Wednesday, June 22, 2005

Deconstructing the Family Birth Center

There are two hospitals in town, "U-M" and "St. Joe's." They are in hot competition with each other for pregnant patients.

A few years ago St. Joe's addressed a hole in its services by opening a NICU. Last summer it upped the ante when with a newly constructed Family Birth Center. U-M has countered with its plans to build a new women's and children's hospital to the tune of $498 million. St. Joe's already has a fundraising effort underway to update its NICU.

Clearly St. Joe's is winning on the marketing front. If you go to its Family Birth Center page you'll see this description:
Our personalized “warm and friendly” nursing care has kept generations of families coming back again and again. Couple this with an experienced medical and nursing staff who deliver nearly 4,000 babies annually, and you’ll see why St. Joseph Mercy Hospital is the hospital of choice when it comes to having a baby.

New delivery and ancillary rooms opened in July of 2004 provide a comfortable home-like setting for the birth of your baby. The area features 12 modern Labor/Delivery/Recovery rooms, two with Jacuzzi tubs and 10 with Jacuzzi showers. After baby arrives, you’ll finish your stay in one of our private mother-baby rooms.
Oooooooh. By comparison, U-M says:

The Women's Hospital Birthing Center is designed to care for both low and high-risk pregnant patients throughout their labor, delivery, recovery and postpartum (LDRP) hospital stay. The Birthing Center is comprised of three units designated Women's East, Women's West and 7 East Mott.

The East unit is dedicated primarily to the peripartum management of high-risk patients. The east unit functions as an obstetric intensive care unit that has three triage rooms, eight LDRPs, three operating rooms and a three-bed post anesthesia care unit.
A little dry, eh? U-M's website also offers a slideshow tour of the facilities.

We all know a fair bit of distance exists between marketing's version of reality and what people actually experience.

St. Joe's "Family Birth Center" is beautiful. Lots of natural wood, earthy colors, art on the walls, which have recessed and track lighting. But for the nursing station, it could be a corporate headquarters.

And yet...

You rarely see anyone in the halls. It is remarkably quiet, especially in comparison to how I remember the hospital's old labor and delivery unit being. For me, L&D floors have an air of excitement and happiness about them. This unit felt very emotionally flat.

Worse, there is a locked security door between the family waiting area and the patient rooms. The door also stands between the patient rooms and the public restroom. I must have passed through it 14 times during my stay.

And how can you put tubs in only 2 of 12 rooms when hydrotherapy is one of the best ways to manage labor pain?

Compare with the university's hospital. The halls make a rectangle with the nurses station and family waiting area in the middle. It is easy for friends and relatives to pop back and forth between the room and the waiting area. They have access to light refreshments while they are waiting. The pregnant mother can stop by and say hello as she walks the halls.

The halls, by the way, are lively. Nurses, doctors, patients, families are moving around, chatting with, smiling at, and generally connecting with each other.

Patient last names are posted outside the rooms, making it much easier to find where you're going. When a mother is admitted, her name is written on a yellow card. After the baby's born, another name card gets posted, this time in blue. Mother and baby charts hang on special rails outside the rooms, mothers in pink, babies in blue. At a glance you can tell whether the mother has delivered or not and how many babies she had.

At St. Joe's -- probably in stricter compliance with HIPPA -- there is no identification outside the rooms other than the room number. It can be hard to remember where on the corridor you're located. I'm sure more than one laboring mother has been surprised by a lost stranger walking into the wrong room.

Environment aside, however, there is one primary reason I remain skeptical of the "Family Birth Center" label. It has to do with those operating rooms that are part of the birth center. Construction doesn't come cheap. What is the fastest way to start making good on your investment? Get insurance companies to send you there money! In other words, get a lot of your family birth center women into your family birth center operating rooms.

If you think pressure to perform surgery is just a fabrication of the natural childbirth cult, be sure to read about this obstetrician.

I applaud hospitals' efforts to accomodate laboring and birthing mothers' needs. Hooray for the jacuzzi tubs. Thank you for putting art, fabric and hardwood floors in labor rooms.

Nonetheless, we need to remember what lies behind the polished finishing touches: an institution that needs to make money...first by having you choose to birth there, then by offering surgery as a lucrative safe route to a healthy baby.


Blogger Julie said...

Hmmm. So perhaps if I'd had my first at U-M instead of St. Joe's I might not have had my second and third at home?

And another thing I'd like to know is, what's the point of all those lovely jacuzzis when they keep you tied down with IVs and fetal monitors so you can't even use it???? (she said, still angry 9 years later)

Your point in the last paragraph is SO true -- that's why they advertise in the first place.

6:56 AM  
Blogger doulicia said...

Nah, you'd have come to the home birth regardless, don't you think? U-M manages a rupture the same way St. Joes does.

As for the irony of jacuzzis, showers even, when few women even get the opportunity to use them...I agree.

8:58 PM  
Blogger Elizabeth said...

*sigh* I found your blog searching for a doula familiar with St. Joe's... I delivered at UM and HATED it... I'm delivering at St. Joes (midwife) and I was hoping for a more positive experience. :( (husband not on board with homebirth).

2:58 PM  
Anonymous Anonymous said...

Honestly, regardless of which hospital you go to your whole experience breaks down to the staff caring for you. If you choose a doctor to care for you...expect to have first year residents who might have only been on the job 5 minutes managing your care...the actual attendings don't show up until the head is crowning on the perineum...or if they do show it is to find out what the hold up is..."let's start some pit and get this labor going" attitude. And then if you get a crappy, lazy nurse who is more interested in chatting at the desk than being an advocate and helping you through labor. I have experienced both hospitals and they each have their ups and downs but honestly if you have to choose a hospital birth (I had to for financial reasons) stand up for yourself and if you don't like the care you are getting from your nurse...ask to speak to the charge nurse and gently explain that you need another nurse who can work well with you....Don't suffer in silence ladies...this is your birth experience...don't let the bad attitudes of others rob you of a pleasant one!

9:43 PM  
Blogger Middy Matthews said...

I just visited a friend who had her child at U of M and said she couldn't get any rest there were SO many people coming and going in and out of her room. I think the quiet of St. Joes sounds better than that.

Also, if you want caring attention while you have your baby, never opt for the doctor. What most people don't know is that a doctor WILL be preset at the birth, just as much so as if you had chosen one, if you chose the midwives. BUT, you will know the midwives quite well by the time you give birth and they will be there with you through the entire process, like someone who really cares about you. You can't expect a nurse you just met to be your best friend and birth coach, can you? Chose a Doula or team of midwives. I had a GREAT birth experience in Chicago with midwives. I couldn't have asked for better.

8:19 AM  
Blogger Angela said...

The link to the OB article isn't working - the site says error. Any google suggestions so I may still access the article? Thank you!!

5:00 PM  
Blogger doulicia said...

Angela, sorry about the broken link. As I recall, this was an OB somewhere along the Atlantic coast who was censured by her hospital colleagues for having TOO LOW a c-section rate! She was in the article because she was complaining about the professional pressure she faced to do more surgeries. I wish I could remember where she was -- even what state, but I can't.

7:41 AM  

Post a Comment

<< Home