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At HCGH, Everything's Coming Up Babies

Kim Barnes, obstetric services coordinator, in the Howard County General Hospital nursery.

The economy may be in a slump, but the baby business at Howard County General Hospital is alive and kicking. In a county with a population hovering near 300,000, a hospital expecting 3,300 births this year is bound to get some oohs and aahs. In fact, stork visits to the Columbia-based community hospital are more numerous than those to Hopkins Hospital and Johns Hopkins Bayview Medical Center combined-enough to push it to number five in the state of Maryland.

Kim Barnes, administrative coordinator of obstetric services at HCGH, says the maternal child unit normally averages 260 births a month, but in April that number peaked at 318 for the first time in the hospital's 30-year history. Barnes explains that factors such as a marketing campaign for the hospital's new labor and delivery unit (which opened in September), fast-paced Howard County development, and the connection to Johns Hopkins Medicine probably contributed to the spike.

But births aren't all that keeps the maternal child unit hopping. Several nationwide trends-such as more 30- and 40-something women having children, higher numbers of women in the workforce, and increased medical malpractice litigation-have led to marked increases in precautionary prenatal testing, infertility treatments, induced labors and Caesarian births, all of which weigh heavily on the unit's resources and staff. "Many professional women are waiting to have kids until they can buy the Beamer or afford the au pair," says Barnes. "Then they are choosing to induce labor to fit their busy schedules."

Midwife Lauren Mayer, who has practiced at HCGH for 11 years, says she's seen a trend toward more conservative management of pregnancies in recent years. "We're prone to take a closer look at cases, and there are much longer periods of testing. We'll spend 12 hours, for example, monitoring a pregnant woman who's been in a car accident, just to be safe."

Although Barnes says the toll on the bottom line is offset by the boost in revenue, she has to incorporate some fancy footwork when it comes to staffing. Often, she says, six patients can become 12 in just two hours. Call nurses are now used more frequently, and some postpartum nurses float to labor and delivery to lend a hand if patient flow demands it. "We're often completely full, mostly because we have more C-sections," says veteran charge nurse Karen Parker. "Sometimes I wish we had Rollerblades."

To free up the unit's 12 labor, delivery and recovery rooms, Barnes has enforced a stricter discharge system, depending on the time and type of delivery. Despite the pressures of working in this fast-paced unit, most staff have been there for decades and relish the opportunity to live and work in a tightly knit community. Turnover remains extremely low. And now, says Barnes, a new generation is starting to swell the ranks, attracted by HCGH's high-tech but hometown feel.

-Lindsay Roylance



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