Nurseries where maternity ward visitors can gaze upon newborns dozing peacefully in their bassinets are disappearing as hospitals shift their focus to strengthening the mother-child bond in the first days of life, officials say.
In Ventura County, where six out of seven hospitals have obstetrics units, only two nurseries remain open on a regular basis. Responding to demands by managed care, evolving technology and changing attitudes toward children and families, hospitals across Southern California and the nation have adjusted their services to allow mothers to keep their babies by their bedside around the clock.
But with the change has come the loss of the popular viewing areas, where hospital visitors burdened by some of life's darkest moments could brighten their day a little simply by peering through the nursery window.
"I was so disappointed," said Susan Delaney of Agoura Hills, who walked to the maternity ward at St. John's Regional Medical Center in Oxnard during a recent break from visiting her ailing 92-year-old grandmother. "When I got there, they said there was no nursery--all the babies were in the rooms with their moms."
Although the result was not intended to deprive people of the joy of gazing upon the fresh and innocent, that is the consequence of the "rooming-in" model of maternal care that has swept the hospital industry over the last 20 years, said Amy Lee, a spokeswoman for the American Hospital Assn., an advocacy group that represents 5,000 hospitals.
"The old days of large, impersonal settings where families don't have any privacy, those days are history," said Bonnie Connors Jellen, director of maternal and child health for the association. "There's been a huge change going on where family-centered maternity care has been the goal of most hospitals."
Hospital associations could not cite figures but said changes in health care and hospital management bear out the trend. New hospitals are being designed without nurseries, but fear of kidnappings and other security concerns are not the driving forces, Lee said.
Many hospitals use nurseries only at a parent's request or for newborns awaiting adoption, hospital officials said. Neonatal and intensive care nurseries are maintained for premature or ill babies.
For Myranda Braziel of Camarillo, who was about to give birth at Community Memorial Hospital in Ventura last week, the nursery provided some much-needed inspiration. In labor with her first child, she walked the corridors of the maternity ward, pausing to look through the window each time she passed.
Braziel's mother and birthing coach, Lorelei Braziel, was surprised to learn that many hospitals do not have these rooms with a view.
"It would be terrible to go to a hospital and not have a nursery, where the grandparents and the rest of the family can look at the baby after it's born," she said.
"The [private] room gets too crowded," said Jackie McDaniel of Ojai at the suggestion she could enjoy the company of her 12th grandchild, Riley Suzette, in the mother's private room.
St. John's closed its nursery in 1992 in response to requests by families becoming increasingly aware that the early days of life outside the womb are crucial for mother and child, said hospital spokeswoman Rita O'Connor.
"Since the 1970s, there's been a real movement toward family-centered care," said Jan Ayala, director of maternal child health and nursing education at St. John's, where 2,800 babies are born each year. "There's no reason to separate mom and baby."
Maternity experts cite the benefits of rooming in: It makes breast-feeding easier, it allows more time for mother and child to become attached and it offers families a chance to bond with their newest members.
But Community Memorial and Los Robles Regional Medical Center in Thousand Oaks said they plan to keep their nurseries open full time. Los Robles does not have private rooms for expectant mothers, said spokeswoman Rebecca Bishoff. Community Memorial does, but moms can choose to keep their babies with them all the time or take a break once in awhile, said spokesman John Masterson.
"For large families where everyone's coming in from out of town, they all want to be able to see the baby, so we keep them in the nursery," said Michael Bakst, executive director of Community Memorial. "And for people where things are not going well, we recognize they would be attracted by the beauty of birth. Sometimes people need to go from the sad, depressing side of the hospital to the happy side. Babies put things in perspective."
For Diana Etchells of Santa Paula, who was accompanied by her daughter and two grandsons, the nursery at Community Memorial provided a respite from watching her 72-year-old father suffer from a heart condition in the cardiopulmonary unit.
"You can see the finished product and it's a little easier. It's pain with a purpose," Etchells said. "We don't know any of these babies, but they're making us smile."