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Poor Valley economy creates baby bust

Maternity wards are empty and birth-control clinics are full because of the recession.

Fewer babies are being born in the central San Joaquin Valley, mirroring declines statewide and nationwide. Hospital newborn-nurseries that were busy just a couple of years ago now have beds aplenty.

Directors of maternity wards blame the baby bust on people delaying childbearing in the poor economy, and on an immigration slowdown because of a lack of farm jobs.

"The recession has a lot to do with it," along with water cutbacks that have hurt some farmers, said Donna Aldrich, clinical director of maternal child services at Madera Community Hospital. "We had a lot of migrant farmworkers, and they’re just not here."

Deliveries at the hospital have plummeted. Three years ago, nurses helped with 200 births a month -- today the average is about 140 births. And it's dipped to as low as 108 in a month, Aldrich said, "which is incredible for us."

Population researchers suspect the recession is at the root of a decrease in birth rates nationwide in 2008. States like California, which have been hit particularly hard by home foreclosures and job losses, saw the most dramatic declines, they say.

Economists are more cautious about assessing the cause. Birth rates can vary for a variety of reasons, they say. Regardless, dips during economic downturns historically have been short-lived.

The slump in births isn't putting hospitals out of business -- labor and delivery departments typically aren’t big money-makers, like cardiac surgery departments, hospital executives say.

More worrisome, said Mark Foote, vice president of finance at Madera Community, is a general decline in patients who are putting off elective surgeries and other procedures in the recession. A decline in births only adds to the problem, he said.

The numbers

California’s births dropped from 566,137 in 2007 to 551,567 in 2008, for a 2.6% dip in the number of births. The birth rate -- based on births per 1,000 women — dropped 2.8%. The state had the third-highest birth-rate decline, behind Arizona and Mississippi, according to a Pew Research Center report released earlier this month.

A check of the number of births in the Valley showed similar declines between 2007 and 2008 — a 3% drop in Fresno County, 2.9% in Madera, 2.6% in Kings, 4.9% in Merced. Births in Tulare County remained steady.

Pew researchers said they found an association between deteriorating economic conditions and people’s decision to have children. A nationwide survey in October found 14% of people between ages 18 and 34 — and 8% of those ages 35 to 44 — reported postponing a child because of the recession.

The decision to delay childbearing appeared greater among low-income families. Nine percent of people with incomes of $25,000 or less said they had postponed having a child, compared to 2% with incomes of $75,000 or more, the researchers said.

In a sign that people are putting off pregnancies, family-planning clinics in the Valley are jammed with patients who want birth control.

Demand for services is up 14% in the past year at Planned Parenthood Mar Monte, said Patsy Montgomery, the nonprofit’s director of public affairs. "We’ve seen this increase for over a year now," Montgomery said. "And it’s not letting down.

"Most of our clients are saying they can’t afford to expand their family size right now," Montgomery said. "They’ve lost jobs. They’ve lost health insurance, and everything is tight."

Historically in hard economic times, people delay marriage and delay childbearing, said Gary Becker, a professor of economics at the University of Chicago and author of a book of family economics.

"Children are costly in a variety of ways, particularly when the mother is in the labor force and has to lose work time," Becker said.

When the economy picks up, birth rates will too, he said.

Many factors

Amid the decline, Ellen Watson, head of the maternity department at Sierra View District Hospital in Porterville, also has noticed that fewer migrant farmworkers are in the area. That, too, reflects broader trends.

The number of unauthorized immigrants in the United States is estimated to have decreased 7% from 11.6 million in January 2008 to 10.8 million in January 2009, according to the Department of Homeland Security Office of Immigration Statistics. A 1 million decline between 2007 and 2008 coincided with the nation’s economic downturn, the government said.

But Philip Martin, a professor of agriculture and labor expert at the University of California at Davis, said the impact of immigration on birth rates isn’t yet clear. "Recession, reduced immigration — we really won’t know which is the main factor until another year or so passes," he said.

Other factors besides the economy can influence the number of births at a given hospital.

Not all area hospitals have seen a decline in births.

At Saint Agnes Medical Center in Fresno, new insurance contracts probably helped the hospital maintain a level of about 3,900 births a year during the past year, said Nancy Hollingsworth, chief operating officer.

In Reedley, a drop in deliveries has a lot to do with an obstetrician’s move out of town this year and another’s departure in 2008, said Susan Alday, director of maternal-child health at Sierra Kings District Hospital. Births dropped from 1,801 in 2007 to 1,596 in 2009.

But she doesn’t let the recession off the hook. "People are moving out of the state to work," Alday said.

At Madera Community Hospital, nurses hope the economy — particularly for farming — turns around soon. Some staff have had to be told to stay home on low census days, said Aldrich, the department manager. Until the recession, the delivery ward had been expanding into other areas of the hospital to make room for mothers and babies. "We had taken over part of the [medical-surgical] unit, because we were just so robust," Aldrich said.

Now, she said, "the rooms are often empty."

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