ON AIR NOW

LISTEN NOW

Weather

partly-cloudy-tstorms-day Created with Sketch.
53°
Overcast
H 73° L 52°
  • partly-cloudy-tstorms-day Created with Sketch.
    53°
    Current Conditions
    Cloudy. H 73° L 52°
  • cloudy-day Created with Sketch.
    59°
    Afternoon
    Cloudy. H 73° L 52°
  • cloudy-day Created with Sketch.
    59°
    Evening
    Mostly Cloudy. H 62° L 43°
LISTEN
PAUSE
ERROR

Krmg news on demand

00:00 | 00:00

LISTEN
PAUSE
ERROR

Krmg traffic on demand

00:00 | 00:00

LISTEN
PAUSE
ERROR

Krmg weather on demand

00:00 | 00:00

Hospitals clamp down on dangerous early elective deliveries

For decades, doctors have been warned about the dangers of delivering babies early without a medical reason. But the practice remained stubbornly persistent.

Now, with pressure on doctors and hospitals from the federal government, private and public insurers and patient advocacy groups, the rate of elective deliveries before 39 weeks is dropping significantly, according to latest hospital survey from The Leapfrog Group, a coalition of some of the nation's largest corporations that buy health benefits for their employees.

The national average of elective early deliveries fell to 11.2 percent last year from 14 percent in 2011 and 17 percent in 2010. Nearly 800 U.S. hospitals report their data to Leapfrog, about a third of U.S. facilities offering maternity services.

“This data shows more hospitals are responding to the evidence,” said Cindy Pellegrini, senior vice president of the March of Dimes, which has been educating women and working with hospitals and doctors to lower early delivery rates. “This means babies are being born healthier and having a better start in life, and have a much greater likelihood of avoiding health consequences later on in life.”

Babies born before 39 weeks are more likely to have feeding and breathing problems and infections that can result in admissions to neonatal intensive care units than those who are born later, studies show. The elective deliveries can also cause developmental problems that show up years after birth. 

Inducing labor early also carries risks for mothers because it increases the chances they will need cesarian sections.

Individual Hospitals

Rates of early elective deliveries by hospital: PDF file anddownloadable CSV spreadsheet

Since 1979, the American College of Obstetricians and Gynecologists has recommended against deliveries or induced labor before 39 weeks unless there is a medical indication, such as the mother's high blood pressure or diabetes or signs that the fetus may be in distress.

Still, an estimated 10 to 15 percent of U.S. babies continued to be delivered early without medical cause, according to a report last year by the Department of Health and Human Services.

Leapfrog Chief Executive Officer Leah Binder said she’s encouraged by the latest figures, but says rates are still too high at many hospitals -- with some as high as 40 percent. “This is a move in right direction, but more needs to be done,” Binder said. 

Leapfrog wants to see rates no higher than 5 percent of all deliveries, a target achieved by nearly half of the reporting hospitals – up from 39 percent of hospitals in 2011.

State averages varied from a high of 26 percent in Pennsylvania to a low of 5.9 percent in Massachusetts and New York. Only states with at least 10 hospitals reporting data were counted toward a state average.

One reason some hospitals have been slow to lower their rate is a reluctance to pressure doctors to change their practice, she said.

Some rural hospitals may also have higher rates because doctors in solo practice sometimes schedule to deliver babies early to stagger their workload. Women who are unaware of the higher risks may also ask to deliver early out of convenience.

Some of the most dramatic improvements last year came from states such as South Carolina and Illinois where business groups and insurers have exerted pressure to decrease high-risk deliveries. In Illinois, the rate has been cut almost in half to about 7 percent through efforts by organizations such as the Midwest Business Group on Health.

Employers and insurers have gotten involved partly to reduce health costs, since stays in neonatal intensive care units can average well over $60,000.

This year, the South Carolina Medicaid program and BlueCross BlueShield of South Carolina stopped reimbursingproviders for performing early deliveries without medical cause. In 2012, the state, working with the March of Dimes and other groups, asked hospitals voluntarily to reduce their rate of early deliveries. The rate of early elective deliveries in South Carolina hospitals fell to 10 percent last year from 19 percent in 2011, the Leapfrog data show.

“We are pleased to see these improved health outcomes,” said Kim Cox, spokeswoman for the South Carolina Department of Health and Human Services.

Texas Medicaid stopped paying for early elective deliveries in 2011, and New York and New Mexico are considering similar actions, according to state officials.

Some hospitals are moving on their own. Boston Medical Center reduced its rate to 5.3 percent last year from 22.5 percent in 2011 by reminding doctors that delivering babies even one or two days before 39 weeks would not be allowed without medical cause. The hospital also informed women about the policy during prenatal care.

“All of the nurses, midwives and doctors on Labor and Delivery are aware that decreasing elective deliveries prior to 39 weeks is an important goal for our service,” said Dr. Ronald Iverson, director of quality improvement for OB/GYN at Boston Medical Center.

We want to hear from you: Contact Kaiser Health News

Read More
VIEW COMMENTS

There are no comments yet. Be the first to post your thoughts. or Register.

  • Unable to convince GOP lawmakers to get on board with a plan to overhaul the Obama health law, Republicans in the House decided not to even force a vote on the measure, a major setback for both President Donald Trump and House Speaker Paul Ryan. “This bill is dead,” said Rep. Greg Walden (R-OR), the Chairman of the House Energy and Commerce Committee, who played a central role in cobbling together this plan. 'This bill is dead,' House Energy & Commerce Committee Chairman Walden says — Cristina Marcos (@cimarcos) March 24, 2017 The bill never even came to a vote, as it became obvious that Republicans had nowhere near a majority of lawmakers ready to vote for it. Democrats were more than happy to pile on the GOP legislative debacle. #ObamaCare 1 – #Trumpcare 0. — Rep. Hank Johnson (@RepHankJohnson) March 24, 2017
  • In the end, monolithic opposition by Democrats coupled with opposition from the far right doomed Friday’s vote on the American Health Care Act, the GOP bill that would have repealed and replaced the law commonly known as “Obamacare.” GOP leadership decided to pull the bill, realizing that it could not pass. The Trump administration made it clear early Friday that negotiations were over, and the president wanted an up or down vote Friday. House Speaker Paul Ryan went to the White House to report he didn’t have the votes to pass the bill; President Trump had previously said win or lose, Rep. Ryan should keep his position as Speaker. The GOP plan (AHCA) would have ended the mandate that all Americans pay for health insurance, replacing it with a plan where the federal government would give Americans tax credits, based on age. That would have saved taxpayers billions of dollars, according to the nonpartisan Congressional Budget Office, but would have left  24 million additional Americans without health coverage within the next decade. Many governors, including some Republicans, also had serious concerns about the additional burdens passed on to states under the AHCA.
  • The Pawhuska woman recently accused of exposing herself to a classroom of students was arrested this week on accusations of stealing a purse.  According to the arrest report, Lacey Sponsler allegedly stole a purse while at the Broken Arrow Lanes bowling alley near 111th and Elm last Thursday.   The report states that witnesses saw her acting suspiciously and looking at people’s belongings. One witness saw her grab a purse and asked if it was hers. She said it was not.   A witness then reportedly saw Sponsler walk into the game room and return wearing different clothes. Police were called and found her in the bathroom.   Sponsler was arrested in February for doing a cartwheel in front of students at a Pawhuska school. She was not wearing anything under her dress and exposed herself to the students.
  • Authorities in Ohio arrested three people after they discovered the badly decomposed body of a 71-year-old Vietnam veteran in a home, according to multiple reports. >> Read more trending news Deputies with the Tuscarawas County Sheriff’s Office found the body of Bob Harris, 71, after learning that his Social Security debit card was being used despite the fact that he hadn’t been seen for months, WJW reported. The body had decomposed to the point where the remains were mostly skeletal, lying in the living room of a home in Wainwright. The body was kept a short distance from where the home’s residents slept, according to WJW. “It’s a horribly graphic case,” Sheriff Orvis Campbell told TimesReporter.com. He said Harris’ body was found in some “of the most deplorable conditions we can describe.” Trash and animal waste was found near the body. Harris was living with a married couple and their daughter, according to TimesReporter.com. The family had spread stories about Harris moving to Stark County and allowing them to use his Social Security benefits, Campbell said. Authorities arrested Brian and Stacy Sorohan on charges of abuse of a corpse and theft of a credit card, according to The Associated Press. The couple’s 18-year-old daughter was charged with abuse of a corpse. Deputies said the circumstances surrounding Harris’ death were not immediately clear. An autopsy will be performed to determine whether his death involved foul play, according to TimesReporter.com.
  • Tulsa police Thursday released video of an incident in which an officer used his patrol car to end a gunfight. Madison Dickson was the suspect in a string of violent crimes that spanned nearly a week when she was spotted in a vehicle near 91st and Harvard last Saturday. She tried to run, and gunfire is heard on the video, which officers say was directed toward them. The officer swerves left as she points the gun at him, then veers right and runs her over as she attempts to flee. Additional videos released to media by TPD indicate an officer also used a Taser on Dickson after she was down, because she still had the gun and wasn’t responding to commands. “She might not be able to, hang on,” one officer says as others are yelling at her to show her hands. EMSA arrived on the scene a few minutes later, but Dickson died from her injuries.