One Lowcountry hospital has whirlpool tubs in its state-of-the-art birthing suites.
Another has a coveted national designation for breast-feeding.
Still another has bragging rights because it delivers the most infants.
So while there are differences in size, amenities and location, all share one common trait:
They want your baby.
Not permanently, of course. Usually only for a day or two, during the labor and delivery process.
The newborn business is so sought-after for obvious financial reasons. Commercial insurance companies reimburse hospitals an average of $18,000 for all maternal and newborn care associated with a traditional delivery, according to a January study by Truven Health Analytics, a health care consulting company.
A report by the federal Agency for Healthcare Research and Quality estimates hospital stays for pregnancy and delivery add up to a $55 billion hospital bill in the U.S. each year.
But hospitals are eyeing more than this immediate revenue stream. Health care experts know that women often end up making decades' worth of medical decisions for their families. Delivering babies develops brand loyalty.
“It's well documented that when women have a great experience, they feel connected to a health system for many years,” said Pam Brock, vice president of marketing at Trident Health, which delivered 2,950 babies in 2012, more than any other hospital system in the Lowcountry.
Feels like 'home'
Raye Coward, 34, pushed her daughter Rowan out of the elevator onto the third floor of East Cooper Medical Center and hung a left toward Labor and Delivery.
“We're home,” she said.
Not really home — the Cowards live nearby in Mount Pleasant — but her comment wasn't totally tongue-in-cheek. This is the hospital floor where Rowan spent the first two weeks of her life after she was born five weeks prematurely on July 12.
It's no mistake that East Cooper Medical Center feels like home for the Cowards. That's exactly what the architects and designers intended it to feel like when the hospital relocated to a new facility three years ago.
Each labor and delivery room — the child is born right where mom stays — is large and bright. All have been outfitted with a pull-out sofa, a flat-screen TV and original artwork. All of them are private.
“That's the feeling that we were going for,” said Cindi Powell, the women's services manager at East Cooper Medical Center. “Whatever we can do to make them feel like they're not in the hospital.”
Coward, who returned to East Cooper in August for a physical therapy appointment with Rowan, raves about the hospital now, but it wasn't her first choice.
She was supposed to deliver Rowan at the nearby Mount Pleasant Hospital, which is part of the Roper St. Francis Healthcare system, but when Coward's water broke more than a month ahead of schedule, her obstetrician recommended that the baby be delivered at East Cooper because it has a higher trauma level neonatal intensive care unit.
“It was stressful in that it was five weeks early and I wasn't prepared, but the decision to go to East Cooper wasn't stressful at all,” Coward said.
Sometimes a woman's choice about where to deliver her baby is dictated by factors outside pure preference — an emergency, like Coward's delivery — or more mundane circumstances like insurance networks, physician affiliation and geography. But often this decision is nuanced and can involve word-of-mouth recommendations, hospital rankings and post-delivery perks.
And with four hospital systems in the Lowcountry, there's plenty to choose from.
Mount Pleasant Hospital, which opened in 2010 and is the newest hospital in the Lowcountry, has a lower-level neonatal intensive care unit than its closest neighbor and delivers fewer babies than any other facility, but it has one accolade that no other hospital in the region can brag about.
It was recently designated “Baby-Friendly” by the nonprofit group Baby Friendly USA, which evaluates how well hospitals encourage mothers to breast-feed their babies.
For state leaders who are focused on improving South Carolina's infant mortality rate, this distinction means more than any posh hospital room.
Some studies show breast-feeding has short- and long-term health benefits, including lowering obesity rates.
An average 49 percent of new mothers in the U.S. still breast-feed their children six months after birth, according to data released in July by the federal Centers for Disease Control and Prevention. But the average is much lower in South Carolina, where only 32 percent of mothers still breast-feed at six months.
The S.C. Department of Health and Human Services will award up to $200,000 to any hospital in the state that earns “Baby-Friendly” status by Sept. 30. So far, only two, including Mount Pleasant Hospital, have succeeded.
“That's a really prestigious designation,” said Dr. Amy Picklesimer, a member of the state's Birth Outcomes Initiative.
The application process is lengthy and includes on-site visits and staff training. Picklesimer said smaller hospitals have been able to earn the “Baby-Friendly” designation more quickly than larger hospitals because there are fewer staff to train.
“The bigger hospitals are working hard on that. We expect more soon,” she said.
In the meantime, it's a feature Roper St. Francis Healthcare marketers can use to promote Mount Pleasant hospital.
“It's showing the community that, yes, we're new, but we're experts,” said Colleen Cooney, a media relations manager at Roper St. Francis Healthcare. “We're the best place for you and your child. That's why it's a huge deal.”
“Baby-Friendly” isn't the only asset hospitals can brag about. Each facility in the Lowcountry offers its own set of benefits to court pregnant women, except for Roper Hospital in downtown Charleston, which no longer delivers babies after closing its obstetrics unit last year.
Tara Walters, 28, of Ladson, who delivered her daughter Isabella on Aug. 20, said she chose St. Francis Hospital in West Ashley because her cousin loved it there. She particularly liked how Isabella could sleep in the same room with her at St. Francis.
“This has been phenomenal,” Walters said. “I can just wake up and look at her and know that she's breathing and she's there.”
About 1,800 babies were born at St. Francis last year. Medical University Hospital delivered more babies than any other single Charleston-area facility, 2,070 in 2012, and has the highest level neonatal nursery and more neonatal specialists than any other hospital in the Lowcountry.
Babies with the gravest medical emergencies can be transferred to MUSC from hospitals throughout the region.
Access to the Children's Hospital of South Carolina at MUSC is a big draw for pregnant women, said Dr. Jill Mauldin, a maternal-fetal specialist at MUSC.
“Heaven forbid, you don't like to think about it, but if you needed pediatric surgery or urology, those are the two of the common specialties we consult,” Mauldin said. “They really can get access to any type of care that they need.”
Trident Health, which includes Trident Medical Center in North Charleston and Summerville Medical Center, aggressively markets its own labor and delivery services.
Trident's baby campaign includes Baby of the Day digital billboards, the lullaby hospital bell, which plays “Brahms' Lullaby” throughout the hospital every time a baby is born, and nine birthing suites in North Charleston, which feature whirlpool tubs, hardwood floors and waterfall faucets.
“You're only there for a short period of time,” Mauldin said. “Really, you just go into the hospital, you have your baby and you learn what you need to learn and then you go home to rest and recuperate.”
When it comes to picking a hospital for delivery, there's not really a bad choice out there, said Picklesimer, who works for the Greenville Hospital System.
“Childbirth happens in all kinds of places all over the world. People deliver in their homes. People deliver in birth centers.”
Even more important than the facility, Picklesimer said, is choosing the right doctor.