MANILA — In the main ward at Dr. Jose Fabella Memorial Hospital, 171 women and nearly as many newborns share fewer than 100 beds. Dozens more expectant mothers line the street outside, some sleeping on the sidewalk while waiting to get in.

The women, most of whom cannot afford to give birth at a private hospital, move through a type of controlled chaos from the street, to the labor room, to the delivery room, to the maternity ward and back out the door, usually in less than 48 hours.

“It’s a never-ending story, 24 hours a day, every day,” said Dr. Romeo Bituin, who added that the government-run maternity hospital was legally required to serve as a safety net for the poor. “We can’t reject patients. If we turn them away, where will they go?”

After years of discussion in the Philippine Congress, the House of Representatives finally decided in August to end debate on a reproductive health bill that would subsidize contraception and require sex education in the Philippines, a country with one of the highest birthrates in Asia. If it passes in the House, which returned to session on Monday, the bill will also need to be approved by the Senate.