As Hurricane Ivan headed for the Santa Rosa Medical Center last week, doctors asked five pregnant women who were especially close to their delivery dates to come to the hospital to ride it out.
It's a common practice in hurricane country. No one wants expecting mothers pinned down during a ferocious storm. Adding to the urgency: a commonly held theory that falling barometric pressure can trigger labor.
As Ivan swept into this Florida Panhandle town on the evening of Sept. 15, three of the five patients, including 28-year-old Erica Kelly, reported feeling the onset of labor. "Something's not right," Kelly, who had been scheduled to have a Caesarean section eight days later, told her husband.
Under the hurricane baby theory, falling atmospheric pressure outside a pregnant woman's womb can tug on the amniotic sac, the protective cocoon that surrounds the baby. In other words, the storm causes the water to break.
Research into the phenomenon is inconclusive. But in hurricane-prone areas, the theory gets a lot of attention. After Hurricane Andrew in 1992, a spokeswoman for one Miami hospital attributed a trio of births to a drop in barometric pressure. The South Florida Sun-Sentinel in Fort Lauderdale reported 17 babies delivered at Broward General Medical Center in 24 hours early during Hurricane Frances this month. An obstetrician said the hospital normally delivers about eight a day. And the Mobile Register, in Alabama, mentioned the theory while reporting at least six births at area hospitals during the approach of Ivan.
Reaching a scientifically conclusive answer about hurricane births isn't easy. Barometric pressure readings vary even inside a given hurricane band. The closer to the eye, the more severe the pressure swings. Researchers ideally would want to know exact pressure readings very near all the pregnant women they are studying. They also need lots of readings _ before labor, at labor and during nonstorm times. At the same time, they have to eliminate premature labors and planned inductions.
One team of researchers in Houston examined 12 significant drops in barometric readings in 1992. After overlaying delivery data from 162 births, they determined "significantly more occurrences of onset of labor" within 24 hours after the drop in pressure. The three researchers _ two registered nurses-clinical instructors at the University of Texas-Houston and a nurse practitioner-professor at Yale University _ published their findings in a 1997 issue of the Journal of Nurse-Midwifery.
That's not enough to convince many others. "It's really anecdotal evidence," said Victor H. Gonzalez-Quintero, assistant professor of medicine in the Department of Obstetrics and Gynecology at the University of Miami School of Medicine. He says pregnant women have enough to worry about without unproven fears about hurricane-induced labor. "There is no convincing data demonstrating that there is an association."
One of the biggest studies touching on the topic came in 1996, by Kenneth L. Noller, in the American Journal of Obstetrics and Gynecology. After studying more than 2,400 cases, he found evidence that labor was less likely to begin after periods of falling pressure but termed the findings not clinically significant.
However, he studied conditions around an inland city in Massachusetts, where he says atmospheric swings are far less than during hurricanes. Noller, now chairman of the department of obstetrics and gynecology at Tufts University School of Medicine, says the hurricane baby theory is widely held at hospitals, as are theories linking tornadoes with deliveries. He's not certain. "I'm not sure I still don't believe it," he said.
At Santa Rosa hospital, operated by Health Management Associates Inc. of Naples, most of the 16 labor and delivery nurses say they believe there is a link between barometric pressure and labor. "When we know a hurricane is coming, we know we're going to get busier," said Lisa Daley, who has worked through more than two dozen hurricanes.
By 6 p.m. Sept. 15, Erica Kelly, who had had previous complications with a pregnancy, felt shaking inside her womb, as if the boy, already named Fisher, was trying to burst through her stomach.
"When he plays football, he's going to be called Ivan the Terrible," Kelly's husband, Mike, 35, told her, trying to break the tension. Outside, the winds were getting stronger. The lights were flickering off and on, even though Ivan was several hours from landfall, about 25 miles to the south.
Doctors studying the fetal monitor were becoming convinced Kelly needed a C-section. They also were worried the hospital soon might have to switch to its generator, not the ideal power source for operations. "Let's go have a baby," said Dr. Sue George, Kelly's obstetrician.
Kelly was wheeled into an operating room. Her husband, who helps operate a power plant at a paper mill, also went in, carrying six long flashlights from home, his Plan B in case of a blackout. Inside, he and his wife held hands as he peered over the surgical sheet. Fifteen minutes later, the doctors lifted up Fisher, who let out a healthy scream.
Kelly was taken to a recovery room, Fisher to the nursery. Mike Kelly, now a father of five, paced the halls. He peered through the third floor windows, built to withstand 130-plus mile-an-hour winds. Their panes kept getting pelted by flying gravel. Shining his flashlight into the darkness, he could see trees snapping and debris hurtling across a parking lot.
In early morning, Erica Kelly and Fisher were reunited. With one eye on the nearby window, she sat on her bed, hunching over her baby, nursing him while trying to shield him in case the window broke. She worried that Ivan would send tornadoes spinning directly at the hospital. "Watch over my baby," she kept praying.
In two other rooms, the women reporting contractions turned out to be experiencing false labor, another inconclusive study.
How strong was the drop in pressure? During the height of the storm, around 1:30 a.m., the hospital's front doors were nearly sucked open. Hospital administrator Pete Gandy and two others tied back the doors with a rope. He says perhaps it's the falling pressure that induces labor, perhaps it's all the stress. In any case, he said, "I've been in hospitals enough that I think there's a correlation."
The next day, Mike Kelly's mother, Joyce Schnoor, stopped by to check on the family. "A little hurricane baby," she said, tears streaming down her face as she walked up to the bed.
On the way to the hospital, Schnoor had stopped by her house and a nearby Christmas tree farm she runs with her husband; both were badly damaged. "I don't worry about the house being gone," she said. "I don't worry about the farm being half-gone. Can I hold him?"
Joshua Jones, 5, kisses his newborn sister, Maranda Lynn Bennett, as midwife Lori Nelson cuddles her in a Stuart motel room. Maranda's mother, Mandy Bennett, left, assisted by Nelson, gave birth at the motel. Hurricane Frances made landfall at 7:11 p.m. Sept. 4, six minutes after Bennett's water broke.