A New Beginning : Daniel Freeman Set to Reopen Obstetrics Unit in Partnership With the County


A rebirth of sorts is under way in the old maternity quarters at Daniel Freeman Memorial Hospital. The walls and trim have turned a rose pink; the rooms are quickly filling up with fetal monitors, high-tech incubators and bottles of baby formula.

Next week the unit will reopen, the result of a partnership between the 365-bed nonprofit Catholic hospital and Los Angeles County aimed at providing care for hundreds of poor women who would otherwise bear their babies in crowded county hospitals.

The unit had closed in 1985 because of what hospital officials described as declining use and financial reasons.

For people such as registered nurse Shirley L. Cook, who worked in the old unit for 25 years, the launching of the new unit has special significance.

Cook, who will be one of the new managers of the unit, glows with pleasure as she walks through the pink halls, pointing out the neonatal intensive care unit and new birthing beds.

"When you have death," she said, explaining why it is important that a hospital have an obstetrics unit, "you have to have life."

A contract will make Daniel Freeman the 38th hospital to join the Los Angeles County Overflow Obstetrics Program, which diverts women to private hospitals to ease the demand for obstetrics services at county hospitals.

Although the county usually contracts for existing obstetrics beds, officials said the Daniel Freeman agreement is the first that prompted a hospital into launching an all-new obstetrics unit.

The hospital anticipates that it will deliver babies each month to between 200 and 250 women served by the county program and 50 private patients paying with insurance or their own money.

The $5-million unit has room for 32 women and their babies. The county helped arrange loans and a $1-million grant, and $750,000 came from the Fritz B. Burns Foundation, for which the unit is named.

Negotiations on the contract began in 1990 at Daniel Freeman's prompting, said Audrey Bahr, director of health resources development for the county Department of Health Services.

"Daniel Freeman came to us and said they'd reopen the service if we'd help them do it," Bahr said.

The partnership is benefiting the county and the hospital, officials said.

The presence of the unit will further relieve the demand for obstetrics beds at county hospitals. And although some hospitals contracting with the county do not have neonatal intensive care units, Daniel Freeman's unit means that some high-risk babies will not have to be moved to other hospitals.

"It makes a much better package for our patients, because they can handle just about anything that comes to them," Bahr said.

Meanwhile, the county contract means that the hospital will have enough patients to re-enter the field of obstetrics, thus expanding "the continuum of patient-care options," said Gail Margolis, hospital vice president and general counsel. That will allow the hospital to provide full-service contracts with insurers or private companies, Margolis said.

And obstetrics can help a hospital attract families who need other services. "By delivering a baby, you start off with a very positive relationship," Margolis said.

The hospital is launching a prenatal unit as part of the county program. Officials are also considering a pediatrics program to care for babies born there and to ease overcrowding at county pediatric clinics.

The new maternity unit includes two "labor-delivery-recovery" rooms and three "labor-delivery-recovery-postpartum" rooms. So-called "LDRPs" are a popular obstetrics trend because they allow women to stay in one room rather than being transferred from one room to another.

The return of obstetrics to Daniel Freeman will mean a change in the treatment of obstetrical patients taken to a hospital by paramedic ambulance.

Until now, Centinela Hospital Medical Center in Inglewood has been the only hospital in the immediate area offering obstetrics services. Although Centinela closed its emergency room to most paramedic patients in 1989, it has continued to accept obstetrics patients brought by paramedic ambulance through a special arrangement with the county.

Centinela Hospital remains "ready, willing and able" to talk to the county about continuing that service, said Eric Tuckman, hospital vice president and general counsel.

But Bahr said Friday that the Centinela contract, which expires June 30, will not be renewed. Instead, paramedic ambulances will take obstetrics patients to Daniel Freeman.

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