WESTMINSTER -- Plenty of people had told Linda L. Hall that Carroll County General Hospital was a "backward, rural" place to go for anything, much less her somewhat high-risk pregnancy.
She had her baby there anyway, and couldn't have been happier with the care, she said. But even she had planned to go to a larger Baltimore hospital until her obstetrician asked her to choose CCGH, which is very close to her Westminster home.
"They have a long way to go before they really start to change their reputation," said Mrs. Hall, who delivered her son, Matthew, last September at CCGH.
The hospital will be more actively promoting its obstetric services, including some improvements set for fall, to lure mothers who would otherwise choose big-city hospitals, said Linda Harder, vice president for marketing.
Half of all Carroll County babies -- about 600 of them a year -- are born at the local hospital. Ms. Harder said she is hoping the percentage will increase to 60 or 70 percent as the hospital lets more physicians and women know that the hospital is equipped and staffed well enough to take care of most pregnancies.
"What we would like to do is make the hospital the hospital of choice in Carroll County," said Arletta Mason, director of maternal-child health.
Changes in the last two years have included 24-hour staffing by an in-house pediatrician and obstetrician, she said.
The birth of a baby allows more time for parents to shop around and choose a hospital based on several criteria, Mrs. Mason said.
"You're dealing with a healthy clientele versus a sick clientele," she said.
"They want to make sure they and their babies can be safely cared for, even if something goes wrong," Ms. Harder said.
Even most larger hospitals would have to transfer babies needing intensive care, she said. CCGH has the ability to stabilize babies and mothers who would need transferring, she said, just as well as a larger hospital. However, some cases such as very premature labor, are transferred to such hospitals before the birth.
Mrs. Hall and Matthew had several complications, but she said the hospital nurses and house pediatricians were able to handle them all.
Nursing care is the single biggest factor in whether a woman is satisfied with the hospital where she delivered, Ms. Harder said. The hospital recently hired a firm to survey two "focus" groups of women who delivered within the previous six months at either Carroll County General, or at larger hospitals in Baltimore, Frederick and Columbia.
"We found the obstetrician is very influential in which hospital people choose, and that didn't surprise us," Ms. Harder said.
So the hospital also will be urging area obstetricians who deliver at larger centers, as well as at Carroll County, to send more of their patients to the local hospital.
Dr. Melvin Yeshnik, outgoing chief of obstetrics and Mrs. Hall's doctor, said he also will talk to his colleagues. He said he rarely needs to send his patients to Greater Baltimore Medical Center, for which he also has privileges.
The Westminster-Hampstead obstetrician said he has urged his patients to give Carroll County General a chance, and wants other local obstetricians to do the same.
"Behind the facade of a country hospital is a very well equipped unit," Dr. Yeshnik said. "You will generally have more than one person checking in on you and more individualized care than people at larger institutions."
He does have some patients who are skeptical.
"I ask them to trust me on this," he said.
Some of the changes coming to the ward include:
* Mother-baby nursing. Each nurse will be trained to care for both the mother and child during her shift.
* A third birthing room. The hospital now has two, one of which has no television or private bathroom.
* More rocking chairs.
* A more extensive security system, such as a lock on the door into the maternity ward and a system in which visitors leave a driver's license or other identification upon entering.
* A "face-lift" to redecorate and renovate the ward.
* More liberal visitation hours and policies for siblings and grandparents.
* Another obstetrician. The hospital is hoping to recruit more obstetricians, particularly a female, to deliver there.
Some of the changes will be less revolutionary, but still important mothers, Ms. Harder said.
For example, the women in the focus group recalled never being able to get enough liquids.
Ms. Harder said the solution may be as simple as providing them with a pitcher of juice at a time, instead of the standard hospital portion.
The women also said private rooms were important. Because the maternity ward at CCGH is operating at about half capacity, most women delivering there end up getting their double room all to themselves, Ms. Harder said.
But as more women start delivering there, she said, the hospital will consider a system to make a few rooms guaranteed private for those who request them.