Early Inductions Being Banned or Restricted in Some Hospitals
The growth of the baby's brain during the last month is hugely significant. Image courtesy of March of Dimes.
These restrictions would include elective C-sections in the same time frame – anything prior to 39 weeks. There are large initiatives taking place nation-wide to ban, or heavily restrict, early elective C-Sections and early inductions prior to week 39 gestational age. The latest is an unusual move by Portland area hospitals.
The March of Dimes has long been pointing out what ACOG has been saying for years – early inductions come with many hidden dangers and risks that aren’t always clearly seen or understood by tired-of-being-pregnant moms. There are tremendous benefits to waiting until week 39 at the very minimum before a non-medically-necessary induction or C-Section take place.
In Portland, Oregon the area hospitals have joined together to create new initiatives which will do just that – require physicians to wait until the 39th week before offering elective or scheduled C-sections and “convenience inductions” as they are sometimes called. According to the Portland Tribune’s article on the subject, the 17 area hospitals have all agreed to the terms. Any induction taking place prior to week 39 of a woman’s pregnancy will require approval by a hospital arbitrator.
…new research has shown that there is significant brain development going on right through 38 weeks. Babies born before 39 weeks of pregnancy are two to three times more likely to be admitted to intensive care as well as have trouble breathing, according to recent studies.
When similar policies have been enacted in other hospitals as many 40-50% of all early inductions did not meet the criteria for “medically necessary.” The savings – in lives and health care costs – have been huge though.
For example Intermountain Health, a group of Utah area hospitals created similar guidelines for their patients care and the results were startling. The number of infants needing NICU care dropped significantly, the annual savings in health care cost for patients has been greatly decreased, and the number of surgical births (failed inductions are a leading cause of C-Sections!) has been greatly decrease – again saving lives and money.
By instituting a ban on inductions before the 39th week, Intermountain kept an estimated 500 newborns from having to use ventilators after birth and saved at least $1 million in health care costs in one year, according to hospital officials.
Fewer inductions also resulted in fewer overall C-sections, according to Intermountain. And that resulted in a savings of over $45 million.
Given the better health for babies, the delicate brain development that takes place in the last few days of pregnancy, and the savings in costs and NICU resources, would you support similar guidelines in your area hospitals?
I’ve been reading several articles like this lately and it’s gotten me a bit worried. I went into labor naturally with both of my sons and (strangely enough) both were born at exactly 37 weeks, 6 days. I wonder if being born slightly early, when it’s caused by “Mother Nature” will affect their health.
I have heard that early term birth (when natural), isnt usually a cause for concern. The stress hormones released during a natural labor prepare the baby to be born then. Your body says the baby is done, and is ready to be born. It is the elective induction and elective c/s that causes the problems. I had early births (35, 36, and 36) due to medical reasons. I spontaneously went into labor with 2 and they were fine,my last was an emergency c/s and was in nicu for 9days.
As E commented, there is a big difference between what your body does naturally, and what we force upon it!
Think of it this way – 40 weeks is the AVERAGE…the bell curve (and by the way – that isn’t even an accurate average. That average is for 2nd time mothers only…first time mothers go average of 41 weeks but that’s another article). So if there are 10 babies out of every 100 that naturally go to 41 weeks, there may be 10 babies out of every 100 that naturally go to 39 weeks and that’s enough for them.
But how do you know which is which at 38 weeks? If you induce at 38 weeks your baby may be just a day or two early. Or he may be THREE WEEKS or more earlier than he should have been. How will you know? By waiting until labor starts! That’s the only true way to know.
Angela <
Also, due dates are just estimates… so it could be that you were more like 38+ or even 39 weeks along when you went into labor naturally.
When we are taking into consideration the best interest of the baby, it seems only rational to wait until the baby is full term and the body is ready to deliver on its own. Mother Nature knows best and I have suffered many over due pregnancies so I know how hard it can be to wait until Mother Nature decides it is time. A medical necessity is obviously an exception to the rule. Otherwise, I agree with the need for a change in policy.
When we are taking into consideration the best interest of the baby, it seems only rational to wait until the baby is full term and the body is ready to deliver on its own. Mother Nature knows best and I have suffered many over due pregnancies so I know how hard it can be to wait until Mother Nature decides it is time. A medical necessity is obviously an exception to the rule. Otherwise, I agree with the need for a change in policy.
I would support policies like this in my area. It doesn’t make sense to induce or schedule a C-section for non-medical reasons. If the health care costs continue to pan out, I could see more and more hospitals initiating similar policies as a cost-saving measure.
I would definitely support such restrictions. I’ve always felt that inducing for non-medical reasons was just not a good way to go, so it comes as no surprise to me that these restrictions are being placed. Thank goodness.
I am 100% behind this! I wish I had this informaton 6 years ago. My first pregnancy was pretty normal. I had a little pit of preterm contractions but the dr was able to stop it. I went in to “real” labor at 38 weeks 6 days my water broke b4 contractions began and I deliverd him 27 hours later PERFECTLY HEALTHY! My 2nd and 3rd pregnancys were much different. With the second I was told my a-fluid was low and needed to be indused, I was 35 weeks and only 20 years old and scared so I listened to the dr it went bad! The dr indused me and left and my son (fell out) in my husbands arms 3 1/2 minuets later. Then my 3rd pregnancy they said the baby was not growing right and indused me at 36 weeks, we that one went even worse Me and my daughter almost died and I was in the icu for a month and my baby girl was in the nicu for 6 weeks. I never want to experience that again. So this pregnancy I told the dr that unless he can SHOW me my baby is in danger I will not allow my secudlued c-secton untill my ACTUAL DUE DATE! The only thing I want is a healthy safe baby! To many children are dieing because people are inpatinate!
I would support these types of policies nationwide. It is absolutely no wonder why healthcare costs are rising out of control in this country when people can have elective procedures for non-medical reasons that are covered by insurance and those elective procedures can cause untold amounts of additional medical expenses because of all the complications involved with them. Not only that, but as others have said, why aren’t women doing what is best for their babies and waiting until their children are READY to be born. Just because you have an estimated due date doesnt mean your child will be developed by the time you think it should be. If it is for a proven medical reason and there are no other options but to induce or do a c-section, then I completely understand. But we have turned birth, and pregnancy for that matter, into a consumer driven business and it has to stop!
My hospital is very conservative when it comes to elective early inductions and they will not perform elective c-sections at all, due to rising costs to both the hospital and patients, not to mention it reduces thier possibility for malpratice and I fully support this. I give drs the the *side eye* when they are known more for thier elective c-sections than trying to support natural labor b/c it just seems like they are more about the money than about good patient health. I imagine that towards the end, alot of these women are just so over being pregnant and that the discomfort and lack of sleep has taken it’s toll. I feel so bad for them, but then I go back to the idea that babies shouldn’t be forced to be born unless it’s a medical necessity to save the life of the mom or unborn child. Why would anyone want to put their unborn child at risk simply b/c they are unwilling to be pregnant anymore? Why has the convienence of the mother’s schedule and comfort has begun to trump the safety of the unborn child? Why take any additional risks by having a c-section, which is major abdominal surgury? I try my best not to judge in these types of situations, but I know for me, I just wouldn’t be able to do that, but I guess to each their own…..
Well I waited and waited, I waited till past 41 weeks. I was sent to the hospital, and they spent nearly three days trying to induce me. Long story short, we waited too long. I had complications from being overdue. My baby was almost 11 pounds, and I was forced to have a c-section because of it. If I hadn’t waited so long he might not have been so large and I might have been able to deliver normally. We both had to stay a couple of extra days due to complications of his size and too long of an induction. I have never gone into labor naturally. Since I have had two other children both born at 39 weeks and at least 9 pounds. All born by c-section. My choice. I would not have done it sooner, but glad we didn’t wait so long again.