relax in a rooftop garden.
- Mission Hospital, Mission Viejo, Calif. The maternity unit at Mission Hospital permits up to five family members to be present at a birth. The facility also provides sleeping accommodations for the mother's partner or guest. Staff facilitates bonding between the new parents and their baby, including in the case of adoptive families or surrogate situations. They do this in part by encouraging alone time for the immediate family and newborn, recommending skin-to-skin contact between parents and the new baby.
- Providence Alaska Medical Center, Anchorage. The Providence Maternity Center opening soon offers new mothers private rooms with a private bathroom and shower; baby-bathing sinks; in-room refrigerators and entertainment options including cable TV, DVD players and wireless internet access. Providence will open a newborn intensive care unit in spring 2013, a prenatal unit for high-risk mothers in fall 2013 and a new labor and delivery unit in fall 2014.
- Saint Francis Medical Center, Grand Island, Neb. The Family Birthing Center encourages new parents to observe a Golden Hour by spending the first hour of the newborn's life alone with him or her, with no interruptions. Staff also recommends skin-to-skin contact between parents and babies. In between bonding sessions, parents can order up room service, in-room movies and Wi-Fi.
- St. Cloud Hospital, St. Cloud, Minn. In June, St. Cloud opened its Family Birthing Center, offering expectant mothers air-jetted tubs, private rooms with private bathrooms, and rooms with scenic views. Support for complicated pregnancies and births is available from St. Cloud's perinatology clinic and neonatal intensive care unit. St. Cloud's birthing center offers an extra layer of security to new parents — it is a locked unit.
Copyright © 2012 by the Catholic Health Association of the United States
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