Early Inductions Lead to Higher Neonatal Risks


According to a hospital watchdog group, too many births are being subject to early induction in the U.S., unnecessarily endangering the health and lives of women and newborns.

The Leapfrog Group surveyed 773 hospitals nationwide and found that the rate of early induction and early elective c-sections varied widely from state to state and hospital to hospital – with some hospitals reporting ten times the amount of early inductions than others. With thousands of babies being induced early each year, the group is issuing a “Call to Action” to reduce the likelihood that newborns will wind up in the Neonatal Intensive Care Unit (NICU) or dealing with life-long health problems.

Nationally, labor is induced in approximately 20 percent of births and one-quarter of those occur before the 39th week of labor – a crucial stage in the final development of a fetus.

The last few weeks of pregnancy are critical to a baby’s health because important organs, including the brain and lungs, are not completely developed until then, said Alan R. Fleischman, MD, senior vice president and medical director of the March of Dimes.

The March of Dimes is working with the Leapfrog Group, a coalition of public and private purchasers of employee health benefits, and Childbirth Connection, a national advocacy organization working to improve the quality of maternity care in the U.S., to spread the word about the importance of the appropriate use of labor induction and the last stages of pregnancy to the growth and development of the fetus.

According to a release sent out by the Leapfrog Group, women are undergoing elective induction at “alarming rates” before the 39th week:

Experts, including those from the American College of Obstetricians and Gynecologists (ACOG), Childbirth Connections, and the March of Dimes, caution that the amount of time a baby needs to develop fully, which includes having a fully developed brain and other organs, is at least 39 completed weeks. Sometimes there is a medical reason to schedule a newborn delivery before the 39th week—for example, if woman has high blood pressure at the end of pregnancy or broken membranes before labor begins. 

The Joint Commission tasked with regulating health quality addressed this issue last year. In 2010, the group began requiring all hospitals to report all elective inductions and at what stage in pregnancy the inductions occurred, as well as cesarean sections for first- time mothers since, as the Associated Press reported last year, these are “too often a result of a failed induction.” The statistics are compiled in a public database.

The move, on the Joint Commission’s part, came about after research revealed the many health risks related to babies born “near term.” In Utah, reports the Associated Press, Intermountain Healthcare saw 28 percent of their early induction births happen before the American College of Obstetricians and Gynecologists recommended cut-off of 39 weeks gestation. Medical charts revealed that those babies, shockingly, had more than double the risk of ending up in NICU, or even needing a ventilator.

The Leapfrog Group, then, in partnership with these key groups, are pushing the Call to Action to spur change across the spectrum. From physicians and midwives to pregnant women, their call is simple: Inducing labor prior to 39 weeks without medical cause unnecessarily places the newborn’s health at risk.

Maureen Corry, executive director for Childbirth Connection, a national advocacy organization that works to improve the quality of maternity care, salutes Leapfrog for making hospital rates of elective delivery accessible so women can make an informed decision about where to give birth.

“Now we need to make the data available for all hospitals and individual physicians and midwives. We are pleased to join Leapfrog’s Call to Action by providing women with evidence-based resources on benefits, harms, and appropriate use of labor induction, including tips and tools for avoiding an unnecessary induction.”

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