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Health Beat: A Minnesota hospital curbs early births

  • Article by: Maura Lerner
  • Star Tribune
  • February 23, 2013 - 4:49 PM

 

It’s an open secret that, sometimes, doctors have been willing to hurry the process of childbirth without any real medical reason. They may induce a woman to give birth early because she’s too uncomfortable, for example, or because it’s more convenient than waiting for nature to take its course.

But now, there are signs that hospitals are putting the brakes on that trend — specifically, what they call “early elective inductions.”

And at least one Minnesota hospital has been leading the charge.

Last week, a national survey by the Leapfrog Group found that early elective inductions — those before 39 weeks of gestation — had dropped from 14 percent to 11 percent of all births in 2011.

At Fairview Southdale Hospital in Edina, the rate was zero.

That was no accident, said Samantha Sommerness, a Southdale nurse midwife and one of the leaders of a project called the “Red Rule.” As in, drawing a red line against early inductions, except for medical reasons.

Sommerness said the hospital started the project in 2007, as evidence was building that early inductions were more dangerous than people used to think. For many years, a baby was considered full term at 37 weeks. But new risks were turning up: Scientists found that newborns were more likely to have respiratory distress, and end up in intensive care, at 37 or 38 weeks than at 39 to 41 weeks. And that the brain was still maturing in those last few weeks. That prompted the March of Dimes, among other groups, to call for a halt in early inductions.

“We said, we’ve got to do this,” Sommerness said. The staff drew up new guidelines requiring doctors to certify a medical reason to schedule an induction. If not, she said, the hospital wouldn’t schedule it.

Some doctors complained, she said, but eventually the policy took hold.“It was definitely a culture change,” she said.

In 2009, about 6 percent of Southdale’s births were induced early. It’s now been zero for almost two years. “We really were kind of ahead of the game,” she said.

maura.lerner@startribune.com

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