Last July, the North Colorado Medical Center in Greeley and McKee Medical Center in Loveland joined a growing list of Colorado hospitals that no longer support elective deliveries of babies before 39 weeks of pregnancy unless there is a medical reason to do so.
This is a positive step that is informed by a growing body of medical research showing the dangers associated with elective deliveries before 39 weeks gestation. While the potential complications are very real, many first-time mothers may be unaware of the risks.
A report issued in January by The Leap Frog Group revealed tremendous variation among hospitals when it comes to early elective Caesarean Sections and elective inductions, with some facilities performing those procedures 10 times more frequently than others. The practices of 773 hospitals nationwide were examined, including those in Colorado. The full report is available at .
Babies born before 39 weeks are more likely to have breathing problems and developmental delays, according to numerous published studies. A review of claims data by UnitedHealthcare showed that 48 percent of newborns admitted to the neonatal intensive care unit (NICU) at select hospitals were from scheduled admissions for delivery – many before 39 weeks of gestation. After sharing these findings, physicians and hospitals in the program altered practice patterns and realized a 46-percent decrease in NICU admissions in the first three months – a decline that has held stable.
Yet a majority of first-time mothers are unaware of the risks associated with early deliveries. According to a national survey released last year, more than 90 percent of first-time mothers believe it’s safe to deliver a baby before 37 weeks of gestation.
In addition, nearly one in four respondents considered a baby to be full-term at 34 to 36 weeks, even though American College of Obstetricians and Gynecologists (ACOG) defines full-term as 37 weeks and advises against elective deliveries before 39 weeks.
The purpose of the survey, commissioned by UnitedHealthcare, was to gauge women’s understanding of full-term pregnancy and the gestational age at which it’s safe to deliver a healthy baby. The survey queried 650 insured, first-time mothers from varied geographic, ethnic and socioeconomic backgrounds.
The study findings underscore how important education is to improve health and well-being. Other studies have already shown that efforts to educate physicians make a positive impact in helping to reduce the rate of elective pre-term deliveries. We should also consider similar outreach among women to help stem the rise in such deliveries.
The reason for concern is simple: As the number of pre-term and early-term births has increased, there also have been increases in health risks for early-term infants, some of whom require extended hospital stays. Parents suffer as well, missing out on important bonding time with their newborns, and some even experience depression.
The decision to induce labor early or perform a C-section before a pregnancy is full-term should take clinical recommendations into account and reflect the baby’s and mother’s health and medical needs, not convenience. To be sure, the last few weeks of pregnancy for many mothers can seem endless and often uncomfortable. But expectant parents should take the opportunity to learn just how important the last few remaining weeks are for their baby’s development and health.
More information about how to have a healthy pregnancy is available at .
Dr. Christopher Stanley is senior medical director for UnitedHealthcare of Colorado. EDITOR’S NOTE: This is an online-only column and has not been edited.
