Change can be glacial in health care, but that hasn't been the case with Minnesota's campaign to reduce early elective inductions of childbirth.

A group of 85 Minnesota hospitals — which provide 99.8 percent of deliveries in the state — has instituted "hard stop" policies that discourage medically induced labor unless there are legitimate medical reasons. Since 2010, they have reduced elective inductions occurring before 39 weeks gestation by a remarkable 94 percent.

That's an estimated 1,752 deliveries that weren't induced early.

A recent national study of births funded by state Medicaid programs also found Minnesota had a lower proportion of early elective inductions than other states.

Elective inductions grew in popularity in recent years, partly for the convenience of parents and doctors to plan deliveries around other events. There were even tales at this time of year of parents scheduling births before January so their children could be tax deductions.

Then came pushback from public health officials, who noted that childbirth even a week ahead of schedule increases the risk of complications and the need for costly neonatal intensive care. Risks include elevated chances of respiratory distress during childbirth, sepsis and neurological complications for the newborn.

In response, Minnesota adopted an incentive program managed by the Minnesota Hospital Association and supported by federal grants. The Minnesota Department of Human Services also played an influential role, given that its Medicaid programs for pregnant women and low-income families cover more than four in 10 births in the state.

Rather than banning the practice, the state supported hospitals' hard-stop policies, in which doctors had to get permission from their administration before performing early elective inductions. This allowed for rare exceptions that might be permissible, such as scheduling births before fathers deploy overseas, said Jeff Schiff, medical director for Minnesota's Medicaid programs.

The progress suggests the approach was correct, he said. "A lot of us see this as a winnable battle."