Most obstetricians agree that babies should not be delivered early, before 39 weeks, unless the health of the mother or her child is at risk. Research shows important brain, lung and vital organ development occurs late in pregnancy. So hospitals across Massachusetts have been working to reduce so-called “early elective deliveries.”Over the last three years, most hospitals have either stopped scheduling early deliveries, or set a goal of less than 5 percent. Last year, the state’s rate dropped, on average, to 1 percent, the lowest in the country. There is still variation from one hospital to the next. But the numbers, compiled by Leapfrog, a business group that advocates for improved hospital quality and safety, show the significant progress hospitals made in just one year.
The state’s low rate “should decrease some of the complications that newborns may experience from being born electively,” including, “admissions to the intensive care unit and long-term complications,” said Dr. Glenn Markenson, an obstetrician at Bay State Medical Center.
Markenson chaired a statewide effort to tackle the problem through the Massachusetts Perinatal Quality Collaborative. He says the success of this campaign will help hospitals develop statewide strategies to improve quality in other areas.
Some mothers are frustrated by the restriction on deliveries, especially if it means that they can’t give birth with the assistance of their regular obstetrician. But many doctors say they are more routinely preparing pregnant women for this possibility and making sure that mothers connect with any colleagues who may be covering the delivery ward when it’s time for these women to give birth.
Leapfrog says hospitals in all states are making dramatic progress to curb early elective deliveries. Last year, for the first time, the national average dipped below 5 percent.
(For more on comparing a range of important quality measures in childbirth, see Martha’s excellent investigation here.)