Inside the Texas Hospital Where Maternity Care Runs Like a Ballet – ryan

If you squint your eyes, you might be able to see how Guadalupe Regional Medical Center (GRMC) could look something like the Bolshoi Theatre. Ethereal light shining as the curtains open, a fluttering of bodies weaving in every which way—all of them wearing the same clothes, all of them knowing where to go.

“It’s just like watching a ballet,” Chantel Ewald, who serves as the clinical director of GRMC’s Birthing Center, told Newsweek. “Everybody orchestrating what they need to do to take care of the patient, to take care of the baby and to have a good outcome.

“I’m so proud of these girls out there because they are taking care of business,” Ewald said of her nurses. “When those emergencies come up, or when those crisis come up, I just stand back and applaud.”

The ease at which GRMC’s Birthing Center operates is part of the reason why the Seguin, Texas, hospital made Newsweek‘s 2025 ranking of America’s Best Maternity Hospitals.

This year’s list, which recognizes 444 hospitals across the country, was done in partnership with data firm Statista. It is the third consecutive year that GRMC has appeared on the ranking but the first time the hospital has achieved five ribbons, the highest possible rank. The hospital was awarded four ribbons in 2023 and 2024.

GRMC’s leap from four to five ribbons is even more impressive because the 2025 edition of the ranking features four major changes to its methodology, all of which made it harder for hospitals to meet that five-ribbon threshold. The modifications were made to incentivize improvement within maternity care.

Like last year’s edition of the ranking, America’s Best Maternity Hospitals 2025 draws from three pillars: an online survey of health care professionals and hospital managers with knowledge of maternity processes, results from patient experience surveys, and consideration of hospital quality metrics.

But there have been four significant updates to this year’s methodology.

“The main changes of this year’s methodology affect the hospital quality metrics score, i.e. inclusion of new data sources, and the reputation score through the implementation of previous years’ recommendation data,” Rafaela Wasserer, an analyst at Statista, told Newsweek in an email. “The thresholds for the three pillars were increased to incentivize improvement within maternity care.”

Higher Thresholds to Clear

This year, institutions in the five-ribbon category needed to score above 84 percent for hospital quality metrics and patient experience. They also needed a reputation score higher than 71 percent. Hospitals appearing in the four-ribbon category this year had to achieve a hospital quality metrics score and a patient experience score above 74 percent, as well as a reputation score higher than 71 percent.

Last year, to be awarded five ribbons, hospitals needed a quality metrics score above 84 percent, a patient experience score above 82 percent and a reputation score above 69 percent. Four-ribbon performances were defined as hospitals with a quality metrics score above 77 percent, a patient experience score above 79 percent and a reputation score above 66 percent.

Wasserer said that in the 2025 edition of the ranking, GRMC’s Patient Satisfaction Score was within the top 10 percent of all evaluated hospitals.

Part of the reason the hospital has been able to deliver such a high score on satisfaction could be GRMC’s unique identity as an independent hospital. “As the only city-county hospital in Texas, GRMC is a non-profit community hospital that does not depend on tax support. Independent hospitals, like GRMC, typically offer care based on the specific needs of its community.”

“We are our own standalone facility, so it’s easy to make change,” Lauren Riggs, director of the hospital’s Birthing Center, told Newsweek. “We can stay up-to-date on evidence-based practice. When we find something that we want to improve or change, the process is much shorter compared to some facilities who might not even have administration in-house. They’re part of a larger system, and that’s not like that for us.”

“When patients come here, they feel like they’re treated as a person, not a number,” she said. “They get the special, little things that the nurses do, which are above and beyond, to make them feel like they are important.”

Riggs said it’s common for patients to have the same labor nurses for consecutive pregnancies because of the hospital’s low turnover rate. She said seeing familiar faces during a vulnerable time also helps to put patients at ease. And even when there are complications, GRMC’s standard for maternal care does not go unnoticed.

“We had one patient who (went through a difficult loss), and there was not much we could do, but she came once a month to visit the staff and bring us cookies and cards,” Riggs said. “She was just so appreciative of everything that we did for her and her family.”

Evaluating A More Comprehensive Database

As part of Statista’s goal to increase the ranking’s comprehensiveness with more hospital data, the AHA Annual Survey Hospital Database—which contains data provided by more than 6,200 hospitals and 400 health care systems—was added as a data source in determining America’s Best Maternity Hospitals for 2025.

This year, hospitals were also ranked based on their participation in the Centers for Medicare & Medicaid Services’ (CMS) health equity program, on whether they were accredited by the American Nurses Credentialing Center Magnet Recognition Program (which recognizes nursing excellence and high-quality patient care) and on baby-friendly hospital designations made by the World Health Organization and the United Nations International Children’s Emergency Fund to highlight hospitals that emphasize breastfeeding support and mother-infant bonding.

GRMC performed especially well on the CMS metric for health equity, receiving “a strong score that surpasses the five-ribbon threshold for hospital quality metrics,” Wasserer said.

The hospital also offers breastfeeding classes and childbirth education classes, and once patients are admitted, they are given preference cards to fill out, which Ewald said are a great way for the nurses to get to know their patients even more.

“You learn so much just by being at the bedside and hearing what their worries are, and their fears, and being able to sit at the end of the bed and go, ‘Let’s talk about it. Tell me what you’re tell me what scares you,’ so I can calm those fears and educate you,” she said.

More Than Just One Good Year

Another new feature of this year’s methodology is the inclusion of 2024’s recommendation data.

This year, Statista once again conducted a nationwide survey of hospital managers and medical professionals with expertise in maternity care, who were asked to recommend and rate maternity hospitals in key areas such as perinatal care, operative obstetrics, patient education and counseling, accommodation and service as well as nurse and midwife staffing.

But instead of just including those recommendations, America’s Best Maternity Hospitals 2025 also factors in the hospitals recommended in the 2024 survey to account for reputational continuity. To ensure that the list reflects the most up-to-date scores, previous recommendations—although still considered—were given less weight.

Wasserer said that this year, GRMC “strengthened and stabilized its reputational standing” thanks to a sizable number of recommendations that gave the hospital “a quality score within the top 10 percent when accounting for the last two years.”

Both Ewald and Riggs spoke highly of the hospital’s leadership, praising the “family atmosphere” among the staff.

“We have a really supportive administrative team. Senior leadership is very supportive, and I think that just trickles down,” Riggs said. “When managers feel supported, they can make their staff feel supported, and when staff feel supported, the bedside nurse can really go above and beyond for their patients.”

Ewald, who has now worked at GRMC for nearly two decades, considers the hospital “home.”

“It was eye-opening to see how good we have it here,” she said. “I can go and knock on the (chief nursing officer’s) or the (chief executive officer’s) door and say, ‘Hey, you have a minute?” And they always invite me in. ‘Yeah, of course, come in.’ They always make time.

“When we get that support, we present ourselves and we carry ourselves completely differently. We’re happy to be here. We’re happy to serve,” she added. “It’s just a totally different atmosphere.”

Updated April 16, 2025, 12:36 p.m. ET: An earlier quote was updated for the sake of clarity.