A decade ago, San Gabriel Valley hospitals found their maternity sections so decimated by the declining birthrate that two--Community of San Gabriel and St. Luke of Pasadena--were forced to drop the service. Others limped along with a low occupancy rate.
Things have changed. Today an increase in the birthrate has prompted Community to plan the reopening of its maternity wing, while other hospitals are competing to attract parents-to-be with a variety of special services, such as alternative birthing centers and sibling visits.
Hospital personnel say the birthrate began declining in 1970 and did not pick up until about three years ago. Countywide, the birthrate was 24.8 per 1,000 population in 1957, declining to 15.7 in 1973 and increasing to 18.1 in 1983.
"The birthrate is increasing because the baby boomers are having babies of their own," said William True, executive director of Community of San Gabriel. "And in our area we have a large influx of Hispanics and Asians, a young population in their childbearing years."
The occupancy rate of maternity rooms is now higher than the occupancy rate of all hospital rooms taken together, according to the Hospital Council of Southern California. It said the overall occupancy rate in Los Angeles County for 1983 was 58.5%. Although the council said it had no specific figure for maternity occupancy, Valley hospitals said their maternity occupancy rates ranged from 45% to 116%.
While hospital occupancy is on the decline in general, many hospitals are emphasizing maternity services because of the baby boom, the council said.
Community will reopen its maternity wing in 1987 as part of the final phase of an expansion program now under way. The 12-bed department will offer, in addition to traditional delivery methods, alternative birthing, in which mothers undergo labor and delivery in a setting like a bedroom.
"Now that birthrates have again climbed, the hospital is committed to resuming the service," True said. "But the new service must reflect the current and coming demands. Clearly, parents-to-be want more choices in where and how their children enter the world."
Nearby Garfield Medical Center in Monterey Park, with 33 maternity beds, has completed an expansion program that includes a new obstetric division. "We have doubled the size of the labor and delivery area," said Peter Kramer, assistant administrator. "If growth continues, we may want to expand further."
Garfield has 220 deliveries a month with 70% occupancy of its maternity beds, Kramer said. It also attempts to attract patients with parenting classes, an alternative birthing room and a financial package in which parents who can pay cash get a flat rate.
Case in Advance Appeals
Kramer said the cash-in-advance program has particular appeal to Asians, and he attributed a large portion of the increase in births within Garfield's service area to a recent influx of generally younger Asians.
Monterey Park Hospital, with eight maternity beds, plans an expansion program that will include adding four more beds, private labor rooms and an alternative birthing center. In 1984, 1,128 babies were born at the hospital.
Huntington Memorial Hospital in Pasadena averages 250 to 300 deliveries a month and has 32 maternity beds and a 90% occupancy rate, hospital officials said. "The birthrate is definitely on the increase," said Dr. Barry Schifrin, director of maternal and fetal medicine. "It is a renaissance of birth--an experience not to be put off forever. Now older women are becoming pregnant."
Recent expansion has taken place at Queen of the Valley Hospital in West Covina, which has 22 maternity beds and an average of more than 300 maternity patients a month. The occupancy rate is 116.8%, according to Mary Ann Harvey, director of community relations, who said the overflow goes into the medical-surgical unit on the same floor.
"Last year we redid the whole maternity department," she said, "adding two labor rooms and one new delivery room and three beds in the recovery room. We now have eight labor rooms and three delivery rooms and three new nurseries."
Like other hospitals, Queen of the Valley attempts to attract maternity patients with a wide variety of services.
"We have an alternative birthing center in which a woman undergoes labor and delivery and stays in the same room for 12 hours. If she is OK, she is then discharged with a follow-up visit in the home," Harvey said. "This is only for low-risk patients. Alternative birthing centers are hospitals' way of reacting to women wanting home deliveries. We all have to offer it because patients want it."
The hospital also offers rooming-in, where the baby remains with the mother most of the day, sibling visitation, a sibling preparation class, childbirth education programs and a breast feeding clinic.
'Consumer Choice Service'
"This is an era of competition in which hospitals aim for the market share," Harvey said. "Some hospitals do advertising and we have to react to that. The consumer can make the decision by picking the hospital first and then a physician who practices there. Maternity is a consumer choice service because of the competition.
"Although we cover the entire East Valley, we are now looking to specific areas for more patients. Walnut and Hacienda Heights are areas of growth with new housing and younger families," she said.
Jeanne Casserly, nursing director for maternal child health at Pomona Valley Community Hospital in Pomona, said, "The marketing that hospitals are doing is new. It is a competitive field and the consumer gets the advantage of all this."
Casserly said her hospital has between 120 and 130 maternity patients a month and would like to increase that number to 200. There are 27 maternity beds but the empty ones are used for gynecology patients so the unit is generally full.
"What has really changed here is the philosophy of obstetrical care," Casserly said. "Before, the baby belonged to the nursery room nurse. The rules and regulations were rigid. And the consumer complained about this.
"Now the postpartum and the nursery are one unit and the patient is the family, not just the mother or baby. Each patient is evaluated separately for what they want for the birthing experience.
"We have alternative birthing rooms, rooming in and sibling visitation. One nurse takes care of both the mother and the baby."
Santa Teresita Hospital in Duarte, with 14 maternity beds, hit an all-time low in 1977 with 296 deliveries for the year, according to Gloria Marold, assistant administrator. "When we began offering classes in the Lamaze method of natural childbirth in 1978, we got up to 407 deliveries," she said, "and in 1984 we had 618 deliveries." Her hospital also offers rooming-in and an alternative birthing room.
But not all hospitals in the San Gabriel Valley have reported an upswing in births.
Inter-Community Medical Center in Covina, which also offers special services, has had a small increase in births, said Evelyn Cochran, assistant director of nursing. "In Covina we have an older population," she said. "The shift in the birthrate is because professional women age 30 and older are starting their families now." Inter-Community has 60 patients a month with 35%to 45% occupancy of its 16 maternity beds.
1,200 Births a Year
Arcadia's Methodist Hospital of Southern California, with 26 maternity beds, has had a stable birthrate in the last five years, said Elizabeth Evans, senior vice president of marketing and planning. She said the birthrate there is about 1,200 a year.
Foothill Presbyterian in Glendora has had a maternity department for only three years but it has always done well, a hospital spokesman said. Thirty-seven babies were born in the six-bed unit last month.
When Foothill opened its maternity department, San Dimas Community Hospital felt the impact, according to a spokeswoman for that 12-maternity-bed hospital. "We suffered a small decline," she said.
Glendora Community Hospital has eight beds, including two alternative birthing centers. There are no plans for expansion, although a hospital spokesman said that in the past year and a half the number of deliveries per month has gone from about 20 to between 80 and 100 because of a Medi-Cal contract.
At West Covina Hospital, with eight maternity beds, spokesmen could not be reached for comment.
St. Luke has no plans to reopen its maternity department because of its proximity to Huntington Hospital, according to Sally Sims, vice president of professional and patient services.