Deliver babies on their timeline, not a mother’s

08/22/2014 3:57 PM

08/22/2014 3:57 PM

Most hospitals in Kansas City and the rest of Missouri no longer will induce labor or schedule a C-section until the pregnancy has gone to term. Pregnant women might have lost some choice about when they deliver their babies as a result, but they gained something far more precious: a better chance for a healthy outcome. That benefits everyone.

Early, scheduled deliveries seemed like a good idea once. People’s lives are hectic, and babies often decide to arrive at the most inconvenient times. Rather than worry about a midnight drive to the hospital for delivery, why not put it on the calendar? And while you’re at it, why not schedule it a little earlier than term to shave a couple of weeks off an uncomfortable pregnancy?

There are many reasons why not.

As more women and their doctors chose convenience deliveries, the evidence mounted that they were risky and costly to the health care system.

Babies born before the 39th week are more likely to have health challenges at birth. For example, their lungs and brains might not be fully developed, and their bodies might lack the fat they need to keep warm. Those early babies therefore often require time in a neonatal intensive care unit, which is expensive. Insurance companies and hospitals pass those costs onto everyone else.

Even with proper treatment, those babies might face lifelong health challenges because they did not get the full amount of time in the womb.

Mothers can encounter problems too, especially if they go to a C-section by choice or because labor-inducing drugs fail to result in a successful delivery. Like any surgery, a C-section has inherent risks. Many women will have no problems at all, but some will have complications that can range from almost trivial to deadly serious. Delivery by C-section affects how future pregnancies will go.

When the evidence became clear, the American College of Obstetricians and Gynecologists, Center for Medicare and Medicaid Services, and other groups began advocating for ending convenience deliveries prior to 39 weeks. (Full term is usually 39 or 40 weeks.)

They have had remarkable success. In just a few years, the rate of early deliveries nationally plummeted from about one in six to fewer than one in 20. In Missouri, they are almost nonexistent. Most hospitals in the state have decided to refuse early deliveries strictly for convenience. There are times when it is medically necessary, but simply accommodating a mother’s schedule is not one of them.

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