Edward to ban elective deliveries before 39 weeks

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Updated: August 4, 2011 4:20PM

When it comes to deciding the right time to deliver a baby, local hospitals are beginning to realize Mother Nature really does know best.

Edward Hospital in Naperville is one of six Illinois medical centers chosen to be part of a March of Dimes pilot program calling for a halt to elective deliveries before 39 weeks of pregnancy.

Likewise, other hospitals, including Provena Mercy and Rush-Copley medical centers in Aurora, have taken aggressive steps to curtail what the American College of Obstetricians and Gynecologists has determined is a dangerous trend.

Since the warning was issued several years ago, both Aurora hospitals have been monitoring the issue closely.

“Patients delivered prior to 39 weeks without an apparent indication are reviewed by our OB committee on a case-by-case basis,” said Von Draper-Jarrett, clinical nurse manager for Women and Children’s Services at Provena Mercy.

Likewise, Jennifer Toerpe, director of Rush-Copley’s Women’s Health Institute, said this past year there have been more guidelines and barriers put in place to make sure no unnecessary inductions or surgeries are scheduled. And as a result, the hospital has seen those numbers “drop by over 50 percent in a short amount of time.”

Sherman Hospital in Elgin has also made it a priority to reduce the number of these early deliveries which, research now confirms, cause more medical problems for babies.

In the past month, the number of elective early deliveries has been reduced to zero, said Dr. Ian Jones, vice president of clinical performances at the Elgin hospital, which delivers about 3,000 babies a year.

“Pregnancy is a big deal,” he said, referring to the sometimes cavalier attitude doctors and patients can take. “There should be no shortcuts.”

The Edward program, which began Monday, makes use of a March of Dimes kit providing information to ensure inductions and C-sections are done at the right time and for the right reasons. Hospital staff members have been trained in the use of this kit, incorporated materials in prenatal classes and posted them at www.edward.org. Physicians also are making patient education materials available in their offices.

Relevant data will be collected throughout the year and submitted to the March of Dimes.

About 3,500 babies are delivered annually at Edward Hospital, said Obstetrics Director Pat Bradley, with 28 percent of these births taking place before 39 weeks of gestation. Half are elective, a number that has risen dramatically during the last decade.

Yet, “the longer the baby can stay in, the better it is,” she said, “as long as there is no medical reason to do otherwise.”

Risks of early delivery

Dennis Crouse, director of the neonatal intensive care unit at the University of Illinois Medical Center Chicago, agrees. Chairman of the committee that oversees the March of Dimes project, he said a baby’s brain, lungs and other physical functions still are developing during the last few weeks of gestation. While the medical community previously thought it was OK to deliver a baby a few weeks early, recent research indicates otherwise.

“These infants have a much higher risk of being admitted to the intensive care unit,” he said. “They have a much higher risk of having respiratory disease. Their hospital stays are usually much longer. It interferes with breast-feeding, and there is evidence long term these infants may have an increased risk of some neurological issues.”

Experts say this disturbing trend continued to grow as patients became more demanding and doctors became too lax. Reasons for requesting early deliveries vary. The dad may be leaving town or is being deployed by the military. The mom may want a particular doctor or might want to end pregnancy-related discomfort. Some moms fear they won’t get to the hospital in time. Others are trying to juggle child care.

Need for education

As our culture shifted toward a more relaxed attitude about delivering early, it was apparent education was needed by both patients and medical staffs.

Bradley said when expectant mothers were asked in a recent study at what gestational age is it safe to deliver a baby, about 70 percent responded it was OK after 36 weeks.

And, while individual doctors may not see the problems associated with early deliveries in their individual practices, this new research brought the problem into focus.

In addition to providing patients, doctors and staff with more information, Dr. Peter Weeks, medical director of obstetrics and gynecology at Edward Hospital, said he hopes the results from working with the March of Dimes program will be “immediate and dramatic.”

Since introducing the materials to staff members several months ago, he’s already noticed doctors are changing their behaviors and informing patients about the wisdom of staying pregnant longer.

Based on data, hospitals participating in the 2011 March of Dimes project can expect to reduce pre-term births and admissions to the NICU by 15 to 20 percent, Crouse said. That is significant from both a health and cost perspective. The typical hospital bill for a full-term baby is about $2,000, he added. That can be 10 times higher when a baby is in the NICU.

Seventeen Illinois hospitals applied to be part of the March of Dimes program. Others that were selected are Decatur Memorial Hospital, St. Elizabeth’s Hospital in Belleville, St. Joseph Hospital in Breese, Katherine Shaw Bethea Hospital in Dixon and the University of Illinois Hospital at Chicago. Also participating are five hospitals in California, Texas, New York and Florida.