My View • Hospitals' agreement to stop some birth inductions saves lives, money
Every week of pregnancy is crucial to a newborn's health, and beginning Sept. 1 every birthing hospital in the Portland area will have a policy in place to help babies get the most from their time in the womb.
On the heels of the March of Dimes campaign, 'Healthy Babies Are Worth the Wait,' 17 Oregon hospitals have come together to agree to place a 'hard stop' on all elective non-medically necessary C-sections and inductions before 39 weeks (Local hospitals agree: Babies come first, Aug. 5).
This policy is in sharp contrast to an increasing trend of inducing labor electively prior to 39 weeks. The number of babies being delivered between 37 and 38 weeks gestation has increased in the past decade and accounts for 17.5 percent of live U.S. births, while births at 40 weeks have markedly declined.
However, we are becoming increasingly aware that if a pregnancy is healthy, it's best for the baby to have 39 to 40 weeks in the womb. New research has shown that a baby's brain nearly doubles in weight in the last few weeks of pregnancy. Also, important lung, liver and other organ development occur at this time.
Although the overall risk of death is small, it is double for infants born at 37 weeks of pregnancy, when compared to babies born at 40 weeks, for all races and ethnicities.
Not only is getting 39 to 40 weeks in the womb in a healthy pregnancy better for the health of babies, but it also has the potential to lower medical costs. It is suggested that if all the birthing hospitals in the United States were to place a 'hard stop' on elective, non-medically necessary deliveries prior to 39 weeks gestation, we'd see half a million less neonatal intensive care unit days for newborns annually, with potential savings approaching $1 billion a year.
Moreover, this would spare families the emotional toll of watching their newborn baby spend his or her first days or weeks in a NICU.
There are medically necessary reasons some deliveries need to be performed prior to 39 weeks gestation. For example, if it is determined that the health of the mother or baby is in jeopardy for various medical reasons. This is why is important to accurately date a pregnancy. When women first see their prenatal care provider during pregnancy, often the first discussion is around the question of 'when is my due date?'
It is important to remember that this is an estimate. It can be a two-week range. Providers and families may believe they are scheduling a delivery for an early-term baby at 37 weeks when in fact dating was not accurate and what you actually have is a late-preterm infant who is at increased risk of needing NICU care.
With 17 of the 53 birthing hospitals in Oregon agreeing that healthy babies are worth the wait, we're giving 49.4 percent of babies born in this state a stronger, healthier start. We applaud these hospitals for coming together in such a dramatic fashion on this issue and adopting a 'hard stop' policy on elective deliveries before 39 weeks. It is not the easiest policy for them and will cause some disruption in their units. They have chosen this policy because it is best for their mothers and babies.
We're not stopping there. March of Dimes, in conjunction with the Oregon Health Leadership Council, is issuing a community challenge asking all the other birthing hospitals in Oregon to follow suit by implementing a 'hard stop' on elective early term inductions and C-sections.
It's what's best for babies.
The goal of this effort is to support hospitals and providers to achieve the American Congress of Obstetricians and Gynecologists' recommendations not to perform elective deliveries prior to 39 weeks. March of Dimes will provide each hospital agreeing to a 'hard stop' patient information and education materials about why the last weeks of pregnancy are so important.
For more information about the March of Dimes 'Healthy Babies Are Worth the Wait' educational campaign, visit the website, www.marchofdimes.com/39weeks. For free access to national, state, county and city-level maternal and infant health data, visit the website PeriStats, www.marchofdimes.com/PeriStats .
Joanne Rogovoy is state director of program services and public affairs for the March of Dimes Greater Oregon.