In Howard, babies born to fit into busy schedules

More women give nature a nudge for reasons medical and personal

April 27, 2003|By Liz F. Kay | Liz F. Kay,SUN STAFF

Angela Jones was working against a deadline.

"My parents are here from out of town, and they want to see their grandchild," the Eldersburg resident said last week as she received medication to induce her son's birth in Howard County General Hospital's labor and delivery unit.

The baby business is booming in Howard and, with many of the mothers older and more affluent than average, some of the spontaneity of having a baby is being eliminated.

For more and more Howard mothers, the baby's arrival is something that must be squeezed into an increasingly crowded personal and hospital schedule.

More than 300 births are expected at the Howard hospital each month between now and July -- a better than 15 percent increase from the average of 260 births per month before the opening of its new labor and delivery unit in September.

"What no one knows is, is this an aberration, or is this the beginning of a trend," said Dr. Marvin Davis, a Clarksville obstetrician. "If it's the beginning of a trend, we'd better buckle our seatbelts."

The pregnant women whom Davis sees are increasingly likely to try to plan one of the most unpredictable moments in anyone's life, a tendency that mirrors what is happening nationally.

In 2001, more than one of every five births was induced, double the 1989 rate, according to the federal Centers for Disease Control and Prevention.

Better drugs that make the medical decision easier have contributed to that trend as well as to concern about the potential for increased medical problems among overdue babies, said Deborah A. Wing, an associate professor of obstetrics and gynecology at the University of Southern California's Keck School of Medicine.

Although most births are spontaneous, Davis said that attempts to plan, through induced labor or Caesarean section, are "definitely getting more prevalent. They're looking at trying to schedule the whole process."

Scheduling can work for and against the hospital, because there's no telling how many spontaneous births may occur.

"Some days it works great. The next day, you have a big storm that comes through," Davis said.

Control factors

A number of factors, including more women in the work force and potential for legal liability for malpractice lead to increased induction of labor, Wing said.

Women "want to have control over when they are taking time off of work," Wing said. Also, "not uncommonly, people want to have friends and families available for deliveries."

With her baby a week overdue and her parents preparing to leave for home in Louisiana, Jones, who is 33, said induction seemed a logical choice.

Only 24 hours after giving birth to Stephen on Wednesday, she prepared to return to her two other children.

"I want to be home for all three of them," Jones said.

As she tucked her baby into a tiny blue suit, there were no indications of the tension from the previous day, when Stephen was born with a heart rate of 60 and wasn't breathing.

He was treated in the neonatal intensive care unit for a short time but was ready to go home with his mother.

"He gave us quite a scare," said Stephen's father, James.

Being in the hospital is not always restful, Angela Jones said.

"They come and take care of you," she said with a laugh. "You don't get to sleep."

Women like Jones who are 30 or older had almost half the babies born in Maryland in 2001, the most recent year for which statistics from the state Department of Health and Mental Hygiene are available.

Nationally, the birth rates of women between ages 30 and 40 have increased more than 20 percent over the past decade.

With increased maternal age comes the increased need for Caesarean sections and induced labor, Davis said. Women in Howard are also likely to receive prenatal care, resulting in larger, healthier babies, he said.

More mothers in Howard County have the disposable income to seek assisted reproductive technologies, such as infertility treatments, which also result in an increased number of multiple births, he said.

Multiple births

Marci Scher, a 31-year-old Ellicott City resident, could tell you that herself. After using infertility treatments, she has spent more than five weeks in the hospital resting while pregnant with twins, surrounded by books with titles such as Mothering Multiples, videos and her laptop computer to keep her busy.

Scher gave birth by Caesarean section to a son, Ian Alexander, and a daughter, Becca Jordan, on Tuesday.

After this, "we're done," she said. Bed rest "is not relaxation. You're hoping everything you're not doing is helping the baby."

The more complicated needs of older mothers -- increased numbers of Caesarean sections and induced labor, as well as those requiring care before delivering -- have sometimes caused backups at the hospital, particularly when complicated by surges of spontaneous deliveries.

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