Does the Philadelphia area have a critical shortage of hospitals that deliver babies?

A new task force made up of hospital representatives, obstetricians, maternity care advocates, and public health officials says the answer is an unqualified yes.

"We are on the verge of a crisis," Carmen I. Paris, the city's interim health commissioner, declared yesterday at a news conference held by a new obstetric services task force.

But that new coalition is seeking help from someone who isn't sure there's a shortage: Governor Rendell. The governor's policy secretary recently met with task force members and studied the issue, concluding earlier this month that there are problems, but that "we do not see a crisis."

Since 1997, 13 Philadelphia area hospitals have stopped delivering babies, including two in the last year.

The task force says 11 remaining facilities in the city and lower Montgomery County are struggling to pick up the slack. But the governor's office, looking more broadly at the five-county Philadelphia region, says supply meets demand.

Among other differing views:

The task force says the average obstetric occupancy rate at the 11 hospitals now exceeds the industry recommendation of 75 percent, with a few obstetric units averaging more than 100 percent occupancy in 2004. This year, 302 beds are available - 15 less than the projected need. In contrast, the governor's office said that although the number of maternity beds in the five counties fell 5.6 percent from 2001 to 2006, demand for beds across all the hospitals "does not exceed capacity."

The task force points out that a large fraction of Philadelphia births - more than 12 percent in 2005 - are low birth weight or premature and require intensive care, but that a recent increase in state square-footage requirements make expansion difficult. The governor's office said it would "explore" this issue, although neonatal intensive-care beds increased in 2006.

The task force says births are expected to remain fairly constant, so it will study whether the closures have affected maternal and infant health. The governor's office agrees that the number of births is stable, but it has declined "sharply" in the last 15 years - from 30,000 in 1990 to about 22,000 in 2005.

The task force says the closures have created hardships for many pregnant women because they have to travel farther. The governor's office did not address this issue, but concluded that declining numbers of practicing obstetricians may make it tough for health-care systems to find enough doctors to deliver babies.

Both sides agree that rising malpractice insurance costs and shrinking reimbursement rates pose problems.

Carmen I. Paris, the acting Philadelphia health commissioner, said at yesterday's news conference that the task force will work with the governor's office and the state health department to find solutions.