Banner Health to limit early deliveries in support of fetal development
GREELEY, Colo. (June 30, 2011) — Beginning July 18, Banner Health hospitals including North Colorado Medical Center in Greeley and McKee Medical Center in Loveland, will no longer schedule elective cesarean sections and labor inductions before 39 weeks of pregnancy unless specific medical criteria can be demonstrated.
This decision, supported by The March of Dimes and other respected health care organizations, will apply to nearly 30,000 deliveries in the 19 Banner hospitals that provide obstetrical care. It is an effort to underscore, unless there is a medical reason why mom or baby is having medical problems, nature knows best when it comes to the time of delivery.
Dr. Paul Hiratzka, Banner Health obstetrician in Greeley, served on the system group that studied and recommended the policy change. He said the literature shows a clear difference in outcomes when comparing babies delivered during the 37th or 38th week compared to the 39th week.
“I think there was a sense that there wasn’t really that much difference, but the literature is now clear,” he said. “NCMC has been one of the leaders in reducing elective deliveries prior to 39 weeks as a result of educating our physicians during the process. We have not had an elective delivery prior to 39 weeks in over a year.”
A full-term pregnancy is more than the advertised nine months. It is closer to 10 months, or more specifically 39-40 weeks. Yet ongoing research and now a new national study have identified specific health advantages for babies that are born after 39 weeks gestation. Eliminating elective deliveries before 39 weeks is supported by American Congress of Obstetrics and Gynecology and The Joint Commission.
A study by The March of Dimes, the National Institutes of Health and the Food and Drug Administration reported in May found that, while not a common occurrence, risk of newborn death was 50 percent less in babies born at 39 weeks or later. The study was published in the June 2011 issue of Obstetrics and Gynecology.
Other research has suggested that babies born at full term have fewer hearing and vision problems, fewer feeding problems and are less likely to deliver at a low birth weight. The brain, lungs and eyes are in the final stages of development in the final weeks of pregnancy, and imaging studies show us that the brains of infants born after 39 weeks are notably larger than younger gestation babies.
In 2010, 42 percent of babies born at Banner Health hospitals were delivered in advance of 39 weeks. Some of those deliveries were a medical intervention to protect mother or baby, and some were spontaneous deliveries. An unknown number were elective c-sections or inductions.
Dr. Hiratzka said the most common reasons to request an early delivery include patient discomfort, logistical issues such as distance from the hospital, dates when spouse has a conflict, or patient/physician/midwife convenience.
“The answer is that doing an induction prior to 39 weeks without a medical justification adversely affects the outcome for the baby,” he said.
Hiratzka added that medical reasons exist when early delivery is indicated for fetal, neonatal, and/or maternal well-being and that won’t change.
The primary risks of prematurity include: difficulty breathing, hearing and vision problems, intestinal problems, learning and development disabilities and even bleeding or fluid in the brain. These will not occur in all newborns that arrive early, but the risks remain.
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