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COUNTYWIDE : UCI Delivers With Budget Birth Center

Two years ago, UCI Medical Center officials were criticized for overcrowded delivery room conditions. On Thursday, they were praised for doing something about those conditions--opening a new birthing center.

The 8,552-square-foot center--paid for in part with $1 million in tobacco tax funds--will provide prenatal care, labor and delivery, postpartum and well-baby care at a cost to patients of about $3,000, about 30% lower than that in a hospital, UCI officials said. Women will stay at the birthing center for 24 hours, about half the time for an average hospital delivery.

In its first year, the center is expected to deliver an estimated 1,500 babies to women with low-risk pregnancies. Staffed by seven certified nurse midwives, it will offer both low-risk indigent and private patients an alternative to usually expensive hospital care.

“We’re very proud to have the first university-associated, free-standing birthing center in the nation that will be staffed by nurse midwives with both prenatal and after-care delivery,” said Mary A. Piccione, director of UCI Medical Center.

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The crucial need for obstetrical care in Orange County was highlighted in June, 1989, when UCI Medical Center was delivering more than 500 babies a month in a maternity ward designed for 250 births a month. Hospital officials responded by announcing a controversial “obstetrical diversion” policy to send some women in labor to nearby hospitals. At the time, local Medi-Cal hospitals also reported crowded maternity wards.

Since then, the obstetrics crisis has eased somewhat, in part because state Medi-Cal officials have allowed hospitals to contract for labor and delivery services alone, without requiring a full Medi-Cal contract that would cover other services.

But Piccione said the need for high-quality, low-cost care still exists. In 1989, there were more than 49,000 births recorded in Orange County. As many as 55,000 births are expected in 1991, far exceeding the area’s capacity for 51,575 births a year, she said.

Dr. Thomas J. Gurite, UCI chairman of obstetrics and gynecology and medical director of the birthing center, said he was skeptical of the birthing center idea until he looked at data supporting them.

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“The data supports the fact that this is a safe option,” Gurite said. “And it’s certainly a heck of a lot safer than a woman not getting any prenatal health care and then dropping in at a place that’s too busy to handle her.”

B. J. Snell, the center’s director of nurse midwifery, said she thinks the trend of the future is to rely more on midwives because they provide a “high-touch, low-tech option.”

Indeed, Tameron B. Mitchell, associate director of the state Department of Health Services, said the center will serve as a model for other health-care facilities in the state and across the nation.

Families will be encouraged to be present during the delivery, which will take place in nine pastel-decorated suites equipped with rocking chairs and special birthing beds. The women and their babies will remain in the suite after the birth.

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Although midwives will provide all care, UCI faculty obstetricians and pediatricians will be available for consultation, and an ambulance will be standing by at all times to transport women to nearby UCI Medical Center in case complications arise.

The midwives have begun caring for about 400 patients, with the first delivery expected a week from Monday and about 50 patients due to deliver this month.


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