Inside The World's Busiest Maternity Ward

Inside the world's busiest maternity ward where women sleep five to a bed and 100 babies are born every day

• 300 mothers arrive at the Dr Jose Fabella Memorial Hospital each day
• The hospital serves a Manila slum named Tondo, built on a rubbish dump
• Mothers share a delivery room with at least five other birthing women 
• Head midwife Anna Prebus has delivered around 200,000 babies
• New babies and their mothers sleep five or more to a bed
• Hospital subject of new BBC documentary World's Busiest Maternity Ward

By Ruth Styles

Published: 15:45 GMT, 30 October 2013 | Updated: 18:20 GMT, 30 October 2013

Rosalyn, already a mother of six children, is waiting to give birth. But she will not enjoy the privacy of her own delivery room, her husband Eduardo by her side.
Instead, Rosalyn will be one of the 300 new mothers crammed into the wards at the Dr Jose Fabella Memorial Hospital in Manila, the capital of the Philippines, which sees, on average, 60 new babies come into the world every single day.
Space at the maternity wing is at a premium, so Rosalyn and her new baby will share with other mothers, usually five to a bed but sometimes more, and she will give birth as part of a group of six when the time comes.

Crammed: The wards at the Dr Jose Fabella Memorial Hospital are packed - with more than five women per bed

Dubbed the 'world's busiest maternity ward', the natal wing at the Dr Jose Fabella Memorial Hospital serves the nearby Tondo slum, a former rubbish dump now home to half a million people.

Here, Rosalyn and her husband Eduardo eke out a living on his daily salary of 380 pesos (£6), augmented by Rosalyn's embroidery work which brings in around 280 pesos (£4) every few days.
'Even if you have no work, you still have to pay the bills,' explains Eduardo. 'I have two jobs for my family's sake.
'I'll do anything to earn more money for my family, odd jobs - even if it's on a Sunday.'
Back at the hospital, Rosalyn is having her final check up with one of the nurses at the Dr Jose Fabella.
Watched by documentary film maker Anita Rani, Rosalyn discusses the blood donors she will need to bring to the birth with a brisk, efficient nurse.

Queued up: Labouring women have to share the delivery suite with at least five other expectant mothers

Documentary: Film maker Anita Rani surrounded by some of the new mothers at the Manila hospital

The Philippines is chronically short of blood which makes bagged blood enormously expensive and out of reach for someone like Rosalyn.
But with a seventh baby on the way, haemorrhage is a real risk so she's arranged for a friend to be at the hospital during the delivery along with Eduardo.
'It would be better to have three donors,' chides the midwife. 'Because here in Fabella, three donors is the equivalent of the amount of blood that would be used for you.
'We prepare for your delivery because we don't know if you will bleed at the time of your delivery. Remember it's your seventh pregnancy.'
Seven children is not unusual in the Philippines. In Tondo, families of 10 or even 12 are common, and as a result, at peak times, midwives at the Dr Jose Fabella can deliver as many as 100 babies within a 24-hour period.
'Sometimes, during high season, 13  to 16 babies are in the delivery room at the same time,' Arlene Matanguihan, a resident doctor, said.
'It's chaotic but an organised chaos. We can still manage – no baby drops out on the floor.'

Privacy: For mothers like Rosalyn, there's no room where they can spend time alone with their newborn

Experienced: Chief midwife Anna Prebus, left, has delivered an estimated 200,000 babies

Chief midwife Anna Prebus has delivered so many babies, she finds it impossible to remember how many she has brought into the world.
'I'm sorry but I can't remember [how many babies I've delivered],' she tells Rani. 'It's so many! Maybe 200,000. I've been here since 1986, almost 28 years.'
One in five of central Manila's mothers come here to deliver their babies, and midwives work day and night.
As a result, conditions in the hospital are grim, with queues of pregnant women waiting in the reception area and hundreds more squeezed into the tiled wards.
Those on the verge of giving birth are packed into a tiny labour room. 'There are five in a bed, sometimes we have more,' notes Prebus, who points to women being wheeled into the delivery room, at the very last minute, in groups of six or more.
But for Rosalyn, giving birth in front of five others is the least of her worries. Although the Dr Jose Fabella is a public hospital, operations have to be paid for.
As a result, she and Eduardo live in fear of complications and a hugely expensive caesarian section.

Uncomfortable: Post partum mothers are crammed into beds while their babies wait in a nearby nursery

Labour: A group of nurses and midwives cluster around a mother giving birth - there's no privacy at all

'I'm worried because it's her [Rosalyn's] due date,' explains Eduardo as he waits nervously by his wife's side.
'I am also concerned with the child, whether it's going to be a normal delivery or by caesarian.
'If she doesn't have a normal birth, we will be in financial trouble. The budget is our number one problem.'
'I will force myself to give birth by normal delivery,' adds Rosalyn. 'I just want a normal delivery. I cannot accept a caesarian section.
'I hope to have a problem-free delivery. That's what I pray for - that we will be OK when I give birth.'
Luckily for Rosalyn, her birth is a smooth one.
'There's no screaming, there's no babies crying, everyone is very controlled and composed,' comments a watching Rani.

Newborns: Documentary maker Anita Rani with two of the babies born at the world's busiest maternity ward

Disgusting: Like many on the maternity ward, Rosalyn lives in Tondo - a teeming slum built on a rubbish dump

'I don't know what that says about Filipino women, something about their psyche... Just like that, another baby is born.'
When Rosalyn's baby boy finally makes his appearance, the new mother is relieved, if apprehensive about his future.
'If the child can finish his studies, I hope he won't be like us where you need to work just to be able to eat,' she says.
'There should be a limit on the amount of children you have. That is why I am teaching them not to follow in my footsteps and have lots of babies.'
Wise words, but for Prebus and her busy team of midwives, the 24-hour round of births continues.