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HaysMed launches new birthing initiative

1/17/2014

By ELIZABETH GOLDEN

egolden@dailynews.net

Hays Medical Center, along with 48 Kansas hospitals, has implemented a "hard stop policy" to reduce early-term elective deliveries, meaning no child will be delivered through induction or cesarean section before 39 weeks of gestation unless a medical issue is present.

According to the American College of Obstetricians and Gynecologists, elective deliveries before 39 weeks are unnecessary and could cause harm to the mother and child.

"A couple years ago, it was identified through studies that women who were having elective inductions or C-sections before 39 weeks, their infants had a higher rate of mortality," said Kristy Schlaefli, manager of the OB unit at HaysMed,

Schlaefli said after ACOG endorsed discontinuing early elective deliveries, hospitals started investigating their processes to make sure they were following the recommendations.

Medical reasons for inducing labor or performing an early C-section could include the baby isn't growing at an adequate rate, the mother is diabetic or has blood pressure issues.

"One thing that has happened is a dad is going off to the military, so he wants to be there at the birth," Schlaefli said, citing reasons for non-medical early delivery. "Also, we're in rural Kansas, so we have mothers that come from two hours away to have babies. They worry about going into labor and trying to get to the hospital or making sure they have someone to take care of their other kids."

Celeste Gray, director of nursing at HaysMed, said the non-medical reasons are putting babies in harm's way.

"They were doing just fine where they were," she said. "They needed to be in the mom's womb, where they should have been until they were ready to be born."

Based on research by ACOG, babies delivered at 37 weeks had an 18-percent chance of being admitted to the neonatal intensive care unit compared to those delivered at 39 weeks needing intensive care only 5 percent of the time.

"If a baby is born before 39 weeks, the problems are usually respiratory," Schlaefli said. "Maybe the lungs weren't quite mature."

The incentive to reduce early elective deliveries is being government run.

According to Medicaid research, 10 percent to 15 percent of all births are performed early without medical reasoning. Medicaid finances cover approximately 45 percent of all births in the U.S. In order to decrease early elective deliveries, the organization is providing "payment disincentives" and offering financial incentive to hospitals who reduce their early elective deliveries.

By reducing the NICU admissions, health care costs are estimated to decrease.

"What happens when you have all these NICU admissions, you drive the cost of health care up because you have all these babies being born that are at a high level of intensive care," Schlaefli said. "Hopefully by decreasing the chance for a mom to have a C-section and decreasing the admissions to the NICU, health care costs will go down. Not just here, but nationwide."

Gray agreed.

"This is a good thing for moms and babies to drive down health care costs and have a more controlled environment," she said.