"It's a good time to have a baby," said Chris Taugher, education coordinator for obstetrics at Hoag Hospital in Newport Beach. "There are so many choices."
Indeed there are.
In 1988, a woman or couple can rely on Orange County hospitals for telephone hot lines for advice before or after pregnancy, free pregnancy testing, an array of educational classes and open-door policies by obstetrics directors and maternity floor nurses.
They can take prenatal classes in Vietnamese or visit a "pregnagym" for an exercise routine.
They can count on obstetrics departments to help them create their own personal birthing plan, which might allow mother and child to go home 12 hours after delivery with the promise of a home visit by a nurse within 24 hours.
And then later, mothers can join other mothers for a hospital-sponsored fitness walk to talk about how it all went. Babies, of course, are brought along.
The large number of services and options is partly consumer-driven, partly created by insurance company pressures and partly the result of competition by hospitals.
Obstetrics is a specialty that responds to marketing and promotion, according to Dennis Gaschen, public relations director of St. Joseph Hospital in Orange.
It is a highly competitive market, he said, because if a woman and her family like how a hospital treats them when a baby is born, they are likely to bring their business back.
"Having a baby is a positive hospitalization," and hospitals want to provide services that will entice a woman to return, said Beth Groves, community relations coordinator at Mission Hospital Regional Medical Center in Mission Viejo.
Mission, for example, added "FirstBorn" to its arsenal of obstetrics services in November. The program caters to the woman pregnant for the first time and provides a 24-hour "Well Baby Line" and monthly newsletters. In mid-February, 143 women were enrolled. "It shows we do have a need," Groves said.
Hospital marketing and obstetrics spokespersons agreed that consumer demands have stepped up in the past few years.
Health care consumers on the whole "are much more sophisticated " than they once were, said Mary Urashima, director of public relations and marketing at Humana Hospital in Westminster. "We get very directed questions."
And "women make 80% of all health care decisions," she added.
Humana enrolls pregnant women in its Cradle Club education program and a year ago added to that its First Steps program for mothers with newborns. "A need was there--a lot of women call the maternity department after they go home," Urashima said. "The advantages to us are obvious. It keeps our name in the household."
"Women are much more assertive now," said Tess Payne, registered nurse and director of obstetrics education at St. Joseph Hospital.
So assertive that it is not uncommon for pregnant women to walk off the hospital elevator and onto the maternity floor and ask for a tour, she said. Or to ask her for an interview about "what it means to have a baby at St. Joseph. Or what it means to have a baby."
Another factor being considered by hospitals and couples is cost. Because of that factor, early discharge programs--which allow a healthy mother and baby to leave the hospital from 12 to 24 hours after delivery--are increasing in popularity, particularly for the uninsured, according to Kathy Cline at Hoag Hospital.
Dr. Tom Garite of UC Irvine Medical Center in Orange points out that hospital marketing also has been forced to undergo radical change. Where hospitals once aimed their marketing almost exclusively at physicians, now they must target patients and insurance companies.
"Hospitals now have to be full service to compete for third-party payers (insurance companies)," said Garite, chief of obstetrics. And the current thinking is that "obstetrics is the big attraction that brings" patients to a hospital.
It all adds up to good news for consumers who happen to be pregnant. But how does a woman wade through the various hospital maternity services to find what's right for her?
She can start by calling the many pregnancy hot lines for information. Hoag said it receives an average of 460 to 520 such calls a month.
Many hospitals provide a physician referral service. Public relations director Gaschen said St. Joseph Hospital gets 1,000 calls a month for referrals of all specialties of physicians.
And many women are taking advantage of old-fashioned monthly maternity teas which have been offered for years by most hospitals. At the teas, hospital volunteers or staff members outline services, and tours of the maternity floor often are included.
Teas "are a big deal," said Payne of St. Joseph. Women attend them "to check a place out."
Payne said she "definitely encourages" women to call obstetrics departments to ask questions on the phone or to ask for interviews. "I encourage people to find a physician who is in philosophical agreement with them," she added.
"We encourage women to come to the maternity teas even before they get pregnant," said Marjorie Pyle of the obstetrics department at Los Alamitos Medical Center in Los Alamitos.
Pyle said she would tell women "to come in and sit down with the obstetrics supervisor" to create a birth plan.
At Hoag Hospital, Cline said she advises women "to do some soul-searching about what's important to them" in the pregnancy and delivery process, and not wait until the ninth month of pregnancy to do so.