Tied up with a red ribbon, the 400 notes given out to various state representatives last week at the Tiffany Diner looked harmless enough. But the ribbons were a fancy dressing to a large problem – there is no place to go within the limits of Northeast Philadelphia, to have a baby."We have 5,000 births (per year) up here," said Letty D. Thall, the public policy director of the Maternity Care Coalition (MCC). "Where are they supposed to have babies?

Reacting to a suggestion by Matt Taubenberger, a legislative assistant to State Rep. George Kenney (R-170), the local chapter of MCC decided to have a small meeting with elected officials, to further open the doors of discussion regarding what many are considering a crisis.

"It is a crisis, and very often the people who are going through this crisis are not people with loud voices," said Sue Rosenthal, the chairwoman of the community board at the MCC District 10 Health Center. "They are people of the middle class or on Medicaid. Because they are young and don't have time to spare, we don't hear from them. They need to have voices for them."

Since 1980, the MCC has been that voice, acting as an advocate for safe maternity care in high risk areas throughout Southeastern Pennsylvania. Through their own programs, they estimate to have helped over 60,000 expectant mothers. Recognizing that the lack of maternity options puts Northeast Philadelphia at risk, the organization held a town hall meeting this past November to shed more light onto the issue. Last week's meeting was an offshoot of that town hall meeting.

"I thought that we needed a small environment, to talk about the changes that are needed," Matt Taubenberger said. "We all live here in Northeast Philadelphia. We deal with the inconveniences of living in the city, but we also want the conveniences. Now we have a situation that if you are going to give birth, you have to leave the city. I think that we can do better."

According to the MCC's web site, approximately 50,000 babies are born within the five county area surrounding Philadelphia. That figure has remained fairly constant in the past ten years, while 13 local hospitals have ceased to provide maternity care. Last year, both Frankford and Jeanes Hospitals followed suit. Obstetricians are also leaving the state. The reasoning for both occurrences has been the rising cost of running a maternity unit.

"We need to get higher reimbursements for obstetrics and neonatal care," said State Senator Mike Stack (D-5). "That's why they've close the units. If we raise that rate, it might be more feasible. In Northeast Philadelphia we are doing well on health care, but with neonatal and obstetrics, we're doing lousy."

"The hospitals lose money in delivering babies, so we have to find a solution that is fair and equitable," said State Rep. John Sabatina (D– 174). "We have to resolve this problem."

Currently, the only places within the city limits to have a baby are Northeastern Hospital, Temple University Hospital and Einstein Hospital. Many residents have opted to travel to the suburbs, to Abington or Holy Redeemer Hospitals in Montgomery County, or St. Mary's Hospital in Langhorne. But often, going to those institutions can cause other problems.

"My son was born at Jeanes Hospital, but I have a granddaughter that had to be born at St. Mary's, because Jeanes closed," said Oxford Circle resident Marlyn Bradshaw, herself a nurse. "There has to be options – something closer."

"(The hospitals) don't accept all health insurance policies," Thall added. "And if you call 911, there is some question over whether of not they will cross county lines."

One option that was discussed at length last week was the opening of a birthing center in the area. It was an option endorsed by Stack.

"If we can combine that (with hospital support) it's going to be a better situation," he said. "Eighty percent of babies are born without complications. Nurse Mid-wives, this is what they do."

Former mayoral candidate and president of the Greater Northeast Philadelphia Chamber of Commerce Al Taubenberger was on hand to lend support. His son, Matt, was also born at Jeanes Hospital.

"I want to chat with all three of the major hospitals in the area (Frankford, Nazareth and Jeanes)," Taubenberger said. "It makes sense to have an opportunity to have a baby close to home. That's why cities exist, for convenience. This has to be resolved."

While local hospitals are catering to the significant senior population in the Northeast, Taubenberger contended that more young people are moving into the area. That means a potential for more babies being born. Thall was particularly upset that, after closing their maternity facilities, Frankford Hospital opened a new cardiac unit.

"How did they get the money from private insurers, when there wasn't enough money to deliver babies?" she asked. "How come my insurance company is paying more for my heart than for my babies?"

One of those younger people at the meeting was Brendan Boyle. An aide to Stack, Boyle will once again run for the 170th legislative seat, probably against Matt Taubenberger.

"If we want to attract younger families to put down roots for the next 30-40 years, we need more birthing centers, and the ability to give birth right here in the Northeast," Boyle said. "We need to increase and improve the incentive for them to reopen birthing centers; it will help with this problem."

"It is a complex crisis," Thall conceded. "There's not one simple fix. That's why we're asking our elected officials to help, to take a look at making insurance more public, to pass a bill to help hospitals and support midwives. Everybody has to be involved."