C-Wing = Cha-Ching?

Ogden Regional Medical Center in Utah recently opened a wing solely dedicated to cesarean births, as reported by the Standard-Examiner:

The C-wing is the first of its kind in Utah, said hospital marketing director Craig Bielik. It includes eight C-section/postpartum suites, single-room maternity care, newborn and transitional nurseries, larger than normal hospital rooms and rooms fully equipped to handle emergencies.

The new C-wing also includes flat-screen televisions, Wi-Fi access, a sleeper chair and access to the new Ronald McDonald family room.

Former ICAN president Pam Udy visited the “c-wing” at Ogden Regional several weeks ago. She describes her initial reaction like this:

I walked around, going into several “cesarean suites”. I noticed the big tvs, walk-in showers and baby warmers. I walked back to the nurse’s station. There I see a certificate of congratulations from the Chamber of Commerce on the opening of the new Cesarean Section Wing. The nurse offered to give me a tour….

I asked how many operating rooms they had. She said, “Only one. We can only do one cesarean at a time. That will change, though, we are adding another operating room, so we can do two cesareans at a time.” It will be ready by the end of 2010…

I went to ask questions and get information, not to confront or accuse. Yet, I really felt as if I was walking around a crime scene. The rooms were pretty, but I wondered how much were an effort to cover up an ugly truth: Cesarean sections are major surgery, difficult to recover from, for both mom and baby. Thus, we need a recovery wing just for cesarean moms, with the NICU close by.

A new hospital in Maple Grove, Minnesota has also opened it’s doors this past month, focusing almost entirely on labor and delivery. A recent open house at the Maple Grove hospital was featured in in the Minneapolis Star-Tribune (emphasis added):

On Saturday, nearly 6,000 visitors showed up for an open house at the new facility. People milled around the lobby clutching gift bags and chatting with Cochrane as the Maple Grove High School jazz band played. Kids got their faces painted. Outside, families posed for photos in front of a North Memorial helicopter.

Todd and Christine Nelson of Ramsey were in a long line waiting to tour the birth center and surgical area. Christine is expecting her first baby in April. She says she changed obstetricians so she could deliver at Maple Grove.

Unlike Ogden Regional, Maple Grove hospital does not have a dedicated cesarean wing. However, it’s very first delivery was a scheduled cesarean, as reported by WCCO-TV:

Melissa Bistodeau, had a scheduled C-Section in the afternoon. She, along with her husband Joe Bistodeau, and son Cole, got the royal treatment.

Nurses and doctors gave them a standing ovation as they made their way to their room.

While these new hospital facilities promise to provide cesarean mothers with the best possible experience, the rising cesarean rate in the U.S. begs the question: who really benefits in the long-run?

The CEO of Maple Grove hospital is fairly clear about the reason for that hospital’s focus on labor and delivery. As reported by the Minneapolis St. Paul Business Journal:

The owners of Maple Grove Hospital will face challenges as they open its doors during a poor economy, but officials there say they have a strategy to make the operation viable: Deliver plenty of babies.

When the $138.9 million hospital opens in December, more than half of its initial 30 beds will be devoted to moms recovering from labor, and a quarter of its initial staff of 120 will be involved with infant deliveries.

That doesn’t count the host of amenities and services the hospital plans to offer to make giving birth there as hassle-free as possible — or the marketing/advertising campaign that will highlight the hospital’s birthing services.

“We anticipate delivering a lot of babies,” said Maple Grove Hospital CEO Andy Cochrane.

And Ogden Regional’s director of women’s services states that one reason for the c-wing is a business move, making room for more births in the “family birthplace”:

“C-section patients’ length of stay is on average 72 hours, where a vaginal delivery is 48 hours,” Garcia said. “By providing our C-section patients with their own specialized unit, we will be able to accommodate an increase in vaginal births in the existing family birthplace. This is a win-win situation for all customers, including the OB providers.”

Clearly, hospital facilities like the c-wing are beneficial for business. With cesarean rates on the rise year-after-year, this will no doubt continue to be the case. One might even ask if c-wings will encourage further growth in cesarean rates (if you build it, they will come?)…

But what about benefits for cesarean moms themselves?

It is certainly true that mothers recovering from cesarean could benefit from care that is tailored to their post-surgical needs. Any cesarean mama can attest to that. Pain management, help taking that first walk, assistance with holding and nursing the baby – these are unique needs facing moms post-cesarean. By this logic, a wing with resources and trained staff dedicated to these needs could be a very good thing.

However, these are not the “amenities” being advertised at Ogden Regional. Instead it’s flatscreen TVs and WiFi access that are touted as providing a state-of-the-art postpartum experience. No mention is made of lactation consultants, for example. For mothers hoping to encourage nursing post-cesarean, these would be far more valuable than access to the Internet.

No matter how you look at it, cesarean wings are at best a mixed-bag. While they may validate and provide for the special care women need post-surgical birth, they will certainly not do much to decrease the need for such care in the first place. The hospital administrators cited above have acknowledged that financial viability is part of what’s driving the creation of such facilities. Unfortunately, such a focus obscures a more crucial need for mothers and babies in our society. What if, instead of investing in flatscreen TVs and WiFi access, hospitals spent money on premiere, evidence-based maternity care, like doulas, lactation consultants, water tubs and lowering intervention rates?