High Rates of Early Elective Delivery at Some U.S.
WEDNESDAY, Jan. 26 (HealthDay News) -- Five to 40 percent or
more of births in the United States are induced early without any
good medical reason, according to a new hospital-by-hospital
And there is tremendous variation in the rates documented by
hospitals voluntarily reporting these "early elective induction"
deliveries, even within the same community. In Los Angeles, for
instance, the rates of babies delivered early without a good
medical reason ranged from 4 percent to 29 percent. In Boston, the
rates reported by different hospitals ranged from near zero to 27
"This is the first real evidence that the practice of scheduling newborn deliveries without medical reasons is common and varies among hospitals," said Leah Binder, CEO of the Leapfrog Group, an employer-driven hospital quality watchdog group. Leapfrog announced the findings of its annual hospital report at a Wednesday news conference.
"The information is extremely disturbing," she continued. "We are calling on hospitals to put policies in place to prevent early elective deliveries."
According to Binder, "elective inductions have now outpaced
The consequences of such deliveries can be grave. "The last few
weeks of a pregnancy are critical to the development of the baby's
brain, lung and liver," said Dr. Alan Fleishman, senior vice
president and medical director of the March of Dimes Foundation.
"Babies born just a few weeks early have feeding problems,
jaundice, inability to hold temperature and tremendous increased
costs. Every week counts."
Babies delivered early also face a higher risk of death,
spending time in a neonatal intensive care unit and life-long
health problems, according to a statement from the Leapfrog
Plus, using gestational dating to figure out a delivery time can
be "grossly inadequate" unless a woman has an ultrasound exam in
the first trimester, Fleishman pointed out. If the dating is off by
even two weeks, the baby could end up being premature (born before
37 weeks), he said.
Leapfrog's target goal for 2010 was 12 percent, but it is now
lowering that threshold to 5 percent, said Barbara Rudolph, senior
science director of the Leapfrog Group.
The good news is that about 50 percent of hospitals reported
early elective delivery rates of 12 percent or below. The bad news
is that an equal half reported rates higher than that figure.
But more good news is that 29 percent of hospitals reported
rates of 5 percent or less, indicating that such low rates are
achievable, said Rudolph.
Why are so many early elective deliveries occurring?
According to Maureen Corry, Childbirth Connection's executive
director, a recent survey found that the leading reason (accounting
for about 25 percent of early births) was caregiver concern that
the mother was overdue. About 19 percent were medical inductions,
another 19 percent were due to the mother's desire "to get the
pregnancy over with," and the final one (17 percent) came from
concern about the size of the baby. According to Fleischman, large
babies aren't a valid reason for early delivery.
And 75 percent of mothers actually think that 34 to 36 weeks is
full-term (although it is really 39 to 40 weeks), Fleischman added.
Providers' desire for convenience and predictable schedules could
also play a role.
"We encourage women to wait until they've completed the 39th week of pregnancy [to deliver] unless it's medically called for," Binder said. "Every woman in America needs to know [information on a hospital's early elective delivery rate] before she enters the door of a hospital."
Leapfrog has national hospital-by-hospital data on
early elective deliveries.
Copyright © 2011
. All rights reserved.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.