Baby Boom at Hospital Puts Strain on Staff : Health: The county unit is swamped by immigrants and Medi-Cal patients other facilities have turned away. Deliveries have soared by 54% since 1985.

A baby boom of unexpected magnitude has placed a critical strain on the Ventura County Medical Center, where expectant mothers sometimes wait on stretchers in the delivery room hallway while the obstetrics staff searches for empty beds.

Since 1985, the number of births at the medical center has increased by about 54% to about 3,500 annually--far more than staff anticipated at the only public hospital in the county.

The number of births is expected to continue increasing at a rapid pace--possibly reaching 4,000 per year by 1992--while the birth rate at some of the private hospitals in the county holds steady.

“It’s like a three-ring circus,” said one nurse, running into a delivery room. “It just never stops.”

Hospital officials give two main reasons for the increase: the withdrawal of private physicians and hospitals from Medi-Cal contracts because of extremely low reimbursement rates and the large influx of immigrants into the area from Mexico and Central America.

If measures are not taken to increase staffing and expand the facility, officials fear that they may have to turn away patients. Some public hospitals in Los Angeles and Orange counties have already reached that point.

In 1989, UC Irvine Medical Center adopted a controversial “obstetrical diversion” policy in which security guards were used to turn away women in labor. Meanwhile, Los Angeles County hospitals at times have become so overcrowded that the conditions at the facilities have been judged unsafe to the health of babies and mothers.

For example, one night about a year ago, a single resident physician at Women’s Hospital in Los Angeles was left to supervise 42 women, nearly all of them in labor.

Under less stressful conditions, the resident might have noticed the abnormal fetal monitor readings on one of the women in labor. The abnormal reading went unnoticed for 10 minutes, a critical oversight that resulted in a serious brain injury to the infant. It also resulted in a $500,000 malpractice settlement paid by Los Angeles County.

The situation at the Ventura County Medical Center’s obstetrics unit--which is operating about 2% over its 45-bed capacity--is not nearly as severe as the public hospitals to the south. The number of malpractice suits has actually decreased, hospital officials say. And the county’s infant mortality rate continues to be below the state average.

But, according to hospital employees, the obstetrics ward is often understaffed and nurses and doctors are overworked.

“Some days we say, ‘We should have gotten battle pay,’ ” said Sheila Dedrick, a senior registered nurse. “My legs ache so much by the end of the day, I can hardly stand.”

The pace is so quick in the obstetrics unit that the staff rarely has time to eat lunch or dinner. Full cups of strong black coffee are left on a table in the break room as nurses and doctors change into smocks and run into delivery rooms.

“One night I left here so tired that I almost dozed off driving home,” said Judy Gifford, a senior registered nurse.

Usually, there are enough obstetrics doctors to deliver the babies, but sometimes there are not. One day last week, a frantic nurse made an urgent call for additional doctors.

“We need a doctor immediately!” she yelled into a telephone. Within minutes, a physician from another unit arrived to assist with three premature births.

Kelly McGrath, a resident doctor, said physicians often perform “balancing acts” between delivery rooms.

“There are times that I deliver a baby, take my gown off, wash my hands and go into the next room to deliver another,” McGrath said. “It is pretty much constant work. It is fairly common to go six weeks without a day off . . . and we’re working anywhere from 70 to 100 hours a week.”

McGrath said he chose to do his residency work at Ventura County Medical Center because it has a reputation for being busy.

“But I didn’t realize it was going to be quite this busy,” McGrath said.

Nevertheless, the baby boom has caught hospital administrators by surprise.

“No one expected it to be this way,” said Vonnie Haller, the nursing supervisor of the obstetrics unit. “We thought maybe we would have 50 more deliveries a month, but it has gone way beyond that . . . and it’s only going to continue.”

One day recently, 18 babies were born at the county medical center. And by the end of the year, hospital officials expect the number of births to reach 400 during some months.

“Occasionally, we have women waiting for beds,” Haller said. “We had 10 deliveries one night and we had them lined up in the hall.”

The only other hospital in the county that comes close to the number of births at the medical center is Community Memorial Hospital of San Buenaventura, with about 220 births a month.

The other large area hospitals average 100 to 140 deliveries a month.

County hospital officials first noticed the influx of pregnant mothers several years ago after more private hospitals and doctors started refusing Medi-Cal patients.

“The payment was slow and there was a lot of bureaucracy to deal with,” said Phillipp K. Wessels, director of the Ventura County Health Care Agency. “Also Medi-Cal patients are harder to manage. Many are high-risk and present a major issue with malpractice insurance.”

Thus, the burden of Medi-Cal patients has fallen on the Ventura County Medical Center, although St. John’s Regional Hospital in Oxnard has agreed to continue accepting some patients.

Combined with the growing number of poor immigrants from Mexico and Central America, the system has been burdened beyond what hospital officials had expected.

“It just has been growing by leaps and bounds,” said Wessels, who oversees the medical center.

Recently, the hospital began renovating office space on one of the floors at the medical center to accommodate about 14 more obstetrics patients, but officials fear that they will quickly outgrow that space as well.

“Once we outgrow that, there will be no other space,” Wessels said. “Except for an additional hospital facility.”

Meanwhile, about two weeks ago, Santa Paula Memorial Hospital agreed to start taking Medi-Cal patients again, but that move is only expected to divert about three or four births a day from the county hospital--hardly enough to have an effect.

“I keep thinking that maybe we’ve reached the peak, but I just don’t know,” Wessels said.

Relaxing for a moment in the break room at the hospital, Gifford managed to joke about the situation.

“We tried to kill the stork,” the nurse said. “We tried to take down the flashing blue light on the front lawn,” she said of the beacon indicating an emergency room. “Nothing seemed to work.”

As she finished her sentence, nurses began rushing into the delivery room. Another woman was giving birth.

NUMBER OF BIRTHS

Five-year totals at Ventura County Medical Center YEAR: BIRTHS 1985: 2,267 1986: 2,443 1987: 2,582 1988: 2,728 1989: 3,122 1990: *3,500 * Number is approximation Source: state and county statistics