Many hospitals have succeeded in reducing the number of babies who are delivered early without a medical reason, according to a report from the Leapfrog Group, a nonprofit watchdog organization that collects quality and safety data from hospitals on behalf of employers. In 2010 only 30 percent of hospitals that report data to Leapfrog maintained an early elective delivery rate of 5 percent or less, which experts feel is a reasonable target for hospitals. That figure improved to 39 percent of reporting hospitals in 2011.
The report notes that there is still a lot of room for improvement. Further reducing the number of elective early births could potentially save the healthcare system nearly a billion dollars, and more importantly, prevent unnecessary harm to newborns.
Unborn babies need at least 39 weeks in the womb to fully develop. Early birth can contribute to breathing problems, temperature instability, jaundice, infection, longer-hospital stays, and a higher risk of death. There is occasionally a clear medical reason to schedule a delivery before 39 weeks—if the pregnant mother has high blood pressure or if there are broken membranes before labor begins, for example—but it is relatively rare.
“Of the hospitals that reported an elective delivery rate in 2010 and 2011, 65 percent improved their performance,” said Leah Binder, Leapfrog's chief executive officer, in a statement. “But there is still work to be done. We are seeing far too many newborns delivered early and without a medical reason.”
At some hospitals, scheduling early elective births is anything but rare. The Leapfrog Group's report notes wide variation among the 757 hospitals that report data. Some of those hospitals reported that over 40 percent of their deliveries were done early without a medical indication. And there is no information on the hospitals that don't voluntarily report their data to Leapfrog. “Next we need all hospitals to make the data available to the public,” said Maureen Corry, executive director of the maternity care advocacy group Childbirth Connection, in a statement.
Experts note that there are financial incentives for hospitals and doctors to intervene in childbirths, rather than let the pregnancy proceed on its own course. Some obstetricians may simply prefer to control the scheduling, so labor doesn't occur when they are unable to deliver the child. That’s why choosing a provider is so important, Corry says. Family physicians generally have lower rates of scheduling early deliveries than obstetricians, she says. And midwives generally have the lowest rates. But there are always exceptions, so talk to your provider.
Some women may schedule their births for their own convenience without realizing it increases risks for their child. That's why, Corry says, “it's critical for women to be informed, know their rights, and protect themselves and their babies.” To look for your hospital's rate, see the Leapfrog Group's report.
For more on maternity, see: “Back to basics for safer childbirth,” and “10 over-the-counter drugs to avoid during pregnancy.”