Can a hurricane induce labor? Women in the path of Irma are worried

The phone has been ringing off the hook at Memorial Hospital West. Scores of pregnant women are calling — some crying; others panicking — all asking the same question: Can we stay there during Irma?

Many of Florida’s hospitals are built to withstand hurricane winds in order to protect patients. While most don’t act as emergency shelters, some make exceptions for expectant mothers facing high-risk pregnancies. They allow them to inflate mattress inside their walls, provided they bring their own sheets and snacks, in case they enter labor.

The reason is rooted in the idea that low barometric pressure induces labor. The debate has fascinated local reporters for years: Back in 1992 the Sun Sentinel reported that at least 1,500 women were hospitalized during Hurricane Andrew. A handful of studies — including a 2007 retrospective study published in the Archives of Gynecology and Obstetrics — further suggests there’s a connection between low barometric pressure and the likelihood that fetal membranes will rupture.

But some clinicians are frustrated that a demand for shelter exists based on a scientific theory that’s only backed with scant evidence.

“Hurricanes don’t cause premature labor,” said registered nurse Mary Roberts, director of the Family Birthplace at Memorial Hospital West in Pembroke Pines, Fla., just outside Miami. “It’s like saying, ‘Oh my god, a full moon! We’re going to have a lot of babies.’ Theorists out there feel there’s a correlation. Do we change our practice because a storm comes by? No.”

Dr. Jonathan Schaffir, associate professor of obstetrics and gynecology at Ohio State University, believes there’s a lot of “folklore” surrounding patterns in nature that may induce labor. In this case, he says the idea of a woman’s water breaking is often compared to a balloon that pops when the air pressure is too low. But he doesn’t buy the theory, because it fails to make sense from a physiological perspective.

“I’m not sure I’d actually believe that,” he told STAT. “Unlike a balloon that’s exposed to the air, the amniotic sac is protected inside a uterus that is not as prone to changes from environmental pressure.”

Even still, some hospitals standing in Irma’s path — including ones in Fort Myers, Miami, and Pembroke Pines — will open their doors to women facing high-risk pregnancies. Each hospital system has slightly different rules for sheltering expectant mothers. But since most require women to be pre-registered to eventually give birth there, clinicians say it’s an easy decision to extend such services to make their patients feel safe, even if medical care is unlikely to be required.

A service, but not a hurricane shelter

Six hours before Hurricane Irma makes landfall — an event projected to occur sometime Sunday morning — officials at Jackson Health plan to let expectant mothers seek shelter at three of its hospitals so long as they meet one of the following criteria: they are carrying more than one baby and are at least 34 weeks into their pregnancy, enduring placental implantation abnormalities at least 28 weeks into pregnancy, or experiencing preterm labor. The offer of shelter comes even though one longtime obstetrician affiliated with Jackson has claimed in past interviews that he’s never seen a connection between atmospheric pressure and women going into labor in his more than two decades of practice. (A Jackson spokesperson declined to make him available for comment.)

Memorial Healthcare System spokesperson Lourdes Rodriguez-Barrera says three of its hospitals will also let pregnant women shelter in the lobby starting Saturday afternoon if they are within two weeks of their due date or are deemed “high risk.” Roberts notes that “almost everyone thinks their pregnancy is high risk” but the hospital has a specific definition that includes expectant mothers who are older than 35 years, are morbidly obese, or who expect twins or triplets.

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These offers of shelter are inevitably draining hospital resources. Roberts, for her part, is now tracking 200 pregnant women who want to come to her hospital. She has 20 beds in her neonatal unit.

“Unfortunately the media makes it utterly chaotic — newscasters this morning said, ‘If you are pregnant, get to the hospital,” Roberts said. “Because of the fear produced, patients [have the wrong] expectations. They come in wanting a bed, wanting a private room. We offer them space in the lobby.”

Roberts says the “community service” that Memorial Hospital West is offering should not be mistaken as a form of medical treatment, but seen as a way to offer future patients peace of mind. But as a letter posted in the hospital reminds everyone else: “We are not a hurricane shelter.”