Baby shortage

Birth deliveries at the country’s largest maternity facility, Victoria Jubilee Hospital (VJH), have tumbled from more than 500 last year to just over 300, a startling shift that confirms a national decline in childbirth.

Sister Dawn Williams Gordon, the hospital’s ward manager of labour and delivery at the VJH, who confirmed the notable decline, described the current trend as “unprecedented”.

Speaking with The Gleaner yesterday, Williams Gordon, who has been in her current role for nearly two years but has previously worked in other capacities at the hospital, said, “We are used to delivering at least 500 babies monthly.

“Prior to now, we were looking at over 500 deliveries per month, and now we’re down to just over 300; so it’s a significant drop in the amount of babies that are being born.

“Now, we’re seeing one or two deliveries on a shift. Those things are unheard of, something we’re not accustomed to – not even during crop season.”

Crop season is the September to October period when the hospital usually sees a higher number of birth deliveries.

Citing delivery data for this year, Williams Gordon shared that the hospital recorded 459 births in January, 364 in February, 362 in March, and 342 in April. This, she said, is in stark contrast to last year, when the data was averaging more than 500 births monthly.

In December 2023, Jamaica, with a population of roughly three million people, recorded a fertility rate of 1.9 for the first time, falling below the internationally recognised replacement level of 2.1. The number of births for 2023 is 52,000.

The Reproductive Health Survey Jamaica (RHS), 2021 reported that Jamaica’s total fertility rate (TFR) fell significantly, from 4.5 births per female between 1973 and 1975 to 1.9 in 2021, contributing to a decrease in the country’s population estimate.

Urgent discussions

This demographic shift has raised concerns about the nation’s strategic and developmental future, prompting the need for urgent discussions around the resources and policies needed to support a sustainable population.

When asked whether the Government should consider incentivising childbirth to reverse the declining trend, Williams Gordon said it should be done if the decline becomes drastic.

She said the Government might also try a public campaign, as they did in former years, though it might not be possible now as the country is in an election year.

“Back in the day, when there were a lot of children being born, there was this promotion that ‘Two is better than too many’. So maybe they are going to be coming with that, because everything that we do, the information is submitted to the Ministry of Health and the stakeholders will look at it,” she said.

The health administrator, however, agreed that while public education is good with this new generation of mothers more focused on education and stability, the approach may need to be different – perhaps something more tangible.

Nonetheless, she remains hopeful that the lull is temporary.

“There’s a season for everything,” she said. “Maybe this is just a season, and soon we’ll see those numbers going up again.”

The decline in births has also coincided with a shift in the age demographic of expectant mothers, with more women now delaying pregnancy in favour of achieving career goals and financial stability.

“We’re seeing a lot more women in the advanced maternal age category – 35 years and older,” she noted. “Many of the younger women want to ensure they have their house, car, and career before thinking about children.”

Despite concerns often associated with older mothers, Williams Gordon was quick to point out that age alone does not determine a high-risk pregnancy.

“Many of these women are healthy, active – even working in physically demanding jobs, like farming. They can go through their pregnancies with fewer complications than some younger, first-time mothers.”

She also highlighted that there is no stigma within the hospital against older mothers, noting that some have very successful pregnancies and deliveries.

On the subject of family planning, Williams Gordon said despite the decline, she was not seeing any increases in requests for tubal ligation, popularly known as ‘tie-off’.

“It’s usually mothers who have had multiple children, or who have had a traumatic delivery experience, who bring it up,” she said.

Women undergoing C-sections may opt to have the procedure done at the same time, while those with vaginal births would need to return for screening and counselling, Williams Gordon explained

She also revealed that most of the women giving birth now, based on the data, are having their first, second or third child, while the high-parity mothers are becoming less common.

Acknowledging the lingering public stigma about the hospital, Williams Gordon was eager to dispel myths of poor treatment and outdated care.

“There’s still that stigma, but a lot of our patients have very good outcomes,” she said. “Even women who used to go to private facilities are now coming to VJH.”

The hospital has invested in improved monitoring equipment, ultrasound machines, emergency kits, and additional beds and cots. The focus is also on patient education, with added educational material now included in the Child Health and Development Passport, which is given to each mother for their child at birth.

“We’re doing surveys post-delivery to hear directly from the mothers,” she shared. “And we’re trying to make sure every mother who comes here leaves with a positive experience — not just in terms of care, but in how she is treated by everyone, from nurses to porters.”

tanesha.mundle@gleanerjm.com