Baby Steps: Hospitals Reducing Early Elective Births. Slowly.

This is a corrected version of a blog that was published on January 25, 2012.

“Keep ‘em cooking.”

That’s what doctor organizations, advocates and hospital watchdog groups say about babies delivered before between 37 and 39 weeks gestation.

With urging from the March of DimesAmerican College of Obstetricians and Gynecologists, the Leapfrog Group and others, hospitals from Massachusetts to Kansas have been reducing the number of early elective deliveries -- labor inductions and cesarean sections performed before 39 weeks without a medical reason.

Releasing its 2011 hospital survey data on Tuesday, the Leapfrog Group reported that elective delivery rates are down across the country. For this survey, 757 hospitals nationwide voluntarily reported their rates. In 2010, an average of 17 percent of the births between 37 and 39 weeks were elective inductions or c-sections. In 2011, the average dropped to 14 percent. The findings excluded inductions and c-sections done for medical reasons. 

California hospitals rank among the most successful in the country, a list that includes hospitals from Colorado, Massachusetts and Ohio. Still, in California, the range is wide. Hoag Memorial Hospital Presbyterian in Newport Beach, for example, clocked in at just 0.1 percent in 2011, while other hospitals, such as Clovis Community Medical Center, reported that 36 percent of all their hospital births last year were early elective deliveries.

In Leapfrog’s opinion, no hospital should have an early elective delivery rate over 5 percent.

Babies born at 37 and 38 weeks are at greater risk for serious health problems compared to babies born at 39 and 40 weeks. They have a higher chance of being admitted into neonatal intensive care units, they have more difficulty breathing and they have a higher chance of bloodstream infections. There is also an increased risk of death for babies born at 37 weeks compared with those born at 40 weeks.

“Induction of labor or cesarean section before 39 completed weeks poses serious risks for babies and women,” said Maureen Corry, executive director of Childbirth Connection. “It’s also important for women to understand the benefits and harms of induction of labor.” (See Childbirth Connection’s Induction of Labor: What you need to know.)

Leapfrog CEO Leah Binder says it’s crucial for pregnant women to ask their caregivers and hospitals for data. She also hopes that more hospitals will report their rates in the future.

Due to inaccurate information provided by Leapfrog Group, the story originally said that on average, hospitals reported that in 2010, 17% of all their deliveries were early elective ones and in 2011, 14% of all deliveries were early elective deliveries. In fact, hospital rates are early elective deliveries as a percentage of early deliveries, excluding those that were performed for medical reasons. 

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Lauren M. Whaley

Freelance journalist Lauren M. Whaley is a photographer, radio producer and print reporter specializing in topics related to mental illness, reproductive health care and health disparities. She is also a childbirth photographer.This year, She is working on a series about how low-income parents access care for perinatal mental illnesses. The project is funded in part by the Rosalynn Carter Fellowships for Mental Health Journalism.She was a 2016-17 Knight Science Journalism Fellow at the Massachusetts Institute for Technology.Her work has been recognized by the Association of Health Care Journalists, the Scripps Howard Foundation and the Public Radio Exchange (PRX) STEM story project. She has contributed radio, video, photography and written stories to KQED Public Radio, Southern California Public Radio, the San Jose Mercury News, the New York Times and other media outlets. For six years, she worked as the Center for Health Reporting's multimedia journalist. She is a past president of the national organizationJournalism and Women Symposium (JAWS) and spent her early 20s leading canoe expeditions for young women, including a solo-led 45-trip in the Canadian Arctic. She is based in Los Angeles.

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