Heart wins out over stork at hospital


Union Memorial Hospital, faced with a busy heart-surgery program in need of improved space and an obstetrics program that is the least busy of any in Baltimore, will quit delivering babies as of March 25.

The decision will end a program that began Oct. 10, 1930, with the opening of a maternity ward in the hospital at North Calvert Street and East University Parkway.

The hospital's gynecology and pediatrics programs will continue. Its growing heart-surgery program - already one of the busiest in the area - will be consolidated from various locations on the ground floor onto the fourth floor, long the home of its labor and delivery rooms.

"The driver here is our vision for our new comprehensive heart center," said spokeswoman Amy Strong Asfa, explaining that the hospital doesn't have vacant surrounding space on which to build. "It's space: We have the lowest obstetrics volume in the city and the highest heart volume in the city."

The hospital will hold a public informational hearing on the decision at 7 p.m. Wednesday in its Memorial Auditorium. But its obstetrician/gynecologists, such as Dr. Myron Maes, already have begun notifying expectant mothers.

There were fewer than 900 births at the hospital in 2001, though it wasn't unprofitable, Union Memorial said.

By comparison, it said, Mercy Medical Center had 3,048 births and Sinai Hospital of Baltimore had 2,325. Both hospitals are less than a 5-mile drive from Union.

"They can close this service because there are other hospitals in the area that are offering the service," said Barbara McLean, executive director of the Maryland Health Care Commission, which regulates health care services in the state.

"I would imagine most of the patients will be going either to Hopkins, Maryland General or University, all of which have obstetrician services."

It wasn't that Union Memorial didn't try. It upgraded rooms, recruited doctors, advertised the program and even held a contest for two years giving away a college scholarship through the Maryland Prepaid College Trust. Any baby born there was eligible.

But Asfa, the hospital spokeswoman, said expectant mothers nonetheless seemed to prefer the women's health pavilions other hospitals like Mercy were offering.

Union Memorial didn't have the land to do something similar, and many expectant mothers who lived nearby drove right past to competitors to deliver.

"It's a good business decision with low volume because you've got a lot of fixed costs with an obstetrics unit - a lot of standby costs that you need to maintain," said Gerard Anderson, director of the Center for Hospital Finance and Management at the Johns Hopkins Bloomberg School of Public Health.

The hospital's 70 obstetrics program staff members learned of the decision in Tuesday meetings that brought tears to the eyes of many, said Lorraine Ebel, a hospital staffing coordinator.

All will be offered jobs in the hospital or in one of its sister hospitals within the nonprofit MedStar Health system, which includes Good Samaritan and Franklin Square hospitals.

"The hospital tried to support us," said Maes, who explained Union Memorial paid his salary and those of other doctors who delivered there. But, he said, "It came down to liability and decreased number of deliveries. It costs a lot to keep a labor suite open."

Maes is among about four doctors who are leaving Union Memorial because of the decision. Its other five affiliated obstetrician/gynecologists are staying and plan to expand gynecological services, Asfa said.

By comparison, she said, the hospital's heart program - which handled 1,042 open heart surgeries last fiscal year - has 90 affiliated doctors, including surgeons and cardiologists.

Maes said he has yet to decide what he'll do next, though he said he has gotten calls from other interested hospitals.

Ebel, the staffing coordinator, studied to become a nurse in the now-defunct Johnston School of Practical Nursing.

Sometimes, during her classes on the building's fifth floor, she would gaze out the window and into a fourth-floor window of the building next door. It was a perfect view of Union Memorial's nursery.

"I could see the nurses holding babies and rocking babies," Ebel said, adding that from that point on it was the only place in the hospital she wanted to work. Now, 21 years after she took her first job there, the end of the obstetrics program seems like a death in the family.

Even so, she said, "We all knew it wasn't substantial enough growth to maintain an entire department. We thought someday it would happen: They would close us."

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