Delivery Service

Keeping mothers happy during the birth experience isn’t just good medicine and proper public relations. It’s also good business.

July, 2003

It was one of the more unforgettable moments in a job in which the unforgettable happens on a daily basis. Dale Reimer, director of women and newborn services at Kapiolani Medical Center for Women and Children, walked by the waiting room of the hospital’s birth center one day and saw an expectant father making himself comfortable for the long day ahead. He had brought with him a small hibachi and a bag of charcoal.

“You aren’t going to light that, are you?” asked Reimer, pointing to the ward’s sprinkler system overhead. “If you do, we are all going to get awfully wet.” Kapiolani, like most hospitals on the island, encourages families to take an active role in the whole birth experience, but you have to draw the line somewhere.

According to the National Center for Health Statistics, in 2001 the average age for women giving birth rose to 24.8 years, up from 22.1 years in 1970. More women are getting proper prenatal care, 83 percent in 2001, compared to 76 percent in 1990. Thanks to technology such as the Internet, these expectant mothers are also better informed and are taking a more active roll in the birthing process. Increasingly, women and their families know what to expect and what they want, and hospitals are likely to accommodate those requests (except for the occasional cookout).

“Expectant mothers are the only patients who aren’t sick when they come to the hospital,” says David Earles, director of marketing and business development at Castle Medical Center. “Most people are just too ill to notice whether the walls are painted white or green or whether their room has a nice view. Moms show up with their families and it’s an opportunity to make a good impression on everyone. It’s a happy time.”

Keeping mothers and families happy during the birth experience isn’t just good medicine and proper public relations. It’s also good business. According to Lindsey Carry, manager, women’s health at The Queen’s Medical Center, women are a potent economic force. By the year 2008, women ages 45 to 64 will be the largest and richest segment of the United States population. Today, they are the major consumers of health care in the country, accounting for 59 percent of prescription drug purchases, 61 percent of doctors’ visits and 66 percent of hospital procedures. However, most importantly, women make 80 percent of all health care decisions in a family.

“We are consistently getting e-mail from women who are doing their research. Ten years ago, expectant mothers didn’t ask about birth plans and outcomes,” says Carry. “Today, they want accessibility, convenience and excellence, and they are making those decisions on a consumer-driven approach. We are just listening. Delivering babies is not a hugely profitable area for a hospital. But women are very loyal and if we build strong relationships, we know we will be top of mind when their husbands, parents or other relatives need care.”

Later this year, The Queen’s Medical Center will be enhancing the services of its state-of-the-art birth center, which delivers about 125 babies a month, about half its capacity. By the end of the year, Queen’s plans on constructing a new retail boutique, which will offer breast pump rentals and other baby equipment and supplies. By then, hospital officials hope to have full-time lactation specialists on staff. In addition, they are recruiting more female OB/GYNs, because, according to hospital surveys, that’s what women want. Recently, the birth center started offering special meals created by 3660 On The Rise chef Russell Siu. The hospital also has increased the amount of women’s health and life skills classes, as well as the number and scope of its outreach efforts.

“We’ve had this jewel of a facility and we haven’t marketed it to the extent that we should have,” says Carry.

Queen’s maternity ward, on the top floor of the Queen Emma Tower, features 25 private postpartum rooms and 12 LDRPs (Labor Delivery-Recovery Postpartum) rooms, which accommodate the mother for the entire duration of her hospital stay. When the ward was completed 15 years ago, the use of LDRPs was relatively new and Queen’s operated close to its ideal capacity, with as many as 200 births a month. However, as other hospitals renovated their facilities to include LDRPs, the number of births at Queen’s steadily declined. Spacious, modern and quiet (thanks to its light traffic), Tower 10, as it is commonly known, resembles a sleepy hotel more than a hospital.

“Queen’s doesn’t pop into the average person’s mind when you think of labor and delivery,” says Dr. Robb Ohtani, chief of the OB/GYN department. “But recently we’ve found through word of mouth, that we have a high proportion of mothers (37.1 percent) come to us for their second babies. They’ve heard what a nice experience having a baby here can be. Patients make choices according to what they see and hear, so marketing is important. It took us a while to realize that.”

Word has already started to spread. In 2003, Queen’s is averaging 125 births a month, a 6 percent increase over 2002.

The 800-pound midwife in Hawaii’s baby world is Kapiolani Medical Center for Women and Children. The 106-year-old hospital is the only facility in the state and Pacific Rim that specializes in maternity and infant care, and is one of fewer than 20 women’s hospitals throughout the nation. On any given month, 450 to 550 babies are born at Kapiolani, nearly 60 percent of all babies born on Oahu.

Kapiolani’s big selling point for mothers is its neonatal, intensive and intermediate nursing care for sick and premature newborns. Although a vast majority of families will never set foot in these units, they are a very comforting security blanket for nervous mothers.

But this isn’t an unreasonable worry. According to Reimer, because of its unique ethnic mix, as many as 40 percent of Kapiolani’s deliveries are classified as high risk. Hawaiian women have a high rate of cardiomyopathy (weakening of the heart muscle). Japanese mothers have a problem with gestational hypertension. Their babies have a high rate of jaundice. These characteristics are compounded by the fact that women are giving birth later in life. Overall, there are a higher percentage of pre-term births in Hawaii than on the Mainland.

According to Reimer, Kapiolani’s program began to grow shortly after it opened its Neonatal Intensive Care Unit in 1969. Today, the hospital’s third-floor birth center has 26 LDRPs and 37 postpartum rooms. It also has three operating rooms. In her four years at the hospital, she says that births have increased 2.5 percent annually.

“We are increasing steadily and are making plans to deal with more capacity,” says Reimer. “We can handle as many as 7,500 births a year, so it will be a while before we reach our full capacity.”

Over the Pali, Castle Medical Center’s Birth Center is experiencing a baby boom of sorts. This year, the cozy facility has been averaging between 50 and 55 births a month, up from 30 to 35 last year. This growth is despite the fact that Windward Oahu’s population growth is stagnant and its residents are aging. However, the center, which was renovated about a decade ago, features six LDRPs, all with views of the Koolaus. It is widely considered one of the prettiest birth centers on the island.

“It used to be that a high percentage of our expectant moms would drive right past us on their way to Kapiolani. No one bothered to look at us,” says Earles. “We know that they have the latest, greatest technology for the complicated cases. However, mothers are now looking around and they like what they see.”

Word of mouth has helped for sure. But Earles believes that Castle’s sudden surge of births may be attributed to its recently completed, $10 million expansion, which did not include renovation of the Birth Center. “To be honest, all that construction served as a $10 million billboard,” says Earles. “It told people that Castle Hospital is growing, we’ve got new technology. You should check us out. Women are going where they feel comfortable and safe. Sometimes that’s having an NICU down the hall. Sometimes it’s being in a nice, quiet room close to home.”

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