Hospitals around the country, especially throughout the West Coast, New York, Texas and Florida, are responding to a growing midwifery trend with renewed marketing interest and financial commitment.
Since 1975, the number of certified nurse-midwife (CNM)-attended births in hospitals has soared almost 100% from 19,686 to 195,410 in 1994, with the greatest surge in the early 1990s of 71%, according to the American College of Nurse-Midwives, which currently has about 6,300 members.
Now more than ever, hospitals are finding that birthing centers staffed with qualified CNMs can provide a well-needed image overhaul of personalized care and compassionate attention to women's healthcare needs in spite of a perceived manage care environment obsessed with a profitable bottom line.
"OB/GYNs just don't have the time that nurse-midwives do; the nurse-midwife spends on average 45 minutes to an hour with her patient, whereas physicians will spend a maximum of a half-hour with each patient," said Kimberly Patamia, ACNM's manager of marketing and PR.
Hospital marketing departments are reveling in the fact that home-like birthing centers can deliver more for less. Since CNMs can save hospitals $1,000 to $3,000 per birth and deliver more personalized care, birthing centers present an attractive situation, according to James Unland, president of Chicago-based Health Capital Group who negotiates large managed-care contracts.
Birthing Centers Generate Free PR
For St. Luke's Roosevelt Hospital in New York, no expense was spared when it created its birthing center last year. Unlike most birthing centers that are off-site, this one was created on the hospital's 11th floor. Barbara Brennan, director of the Birthing Center at St. Luke's Roosevelt Hospital, inherited this project from Dr. Solan Chau, the hospital's director of obstetrics, who wanted it to be the "wave of the future."
For about $200,000, the hospital renovated 5,000 square feet of its 11th floor to make way for three birthing rooms, a family room, a classroom, waiting area and office space. Brennan said, "This birthing center was developed to emphasize the healthy, normal process of having a baby." To this end, the birthing rooms feature queen-size beds, armoires, lamps (instead of overhead lighting) and even jacuzzis.
When the birthing center was launched last February, Brennan projected that 200 babies would be delivered within the first year. Due to the exceptional response generated from its marketing and PR efforts, the center has already delivered 170 babies.
To get the word out, St. Luke's Roosevelt placed ads in local free neighborhood newspapers like the Manhattan Spirit, Westside Resident and the West Sider and used some local radio. Press releases and brochures touting the birthing center as an excellent and safe option for low-risk women blanketed local media outlets.
Amazingly, those efforts yielded phenomenal returns. In fact most of the buzz that was generated about the center was through free PR, a hospital PR/marketer's dream.
Starting with New York Magazine mentioning the birthing center as the town's best place to have a baby, word quickly spread like wildfire. Soon thereafter, Lifetime Television, upon being contacted by someone impressed with her birthing experience at the center, did a segment on the birthing center. Then Self Magazine deemed it one of the country's "10 Best Hospitals to Have a Baby." Even Helen Hunt's character in NBC's "Mad About You" selected the hospital as her birthing place, possibly due to all of the positive and exciting press the center has enjoyed since its inception, according to Brice Peyre, spokesman for St. Luke's.
Breaking through Cultural Barriers
Presently, CNMs are most appealing to whites, then Hispanics and Asians, according to ACNM. "The greatest challenge is marketing to minorities," said ACNM's Patamia, who says that African-Americans are particularly resistent to the trend. Since birth rates are increasing the most among Hispanics, Asians and African-Americans, ACNM strongly suggests that hospitals implement strategic marketing efforts to these groups.
African-Americans, in particular, seem to associate midwifery with substandard, low-status care. "Although granny midwives have a long history of delivering some of the best pediatric care in this country, many African-American women identify them with slavery or low-rate healthcare, reminding them of a time when they were denied access to doctors," said Patamia.
Gwen Spears, program director for the King-Drew Medical Center in the south central area of Los Angeles, agrees. Spears is heading up the hospital's $1.2 million effort to open an off-site birthing center for King-Drew within the year. "African-Americans tend to be more into the prestige of where they have their babies. If the hospital has an upscale image, they want to be able to say that's where they delivered their baby, regardless of the quality-of- care issues."
As a result, Spears anticipates her initial patient base will primarily come from the area's significant Hispanic community and secondarily from whites and Asians.
Interestingly, about 14 years ago, the state-funded Martin Luther King Jr. Hospital (King-Drew's predecessor), had its own birthing center that was staffed primarily with CNMs and pediatric nurses. Servicing a largely indigent women patient-base on Medic-Cal (California's Medic-Aid provider), the center thrived for about 12 years. "But once Medic-Cal went to managed-care, more and more women started choosing hospital-care over the birthing center, forcing us to eventually shut down [in 1995]," said Spears.
Then, recognizing the revenue potential and improved women's healthcare image a birthing center could bring, Drew University launched a new birthing center that would also be the most prominent educational midwifery site in the area.
This yet-to-be-named birthing center has a strong grassroots marketing plan. Community outreach efforts will be the campaign's major thrust, according to Carol Miro, CNM and assistant professor of nurse-midwifery at Charles Drew University.
Targeting Hispanics and African-Americans in the area, Miro plans to inundate local churches, beauty salons and baby clothing stores with press releases and promotional literature like brochures and coupons announcing the center's grand opening and the full range of services to be offered.
With the help of freelance marketers, Miro will also court HMOs with targeted brochures that will emphasize the center's enhanced care while providing attractive cost savings.
The undetermined marketing budget will be fueled by funds from the university's medicine and science departments, which it expects will be reimbursed by profits generated by the center once CNMs are paid their salaries.
The birthing center will be housed in a new 10,000 square-foot building close to the hospital. The center will not only feature four spacious birthing rooms, but will also be the area's only state-of-the-art site for nurse-midwifery training.
(ACNM,202/728-9876; Health Capital Group, 312/939-6906; St. Luke's Roosevelt, 212/877-5556; King-Drew Hospital, 213/563-4951)