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Early deliveries vary widely in Augusta

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When it comes to allowing mothers to choose to deliver early, there is a wide variation among Augusta hospitals, a national health care consulting group reported Thursday.

The Leapfrog Group presented results from its annual hospital survey of early elective deliveries – those babies delivered before 39 weeks’ gestation without a medical reason. The group is pushing hospitals to limit those deliveries to 5 percent or less of the total.

Doctors Hospital, which has had a policy of not allowing early elective deliveries since 2009, had a rate of 1.5 percent for 2012; University Hospital’s rate was 59.8 percent.

The report included only 15 hospitals in Georgia as many don’t want to take the time to fill out the group’s survey, said Leah Binder, Leap­frog’s president and CEO.

Of the 773 hospitals surveyed, 46 percent hit the target of 5 percent or less, up from 39 percent last year, and 75 percent showed improvement, she said.

“Still, we all need to do more to protect women and babies from this harmful practice,” Binder said.

According to a study just published, early delivery increases the chance of the baby experiencing problems by 200 percent, and waiting until 39 weeks reduces by 50 percent the chance of harm to the mother, said Dr. John D. Nash of the Geisinger Health System in Pennsylvania.

His health system reported no early elective deliveries last year. Evidence has been accumulating over the years about how important those last few weeks are for fetal development, Nash said.

“Just three weeks makes a huge difference in the neurological development of the infant,” he said.

Patients and physicians might be tempted to deliver early, particularly when the patient lives in a rural area where she must travel some distance to deliver, a problem for many in areas surrounding Augusta.

“It is a difficult problem to face,” Nash said. “But I would argue that when you are talking about the life of a baby and the lifelong disability that a baby may incur by early delivery, we just have to engineer the health care process so that we can optimize the outcome.”

Doctors Hospital made it a policy in 2009 not to do early elective deliveries after a companywide initiative presented evidence about how much better the outcomes would be for mother and child, said Annette Repko, Doctors’ director of women’s services. It took a lot of physician education and presenting of that evidence to win them over, she said, and she still sometimes has to work with new physicians on the staff who aren’t familiar with it.

While Doctors’ rate was reported as 1.5 percent, Rep­ko said it is probably only three cases, each with a medically valid reason.


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