Hospital Statistics Point to Baby Boomlet

By JAMES KINSELLA
Gazette Senior Writer

Delight courses through Althea D'Antonio's voice as she
talks about giving birth last week to twin boys at the Martha's
Vineyard Community Hospital.

"It went really, really, really well," Ms.
D'Antonio said Wednesday, in between to cooing to her newborns.
"I'm up and having fun."

Her newly arrived twins - Lazlo Edmond D'Antonio and
Lucas Carlo D'Antonio - are part of a bit of a baby boomlet
at the Island hospital, where the number of births has been increasing
in recent years.

Last year, 152 births were recorded at the hospital, situated off
Linton Lane in Oak Bluffs. Ten years ago, 125 births occurred at the
hospital, with the totals falling to 110 in 1998 and 107 in 2000. Last
year was just a bit behind 2002, when 154 births were recorded.

The increase is just part of the current picture of pregnancy,
prenatal care and birthing on the Vineyard that emerges from data
collected by the Martha's Vineyard Community Hospital.

Dr. S. Patrick Donegan, the obstetrician-gynecologist at the Center
for Women's Health at the hospital, said recent Island births
reflect the evolving face of the Vineyard. "This is the next
generation," he declared.

Information gathered and tracked by the hospital and its employees
as part of its reporting to the state Department of Public Health shows
that a rising proportion of Island births are coming to parents born in
Brazil. The data also shows that many births last year were the first
for the mothers, that most mothers were breast-feeding when they left
the hospital, that many saw a nurse practitioner for prenatal care and
that a small percentage of mothers drank and smoked during their
pregnancy.

Dr. Donegan said he has seen a steady increase over the past three
years of births to mothers born in Brazil. Dr. Donegan said the
percentage has risen from about eight per cent three years ago to about
15 per cent two years ago to about 20 per cent last year. The hospital
can identify these births through the birthplace of the mother and her
preferred language.

Catherine Chase, a nurse midwife who practices at the center with
Dr. Donegan, confirmed the assessment; she estimated that close to
one-third of the Vineyard births now are coming to Brazilian parents.
"Our Brazilian population is increasing steadily," Ms. Chase
said.

The rising number of births to Brazilian mothers has counteracted
what hospital officials anticipated would be a decline in births at the
hospital, given the high cost of Island living can push young couples to
relocate off the Vineyard.

U.S. Census figures for Dukes County, which includes the Vineyard
and the Elizabeth Islands, show that the number of county residents aged
20 to 34 - traditionally the prime childbearing cohort -
fell from 2,433 in 1990 to 2,303 in 2000.

In contrast, the cohort aged 35 to 59 grew from 3,907 in 1990 to
6,311 in 2000, creating by far the largest of all census cohorts for the
county.

Dr. Donegan said the non-Brazilian births often are coming to young
couples whose roots on the Vineyard go back three or five or even 10
generations.

Another population of non-Brazilian mothers identified by Ms. Chase
are women in their late thirties or early forties. "We've
had a lot of very successful outcomes" with mothers of that age,
she said.

But Ms. Chase also said that a number of Islanders are less
insistent than in years past that their babies be born on the Island.

The Vineyard births represent less than .2 per cent of the 77,500
births last year in Massachusetts. Girls accounted for a slight majority
of births last year on the Island, accounting for 54 per cent of the
births. In Massachusetts, 51 per cent of the births were male.

Information gathered by the hospital for 2005, along with
accompanying state data, shows that:

* English was the preferred language for 79 per cent of the
mothers and 76 per cent of the fathers, with Portuguese the preferred
language for 21 per cent of the mothers and 19 per cent of the fathers.

In Massachusetts last year, English was the preferred language of 88
per cent of the mothers and 82 per cent of the fathers, with Portuguese
the preferred language for three per cent of the mothers and two per
cent of the fathers.

* The self-identified race of the mother was white for 89 per
cent and other for nine per cent. The self-identified race of the father
was white for 76 per cent and other for 13 per cent. The information is
required for an infant's birth certificate.

In Massachusetts, the race was white for 71 per cent of the mothers
and 66 per cent of the fathers.

* Seventy-six per cent of the mothers were married. The state
percentage was 70 per cent.

Since she began practicing, Ms. Chase said, she has seen increasing
numbers of Vineyard parents who are unmarried.

* In terms of education, the largest percentage of mothers, 42
per cent, had at least a high school diploma or its equivalent. A total
of 28 per cent had a bachelor's degree. A total of 42 per cent of
the men had at least a high school diploma or its equivalent, and at
least 22 per cent had a bachelor's degree.

* Of the mothers, 64 per cent had no previous births that now
were living, with 28 per cent having one, and eight per cent having two
or three. In contrast, 44 per cent of mothers last year in Massachusetts
had no previous births now living.

Dr. Donegan said the Vineyard percentage reflects the increasing
youth of the mothers now delivering at the Vineyard Hospital. Many are
the daughters of baby boomer parents. He said the boomer mothers tended
to have births later in their lives.

* Sixty-four per cent had not had either spontaneous or induced
terminations. In contrast, the state percentage was 81 per cent. A total
of 22 per cent of the Vineyard mothers had had one and 11 per cent had
had two or three.

* The Vineyard hospital apparently is a mecca for
breast-feeding, at least in the early going. A total of 88 per cent were
breast-feeding at time of discharge, compared with 79 per cent in
Massachusetts.

Dr. Donegan said the Vineyard hospital encourages breast-feeding as
the most nutritious way to feed an infant. He said that although the
percentage tends to drop in the weeks following discharge, about half
the Vineyard mothers continue to breast-feed six weeks after discharge.

* At the Vineyard hospital, a far higher percentage of mothers
saw a nurse practitioner or midwife as part of their prenatal care
compared to Massachusetts mothers as a whole. On the Island, 59 per cent
saw a nurse practitioner and 36 per cent saw a midwife, compared to 14
and .31 per cent, respectively, in Massachusetts.

Dr. Donegan said he is comfortable working with a midwife in the
practice, having participated in the 1980s in a program at Boston
University Medical Center that helped pioneer ob-gyns and midwives
working together.

He said some patients are more comfortable with a midwife and that
some prefer an ob-gyn. He said his participation is required only for
births with complications.

Ms. Chase, who has been a nurse at the hospital since 1980 and a
midwife since 1997, estimated that she delivered about 80 of the babies
who arrived on the Vineyard last year and participated in the delivery
of another 25 or so.

* Despite the health risks to their fetus, seven per cent of
Vineyard mothers smoked up to 10 cigarettes a day during their
pregnancies, and seven per cent had up to three drinks a week.

Dr. Donegan said the Vineyard hospital discourages any smoking or
drinking by expectant mothers, and has gone so far as to require mothers
to sign a contract promising to abstain as a condition of their
continued care. He said a number of mothers curtail their smoking and
drinking as their pregnancies evolve.

* A total of 44 per cent of the infants were circumcised at the
hospital, compared to a similar percentage, 45 per cent, in
Massachusetts.

* A higher percentage of Vineyard births, 37 per cent, were
funded through Medicaid/MassHealth, than in the state at large, 24 per
cent.

About another 40 per cent on the Island, Dr. Donegan said, were
funded through private insurance, with self-payers accounting for the
remainder. He said the payment plan percentages reflect the economic mix
on the Island.

The hospital now is planning a $42 million renovation and expansion
at its Linton Lane campus. Chief executive officer Timothy Walsh said
that although the hospital is not expecting much of an increase in the
number of births on the Island, the institution does plan to improve its
women's health facilities.

In particular, Mr. Walsh said, the hospital plans to build four
labor-delivery-recovery-postpartum rooms. He said the rooms will allow
families to share the birth experience in what is more akin to a private
room, with a trip to another delivery room necessary only in more
complicated births. At present, births at the hospital occur in the
delivery room next to the operating room.

"For a regular birth, it's a pretty nice concept,"
Mr. Walsh said of the labor rooms, which the hospital now lacks.

Mr. Walsh said the hospital also plans to enlarge its nursery, whose
equipment is limited by its small size.

Ms. D'Antonio, 33, who gave birth last week to the twin boys,
applauded her experience at the Vineyard hospital. The wife of Milo
D'Antonio of West Tisbury - they already have two girls and
a boy, ages 11 to five - she is a former Vermont resident who has
lived on the Island 14 years.

Ms. D'Antonio called Dr. Donegan, who handled her delivery,
awesome, and said she was willing to stay longer at the hospital, since
"they were doing such a nice job."