Induced Labor?


January 17, 1993|By ERNEST F. IMHOFF

J. Courtland Robinson, a veteran Baltimore obstetrician writing to me as ombudsman and friend, aimed his physician's lamp at the annual "feel good" story newspapers and TV like to run about the first baby of the year.

After 40 years in obstetrics, the last 20 of them in Baltimore hospitals on New Year's Eve, Dr. Robinson said he wanted to unburden himself of something that he felt news people should know about.

"As New Year's Eve moves along, various hospitals in and around the city begin to estimate their odds of beating the competition, being the first and getting the publicity." No cash prizes are involved. Over the years, several area hospitals have claimed the first child.

Dr. Robinson made it clear "there is no evidence of any serious interference." But he continued, "laboring women are evaluated and judicious estimates made about what could be done to get the first. A likely scenario is a woman who needs a Caesarean section, and it can be managed to be ready exactly at midnight."

"Vaginal deliveries can also be managed by the judicious use of forceps, having the patient not push, keeping her very comfortable. . . . All these steps are reasonable in the management of a laboring woman, so there is real temptation to time it right so as to win the prize."

Dr. Robinson also asked whether hospitals clearly tell expectant parents who may hope their baby is the year's first that they may be forgoing the tax benefit of having a child in the old year. The deduction is $2,300 in most cases. "This option is not often fairly discussed with the parents," the doctor wrote.

Dr. Robinson suggests newspapers and TV get together to "require the New Year child be born by spontaneous vaginal delivery without forceps," minimizing the medical involvement in the race for publicity . . . reducing the shenanigans around New Year's . . . and minimizing pressure to forgo the tax deduction."

For a simple newspaperman, this is getting complicated.

But the doctor gives us a suitable nudge to think about the press role in the matter. C. Fraser Smith, The Sun's reporter on this year's unusual story Jan. 2 -- in which two hospitals argued over which had the first birth -- has been thinking about it as well.

My guess is that the media probably would not agree on a common solution, either Dr. Robinson's or even printing nothing. Cooperating among themselves is as foreign to the media as tranquillity. Of course, if media lost interest or played stories down, hospitals might lose interest. Naturally, hospitals could cool it on their own.

Many patients or relatives may show an interest in publicity, but one local observer familiar with hospitals says: "There is always an implied coercion. If the institution says to a patient, 'The press would like a story, but it's up to you,' the patient will invariably say OK, just because the hospital asked them. They don't say, 'No.' "

The media is not a manipulated victim here; it's often part of the story. It likes first baby stories the way it likes many other warm tummy standards, such as helping the needy at Christmas. Tired of bad news, many readers agree.

A tough political reporter, Mr. Smith is also a veteran first baby writer. He has done about eight or nine first baby stories for The Sun. He usually calls 40 to 50 hospitals the morning after.

This year for the first time, Mr. Smith wondered to himself about possible medical manipulation when he found out that a friendly race had developed between Johns Hopkins Hospital and Francis Scott Key Hospital. The teams in the friendly duel had even talked by phone with each other.

Two healthy babies were born seconds apart, one by Caesarean section, the other by vaginal delivery. TV lights and cameras showed up later. First baby claims were made for both.

Mr. Smith's story, with photos of both sets of babies and mothers, said that the two sets of parents as well as the medical staffs had been aware of the race, the publicity implications and possible tax effects.

Dr. Robinson was in the delivery room at Francis Scott Key Medical Center this New Year's Eve. He is also associated with the Johns Hopkins Hospital. For the past two decades, he's been at either hospital on that evening.

As he wrote his story, Mr. Smith says he thought someone in the medical community might ask questions. He wondered to himself, "Is this right? How much should I make out of the competition? Is the press causing this?"

These are good questions. By their presence journalists prompt people to do funny things. They may even induce stories that are less natural than they seem.

OC Ernest Imhoff is readers' representative for The Baltimore Sun.

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