There have been many studies over the years on the impact of early birth on newborns. It has been found that inducing labor or performing caesarean sections without any medical reason prior to 39 weeks of gestation increase risks of complications and death for the newborn. There has been research that babies born at 38 weeks an increased likelihood of feeding, breathing, and developmental problems when compared to babies born at 39 or 40 weeks.
In one case, a mother was 37 weeks pregnant when her doctor scheduled her for a caesarean section the next week. The doctor said there was no reason to wait. When her son was born his lungs were not fully developed and one collapsed within hours. The newborn spent 13 days in the neonatal intensive care unit (NICU). Most of the days he spent there he was hooked up to a ventilator.
The American College of Obstetricians and Gynecologists has recommended since 1979 that labor not be induced or caesarean sections not be performed prior to 39 weeks except in cases where there is a medical reason. Despite this recommendation it is estimated that ten to fifteen percent of babies in the United States are delivered prior to 39 weeks when there is not a medical reason. Some patients push for early delivery for personal scheduling reasons or they do not want to be pregnant any more. Physicians may also schedule deliveries prior to 39 weeks in order to manage their schedules.
Now some doctors and hospitals are being penalized by insurers for delivering babies early without a medical reason. The goal of the insurers is to reduce stays in the NICUs and to avoid the medical costs of treating problems such as jaundice, feeding problems, and learning and developmental issues. One insurer has even begun paying hospitals more money provided they take steps to limit the number of early deliveries when there is no medical reason. Starting in July Medicare will require that hospitals report the number of elective deliveries that occur prior to 39 weeks. If their rates continue to remain high they may be penalized starting in 2015. Other insurers will not pay for such elective deliveries at all.
Some hospitals have stopped performing early deliveries without a medical reason on their own initiative. One hospital has done so after reviewing studies that show the negative impact early deliveries have on newborns. In the first year the NICU admissions of that hospital for babies born between 37 and 39 weeks dropped by 25 percent. Some doctors oppose these steps claiming that doctors will be discouraged from performing early deliveries even where there is a medical reason to do so.
Other doctors say such steps are necessary to create change. Another way to stop the trend of elective early deliveries is to educate expectant mothers. Many women believe it is safe to deliver before 37 weeks. Mothers who have the experience of how early delivery can negatively impact the health of their newborn have encouraged expecting mother to wait until it is safe to give birth and not to induce or have a caesarian section unless there is a medical reason.
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