On This Day, It Averaged Almost a Baby an Hour

Lots of babies born at Olive View Medical Center never make it to a delivery room.

Paulette Nakamura, the head nurse in obstetrics, had slipped on her high heels and was heading home when it happened again one day this month.

Alerted by a startled clerk, Nakamura ran into delivery’s waiting room in time to see a stunned mother-to-be sprawled on a chair. The baby’s head had poked out, but the delivery wing was several yards away.

“I didn’t have a wheelchair,” Nakamura said. “I was trying to get the husband to help push the chair. I was sliding on the floor. The husband was overwhelmed. He just stood there and watched.”

The healthy baby was born in the chair--just a few feet inside the delivery wing doors.

Similar close calls happen every day, Nakamura said. Women grimace through their contractions in the waiting room when the 22 labor and delivery rooms are filled.

The nurses try to figure out who needs the beds the most. But sometimes a baby surprises them. Or maybe it’s not quite a surprise.

“When you work here, you aren’t surprised anymore,” volunteered Dr. Aldo Palmieri, an Italian-born physician who was trained in a Bronx hospital where a third of the mothers were crack addicts.

Palmieri was in charge the day a reporter visited the most overextended public maternity ward in Los Angeles County. Next on the staff pecking order was Drew Moffitt, a third-year UCLA resident, and below him were other residents, interns and medical students.

By day’s end, 21 new American citizens had been born. It had been a “quiet” 24 hours, according to the floor’s numerical wizards. With the institution’s birth rate skyrocketing, everybody who works there, it seems, can rattle off baby statistics as easily as baseball standings. August was the busiest month ever--748 births. On the craziest day that month a record 38 babies were born. By mid-September, the staff was speculating about whether August’s record was in jeopardy. A running tally was kept on the hallway chalkboard.

Even when the halls are quiet, the ward is drenched in drama, joy and grief. In a far-off room, a grieving couple waited for their child to be born. They know the baby is anencephalic, a baby without a brain. It will only live a few minutes or hours. “What did I do wrong?” the mother had pleaded when she heard the news.

A woman screamed in agony. No one seemed to notice. The fetal monitor showed that her baby’s heart rate had dropped. The umbilical cord was probably wrapped around the baby’s throat.

Moffitt and Lorie Morgan, a second-year resident, took over. They fumbled to put on the latex gloves they keep in their back pockets.

A nurse grabbed a phone. “We need you guys over here stat!”

Within seconds, a pediatric emergency team was hovering at the bedside.

The baby, which slid out easily, was blue and coated with a milky film.

A circle of bobbing heads surrounded the infant.

“Make that kid cry,” a pediatric nurse commanded.

Then it came. The cry.

The tension evaporated.

Someone turned to the reporter standing in the room strewn with bloody towels, gloves and instruments. “Did you know 2.3% of California births occur here?”

Three minutes after the birth, Morgan and Moffitt were walking to the next room for another examination.

“Rule No. 1: Always carry gloves in your pocket,” Moffitt said.

Less than 5% of the women who give birth here are fluent in English. One night a nurse asked a woman with dirty feet where she had been that evening. Mexico, came the answer. She had crossed the border at dusk and delivered at Olive View by midnight. The staff suspects that a good number of their patients are new arrivals lured by Olive View’s growing reputation.

Many women show up here having had no prenatal care. Coping with ignorance is a daily struggle.

After delivering her 12th baby, Palmieri asked one patient if she was interested in contraceptives or sterilization. The woman looked puzzled. She had never heard of birth control. Another patient, who had worked in the fields since childhood, didn’t know her age. She guessed she was 29. She looked 15 years older.

At mid-afternoon, a gurney surrounded by doctors and nurses crashed through the swing doors. The clatter of footsteps attracted even more help. “What’s going on?” a doctor asked. The emergency blew over quickly. But the husband, clutching a white plastic bag containing his wife’s belongings, looked mystified. If he understood English, he would have known the conversation had turned to a “Dirty Harry” movie.

It was late afternoon when the hall phone rang.

A private hospital in the San Fernando Valley wanted to transfer an indigent mother and newborn to Olive View. The caller insisted that the institution did not provide maternity service.

“It sounds pretty fishy to me,” Moffitt grumbled after hanging up.

Nakamura, swaddling a baby within earshot, laughed. “The bottom line is we’re the county, we take whoever . . . .”

She waltzed out of the room with a red-faced baby wrapped from head to foot in a snowy white blanket.

“Can I take that one?” Moffitt asked. “Isn’t she beautiful? She’s 29 minutes old.”

Still fuming, he spoke admiringly of a resident who once turned back an ambulance bringing an impoverished mother to Olive View. A private hospital was trying to get rid of her, but Olive View’s maternity ward was already overloaded.

“Not many of us have the guts to do that,” Moffitt said.

1989-90 BIRTHS AT L.A. COUNTY HOSPITALS

No. of % of Capacity births capacity Olive View Medical Center 3,500 7,103 203% County-USC Medical Center 15,900 18,291 115% Harbor-UCLA Medical Center 6,000 8,854 148% Martin Luther King Jr./ Drew Medical Center 9,500 8,773 92%

Source: Los Angeles County Department of Health Services