Twenty hospitals in Louisiana where babies are delivered, including obstetrics hospitals in Baton Rouge, are voluntarily ending the practice of electively inducing a woman’s labor before her 39th week of pregnancy unless there’s a medical need.
Historically, labor has been induced early for many reasons other than medical, including convenience on both the part of the patient and/or physician.
But at 39 weeks, an unborn infant’s brain, lungs and other internal organs are still undergoing crucial development, said Dr. Rebekah Gee, an obstetrician and gynecologist, at a press conference Wednesday.
“Most women don’t understand that 39 weeks is term,” said Gee, an assistant professor at the LSU Health Sciences Center in New Orleans.
Along with the announcement of the 20 hospitals committing to the “39-Week Initiative,” developed by the state Department of Health and Hospitals, the March of Dimes announced a new patient education program that supports the initiative.
It’s called “Healthy Babies are Worth the Wait.”
“Only 25 percent of women know it’s important to wait until 39 weeks,” said Knesha Rose, state director of program services for the Louisiana Chapter of the March of Dimes.
Babies delivered prior to 39 weeks may experience respiratory distress and need to be cared for in a hospital’s neonatal intensive care unit, Gee said.
Inducing labor also leads to an increase in deliveries by cesarean section because the woman’s body is not yet prepared for labor, she said.
According to the Department of Health and Hospitals, Louisiana has the second highest C-section rate in the country, at 38 percent of deliveries.
The 20 Louisiana hospitals that have committed to what’s called the 39-Week Initiative, introduced by the state Department of Health and Hospitals (DHH), include the busiest obstetrics hospitals in the state and deliver two-thirds of the babies born in Louisiana, according to Bruce Greenstein, secretary of the DHH.
For the launching of the initiative, DHH approached the largest obstetrics hospitals in the state, each delivering upwards of 1,000 babies each year, said Meghan Speakes, public information officer with DHH.
There are approximately 60 hospitals in the state that deliver babies; the remainder of those will be formally approached about joining the initiative in the future, Speakes said.
“We will work with the DHH and others … until we get 100 percent adoption of this (initiative) statewide,” said Jeff Wil-liams, executive vice president of the Louisiana State Medical Society, who spoke at the press conference at Woman’s Hospital.
Woman’s adopted a policy ending early inductions of labor, except where medically required, in 2007, as part of its participation in a national program called the Institute for Healthcare Improvement.
Another hospital, East Jefferson General Hospital in Metair-ie, adopted the same practice.
“Since implementing the initiative at Woman’s Hospital in September 2007, neo-natal intensive care unit admissions dropped 20 percent,” according to a DHH news release.
Since 2007, East Jefferson General Hospital reduced its number of elective inductions, before 39 weeks’ gestation, from 503 to 16, the same news release reports.
The move to take an initiative to hospitals statewide came after the March of Dimes, in November 2010, gave Louisiana an “F” on its annual “Prematurity Report Card” for the country, Greenstein said.
Greenstein learned of the efforts of Woman’s Hospital to reduce early inductions of labor and got the hospital’s help in developing the 39-Week Initiative of the Department of Health and Hospitals, he said.
The initiative is part of the department’s new Birth Outcomes Project, directed by Gee.
Greenstein said that in addition to the health benefits for mothers and their babies, the 39-Week Initiative has positive financial aspects as well.
Through the Medicaid program, the state paid for approximately 70 percent of the more than 65,000 births in Louisiana last year, he said. Of those, Medicaid paid for approximately 7,000 premature births, which typically entail higher costs.
According to the March of Dimes, the average cost for a premature infant in Louisiana is $33,000, compared to the national average of $4,000 for a full-term newborn.
The first Louisiana hospitals that have signed on to implement the 39-Week Initiative in Baton Rouge are Woman’s Hospital, which recently began providing the delivery services formerly provided by Earl K. Long Medical Center, and Baton Rouge General Medical Center.
At the Ochsner Medical Center of Baton Rouge, which began delivering babies in April 2010, Dr. Ralph Dauterive, chairman of obstetrics, said, “We agree with this effort, as it has long been our practice here at Ochsner not to perform elective inductions before 39 weeks.”
Others hospitals that are part of the 39-Week Initiative are Christus St. Frances Cabrini Hospital, Alexandria; E.A. Conway Medical Center, Monroe; East Jefferson General Hospital, Metairie; Lake Charles Memorial Hospital, Lake Charles; Lakeview Regional Medical Center, Mandeville; Lafayette General Medical Center, Lafayette; LSU Health Sciences Center, Shreveport; and North Oaks Medical Center, Hammond.
Others are Ochsner Foundation, New Orleans; Ochsner Medical Center-West Bank, Gretna; Rapides Regional Medical Center, Alexandria; Tulane-Lakeside Hospital, Metairie; Touro Infirmary, New Orleans; and West Jefferson Medical Center, Marrero. The remainder are Willis-Knighton Pierremont Health Center, Shreveport; Willis-Knighton South & Center for Women’s Health, Shreveport; Women & Children’s Hospital, Lake Charles; and Women’s and Children’s Hospital, Lafayette.