Obstetrics

The growing shortage of physicians performing abortions in the United States prompted a group of doctors and public-health experts Tuesday to call for an overhaul of doctor-training programs and a nationwide push for physicians to include abortion in their practices.

Lynda had tried to become pregnant for almost a year. But, discouraged by months of infertility, she was not taking the best care of herself. She had a few drinks at a party. She used a hot tub. She took antihistamines for a cold. Ordinarily, none of these things would be considered unhealthy. But they happened in the first few weeks of Lynda's pregnancy--before she realized she was pregnant.

The severe overcrowding that struck UCI Medical Center's maternity ward two years ago has vanished, and now the teaching hospital is pleading for patients to fulfill its obligation to obstetric students. In June, 1990, the medical center sent shock waves through Orange County when it placed security guards in its parking lot to tell low-income women in labor that it might be better for them to go elsewhere to have their babies because of the overcrowding.

When Dr. Martha Heppard's labor contractions began four months before her twins were due, her choices were two: to be hospitalized for a long time or to be monitored at home. For more than 13 weeks, Heppard stayed at home in bed with a pocket-size monitor strapped around her waist to detect any activity and an automatic syringe about the size of a credit card strapped to her thigh. The device pumped a programmed dose of medication to control early labor contractions.

When Patti was pregnant four years ago, her obstetrician recommended that she have a fetal ultrasound at a nearby radiological center in Newport Beach. This year, when Patti was expecting her second child and needed another ultrasound, the obstetrician offered the test in his office. To Patti, the second test was more comfortable and convenient. But, according to some health experts, the practice raises uncomfortable questions: * Are tests offered in a doctor's office substandard in quality?

A Santa Ana obstetrician accused of botching seven cases, including one in which a child suffered severe brain damage and another in which an infant died, should be disciplined for gross incompetence and plotting to hide her mistakes, a state attorney argued Monday. "There is virtually no known area of competence for this physician," Deputy Atty. Gen. M. Gayle Askren said of Dr. Farhat Khan at the opening of the doctor's state disciplinary hearing.

Hospital administrator Timothy Carda pointed to brightly colored architectural plans for a new obstetrics wing. "It's not the Ritz-Carlton. It's more like the Holiday Inn," admitted Carda, executive director of Western Medical Center-Anaheim. Still, when 14 homey, simply furnished labor-delivery-recovery rooms open in early 1992, it will be a major step for the hospital--and for Orange County.

Six-and-a-half weeks before she was due to deliver her first baby, Lynn Dasteel felt that something was very wrong. By the time she reached the hospital, she was 90% along into delivery, and she had not felt a single contraction. Her newborn had to spend a month in intensive care. Today, Alex Dasteel is 4 1/2 years old and healthy, but because he was born so early, his chances of severe mental retardation were great. Now Dasteel is pregnant with a second child.

For three months, Lynne Randall has been searching for a full-time staff physician for the Atlanta abortion clinic she runs. Randall tried to advertise, she said, but only one OB-GYN publication would accept any notice with the word abortion in it. Medical recruiters turned her down cold. She has also contacted at least 20 doctors. Some said they could earn far more money and prestige in private practice.