Reducing Elective Deliveries: A Success Story

From the CIMS April e-newsletter: Research has shown that early elective delivery (between 37 and 39 weeks of gestation) without medical or obstetrical indication is associated with neonatal morbidities with no benefit to the mother or infant. Induction of labor doubles the risk for cesarean section in first births thereby exposing mothers to harms associated with a major abdominal surgery.

The Leapfrog Group, a national organization with a focus on improving the safety and quality of healthcare has made a point of publically posting hospital-specific elective delivery rates on its website. A 2010 Leapfrog Group survey of hospitals who chose to report their data, showed that elective delivery rates varied widely with no evidence that higher rates led to better outcomes. For example, in California individual hospital elective delivery rates ranged from 1.2%. to 46.8%.

Leapfrog’s 2011 survey results showed that hospitals have already made progress on reducing early elective newborn deliveries. The Leapfrog Group data showed that 39% of reporting hospitals kept their early elective delivery rate to 5% or less, compared to 30% of reporting hospitals last year.

Since some hospitals were able to keep their elective deliveries before 39 weeks to 5% or less, effectively reducing costs without compromising maternal and newborn outcomes, Leapfrog set its own benchmark in 2011 for elective deliveries to 5%. U.S. Hospitals will need to be at or below this target to earn credit from Leapfrog on this measure. The National Quality Forum also supports fewer elective deliveries.

Hospital-specific elective delivery rates for 2010 and 2011 are available from
http://www.leapfroggroup.org/for_consumers/tooearlydeliveries#State.

The Centers for Medicare and Medicaid Innovation in partnership with medical professional associations, business groups, consumer advocate groups and quality improvement organizations have joined to educate the public, state health departments, and maternity care organizations about how best to improve the health of mothers and newborns by focusing on reducing elective deliveries. The Strong Start for Mothers and Newborn initiative is a rich resource for establishing best practice models and funding opportunities for reducing preterm births.

Citizens for Midwifery has published a fact sheet for families on tips to avoid early elective induction.

Our bi-weekly Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them. From Center for the Childbearing Year.

Posted by Patty Brennan on May 10, 2012 • Filed under Birth & Parenting News
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