Trying to Ease a Baby Boom in the Philippines Jes Aznar for The International Herald Tribune Jose Fabella Memorial Hospital in Manila delivers more babies than any other facility in the Philippines. MANILA - In the main ward at Dr. Jose Fabella Memorial Hospital, 171 women and nearly as many newborn babies share fewer than 100 beds. Dozens more line the street outside, some sleeping on the sidewalk, waiting to get in to deliver their babies. Expectant mothers, most of whom cannot afford to give birth at a private hospital, move through a type of controlled chaos from the street, to the labor room, to the delivery room, to the maternity ward and back out the door, usually in less than 48 hours. "It's a never-ending story, 24 hours a day, every day," said Dr. Romeo Bituin, a physician, who added that the government-run maternity hospital was legally required to serve as a safety net for very poor pregnant women. We can't reject patients. If we turn them away, where will they go? The Philippine Congress is considering a reproductive health bill that could have a major impact on the busy Fabella hospital. The bill would subsidize contraception and require sex education in schools. Doctors at the hospital said this would result in fewer impoverished women crowding the wards. The bill is the culmination of more than a decade of effort by proponents of birth control in the Philippines, a country with one of the highest birthrates in Asia. After years of being stalled in often rancorous discussion in Congress, the bill took a step toward passage in August when the House of Representatives finally decided to end debate, a key step toward moving the measure closer to a vote. Even if it does pass in the House, which returned to session on Monday, it would also need to be approved by the Senate, an uncertain proposition. Proponents, led by President Benigno S. Aquino III, who has made the issue a priority of his two-year-old administration, say the measure will give poor women a chance to have fewer children and rise out of poverty. Opponents, backed principally by the Roman Catholic Church, say the bill is out of step with the moral tenets of the overwhelmingly Catholic Philippines and argue that a high birthrate lessens poverty. "Our country's positive birthrate and a population composed of mostly young people are the main players that fuel the economy," said Jose S. Palma, the president of the Catholic Bishops" Conference of the Philippines. Whether it is a bane or a boon, the birthrate in the Philippines - 24.8 out of 1,000 people, compared with 13.7 in the United States - is not a matter of statistics at Fabella hospital. It is a matter of logistics. The hospital, located in a former prison building between a public market and the Manila city jail, delivers more babies than any other facility in the Philippines. Last year, 17,639 babies were born there, down from nearly 25,000 in 2006. The women are allowed into the hospital only when they are ready to give birth. After they have had their babies, they sleep two to a bed in the maternity ward. If they had a healthy delivery without complications, they are sent home after one day. "We cannot admit them if they are not in labor," said Dr. Marie Pacapac, a spokeswoman for the hospital. We don't have the capacity to let them come in early or stay long after delivery. Our delivery room fills up. In 2004, the hospital hit a peak, delivering 120 babies in a 24-hour period, or an average of one baby every 12 minutes. It currently averages about 60 deliveries a day in the summer and about 80 deliveries in a 24-hour period during the peak delivery season, September to December. "These are the babies made last December, during the cold months, the months of love," said Dr. Pacapac with a smile as she walked through the bustling ward. The hospital, which serves the poorest of the poor and accepts pregnant women that other facilities reject for various reasons, charges 3,000 pesos, about $60, for a normal delivery. Women who cannot afford that pay whatever they can. Some babies have been delivered for 100 pesos, or $2.50, while some expectant mothers show up at the hospital without a single peso, hospital officials said. Most of the women who deliver at Fabella have never had any sexual or reproductive health education - which is rarely taught in Philippine schools - and many cannot afford to buy contraception and are unaware of their options, said Dr. Bituin, who noted that these issues would be addressed by the pending legislation.