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November 23rd, 2008
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Planning for babies and other life essentials


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July 16th, 2008 issue

A recent cover story in The New York Times Magazine devoted considerable space to the declining birth rate in Europe, noting that Laviano, a town in southern Italy, offers a “baby bonus” of 10,000 euros to expectant mothers, and predicting extinction for low-birthrate countries such as Greece and Spain.

The Czech Republic also falls below what is considered the “replacement rate” for a society to survive, of 2.1 children per family. According to European Union figures, this country averages 1.2 children per family.
Obviously no one told this to the pregnant women scrambling to find space in the city’s overcrowded maternity wards. Anecdotally, it’s clear there’s a baby boom under way here, with strollers and prams increasingly filling restaurants, trams and the city streets. And, from a medical planning standpoint, there’s no question about the need for more space to accommodate mothers-to-be who have to make reservations nine months in advance — and then are lucky to get a hospital bed.
Government planners can neither predict nor accommodate every demographic bump and bulge with perfect accuracy. (And, in this case, the bump is almost certainly temporary, precluding long-term changes in the system.) But they have to try. There are great societal changes under way throughout the world, and ignoring them will only lead to much more serious, even tragic results.
Many countries, for example, face a major challenge in keeping alive a social security system becoming lopsided with a growing number of retirees and fewer young people paying into it. The surge in oil prices is only the leading indicator of an enormous, increasing strain on natural resources, with food shortages coming up quickly and water expected to be close behind.
There’s a general consensus that the food shortage is man-made, the product of misguided and conflicting quotas, incentives, tariffs and the diversion of crops into biofuels. Similarly, while there’s no quick or easy solution to the growing demand for oil, there are many possibilities for developing alternative energy sources and decreasing consumption. What’s required is foresight and political will.
In that context, Prague’s baby boomlet seems a small problem. But it’s a major issue in the lives of young families, and hardly insoluble. Expanding maternity wards, as Thomayer’s Hospital is currently doing, or creating new ones should offer some temporary and much-needed relief. In a country that prides itself on how it provides for and raises its young, this shouldn’t need much discussion.
But it’s also an indicator of what health planners are thinking — or more accurately, not thinking. To them, we offer a simple and brief bit of advice: foresight and political will.


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