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VNA of Care New England

Hospitals Work to Reduce Unnecessary Early Births

Full-term deliveries give infants best chance to develop and thrive, experts say
TUESDAY, April 9, 2013 (HealthDay News) -- Early elective deliveries of babies were significantly reduced at hospitals that implemented quality-improvement programs, according to a new study.
These types of deliveries -- which include cesarean section and induction of labor without a medical reason -- fell 83 percent (from 27.8 percent to 4.8 percent) in the 25 hospitals that took part in the year-long study.
The hospitals were located in California, Florida, Illinois, New York and Texas. Together, these five states account for about 38 percent of all births in the United States.
The results are good news because babies delivered before full term are at increased risk for serious health problems and death in their first year, according to the March of Dimes, which partially funded the study.
"This quality-improvement program demonstrates that we can create a change in medical culture to prevent unneeded early deliveries and give many more babies a healthy start in life," study lead author Dr. Bryan Oshiro, of the Loma Linda University School of Medicine, in Loma Linda, Calif., said in a March of Dimes news release.
Dr. Edward McCabe, medical director of the March of Dimes, agreed.
"Reducing unnecessary early deliveries to less than 5 percent in these hospitals means more babies stayed in the womb longer, which is so important for their growth and development," he said in the news release.
"This project saw a decrease in the proportion of babies born at 37 and 38 weeks (early-term birth) and a corresponding increase in the 39-to-41-week range (full-term birth) during the one-year period studied," McCabe said. "Additional studies, perhaps over a longer period of time, could clarify whether such quality-improvement programs can also bring down a hospital's overall preterm birth rate."
The quality-improvement efforts implemented at the hospitals used a toolkit designed to guide changes in early-term delivery practices. The toolkit was developed by the March of Dimes; the California Maternal Quality Care Collaborative; and the California Maternal, Child and Adolescent Health Program at the California Department of Public Health.
The study was published online April 8 in the journal Obstetrics & Gynecology.
Hospitals, health care providers and patients should follow the American College of Obstetricians and Gynecologists recommendation that if a pregnancy is healthy, it is best to wait for labor to begin on its own, according to the news release.
The final weeks of pregnancy are extremely important to a baby's health because many vital organs, including the brain and lungs, are still developing, according to the March of Dimes.
More information
The U.S. Office on Women's Health has more about labor and birth (http://womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm ).
SOURCE: March of Dimes, news release, April 8, 2013
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