Hospitals saying no to early deliveries

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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.

A couple of years ago, the American College of Obstetricians and Gynecologists warned physicians against this growing trend. And since then, Mercy Provena Medical Center in Aurora has been monitoring the issue of early deliveries.

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

Likewise, Sherman Hospital in Elgin has made it a priority to reduce the number of these early deliveries — which, data now confirm, cause more medical problems for babies.

In the past month, the number of elected 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, research and education materials to ensure inductions and C-sections are done at the right time and for the right reasons. Hospital staff has 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 added, “as long as there is no medical reason to do otherwise.”

Dennis Crouse, director of the neonatal intensive care unit at the University of Illinois Medical Center in 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. 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.”

Sherman Hospital’s Jones said this disturbing trend was the result of patients becoming more demanding and doctors becoming 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.

Education, it turns out, was needed on both sides.

Bradley said that when expectant mothers were asked in a recent study what gestational age is 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.

It all comes down to “providing the correct information to patients, doctors and office staff,” said Jones of how Sherman is tackling the issue,

Dr. Peter Weeks, medical director of obstetrics and gynecology at Edward, said he hopes the results at his hospital will be “immediate and dramatic.” Since introducing the March of Dimes 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 from these hospitals, participants in the 2011 March of Dimes project can expect to reduce pre-term births and admissions to a neonatal intensive care unit 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 goes up tenfold when a baby is in the NICU.

Seventeen Illinois hospitals applied to be part of the March of Dimes program. Others making the cut 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 Medical Center at Chicago. Also participating are five hospitals in California, Texas, New York and Florida.