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Opinion: Campaign begins against early childbirth

In Sacramento County, about 20,000 babies are born in one year. Of these newborns, more than 2,000 are born prematurely and approximately 110 do not live to celebrate their first birthday. Premature birth is the leading cause of newborn death, and the rate of such births has increased by more than 30 percent since the 1980s.

The statistics are staggering, yet even more alarming is the growing trend of women electing to deliver their babies early. However, it is essential to distinguish the many deliveries that happen prematurely because of the health of the mother or the infant from elective deliveries that have no medical indication.

A healthy, full-term pregnancy lasts 39 to 40 weeks, yet we are observing a rise in births scheduled before 39 weeks – a practice once thought to be safe. Research is now unveiling the serious, and sometimes fatal, consequences of scheduling births even a few weeks too early.

While not officially called “premature,” babies born between 37 and 39 weeks are at greater risks of complications compared with full-term babies. Moreover, many women fail to comprehend the definition of a full-term pregnancy, according to a recent study published in the Journal of Obstetrics & Gynecology. Nearly 25 percent of moms surveyed considered a baby of 34-37 weeks gestation to be full-term, 50 percent defined full-term as 37-38 weeks and 92 percent of women reported that giving birth before 39 weeks was safe. Taken together, the results indicate a clear and pressing need for a targeted plan of public education and engagement on the risks of non-medically necessary labor inductions.

March of Dimes has invested millions of dollars in the fight against premature birth. Now, to assist and expand our resources in this effort, March of Dimes, the American Congress of Obstetricians and Gynecologists, California Maternal Quality Care Collaborative and the California Department of Public Health join together to reverse the trend of early, elective inductions and Caesarean sections – those done without medical indication.

With that goal in mind, we are launching an aggressive education campaign targeting women and physicians, and have developed educational tools and resources to reduce elective, non-medically necessary, early deliveries.

In California, many hospitals are assuming a leadership role to address elective deliveries before 39 weeks. To provide guidance and support to institutions, a new quality improvement tool has been developed in partnership with March of Dimes, California Maternal Quality Care Collaborative, and the California Department of Public Health’s Maternal, Child and Adolescent Health Division. The goal: ensuring that more babies get a full 40 weeks.

The tool kit, titled “Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age,” supports health care providers and hospital staff in changing delivery practices to eliminate elective deliveries. The kit includes educational materials focused on the adverse consequences of early elective delivery for patients as well as tools for health care providers and hospital staff to develop efficient and successful quality improvement programs.

Bending the curve on elective deliveries prior to 39 weeks gestation is no simple task. Accordingly, physician leaders and the March of Dimes California Chapter are working with hospital partners in four additional states – New York, Florida, Illinois and Texas – to pilot this new quality improvement tool. Together, these states, along with California, account for nearly 40 percent of annual births in the United States.

In light of these birth statistics, the successful implementation of this initiative could not only drive changes in birth outcomes in these “Big 5” states but also serve as a watershed moment for decreasing early deliveries nationwide.

The March of Dimes is partnering with the American Congress of Obstetricians and Gynecologists to help disseminate the tool kit that provides guidance in helping to ensure babies have a full 40 weeks of pregnancy. To view the tool kit or to learn more about healthy pregnancies visit www.marchofdimes.com and www.cmqcc.org.

Together, expectant parents, policy leaders, health care professionals and hospitals can make a difference in the health of the more than 500,000 babies born in California each year.


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