Site Compares Hospitals' Rates of Early Elective Deliveries
Major Finding: For the first time, the public can compare rates of early elective deliveries among individual hospitals. Rates ranged from below 1% to more than 40%.
Data Source: Online publication of birth data voluntarily reported by 773 U.S. hospitals in an annual survey by the Leapfrog Group.
Disclosures: Ms. Binder, Dr. Rudolph, Dr. Fleischman, and Ms. Corry work for organizations advocating improved health and medical practices for pregnant women and infants.
Attention to early elective deliveries has been ratcheting up as rates increase despite evidence of the potential harm associated with the practice. In 2010, the Joint Commission, an accrediting body, added elective deliveries to its core measures of health care quality.
Centers for Disease Control and Prevention data show that the average time U.S. fetuses spend in the womb has decreased by 7 days since 1992, according to a Dec. 26, 2010 report by California Watch, a project of the nonprofit Center for Investigational Reporting. Between 1990 and 2006, deliveries at 36 weeks increased by approximately 30% and deliveries at 37 or 38 weeks increased by 40%. There are now more U.S. babies born at 39 weeks than at full term (40 weeks or later), the report said.
C-section deliveries are more common at for-profit hospitals, according to a separate report by California Watch on Sept. 11, 2010. The Leapfrog report did not analyze the data by type of hospital.
National statistics show that between 1990 and 2006, the rate of labor induction increased from 9% to 23% of deliveries, and the C-section rate hit a high of 32%, Leapfrog’s Dr. Rudolph said.
The Leapfrog Group, the March of Dimes, and Childbirth Connection issued a "call to action" in response to the survey findings. Four of the largest U.S. health insurers – Aetna, CIGNA, UnitedHealthcare, and Wellpoint – will conduct a campaign to educate expectant mothers about the importance of a full gestation and the wisdom of comparing elective delivery rates in their local hospitals, Ms. Binder said.
Ms. Binder, Dr. Rudolph, Dr. Fleischman, and Ms. Corry work for organizations advocating improved health and medical practices for pregnant women and infants.
