Less than 39 weeks toolkit

In 2010, the Joint Commission established a new perinatal care core measure set that includes the number of elective deliveries (both vaginal and cesarean) performed at > 37 and < 39 weeks of gestation completed. In order to support hospitals in eliminating non-medically indicated deliveries before 39 weeks, March of Dimes, California Maternal Quality Care Collaborative (CMQCC), and the California Department of Health, Maternal Child and Adolescent Health Division collaborated on the development of a quality improvement toolkit. The new toolkit, entitled Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age; Quality Improvement Toolkit includes:

  • Making the Case: A comprehensive literature review about the importance of eliminating elective deliveries before 39 weeks.
  • Implementation: A step-by-step guide to assist hospital leaders with implementation efforts.
  • Data Collection and Quality Improvement: A guide for measuring and tracking QI effectiveness over time.
  • Clinician and Patient Education: Educational tools for clinicians and staff about consequences of early elective delivery; educational tools for patients about the importance of the last weeks of pregnancy.
  • Appendices: Sample Forms, Hospital Case Studies, QI Implementation Tools, Plan-Do-Study-Act (PDSA) Methodology, Implementation Resources and References.

March of Dimes is pleased to make the toolkit available to all hospitals across the country. Interested clinicians, hospitals, insurers and regional collaboratives are invited to download this document to assist in the development of a comprehensive quality improvement program to address elective deliveries <39 weeks. If your hospital is interested in implementing the toolkit, please consider working with your March of Dimes chapter. To find your local chapter, visit our directory.

Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age; Quality Improvement Toolkit was reviewed by the California Department of Public Health Maternal, Child and Adolescent Health Division and is a resource, but it does not define the standard of care in California. Readers are advised to adapt the guidelines and toolkit based on their local facility’s level of care and patient populations and is not to rely solely on guidelines presented here.

Download a free copy of the toolkit at the Prematurity Prevention Resource Center. Registration is required.

Most common questions

Does the March of Dimes provide information about birth defects?

Yes. The March of Dimes produces fact sheets on several birth defects, including autism, chromosomal abnormalities, cleft lip, congenital heart defects and Down syndrome. Simply type the name of the birth defect into the search box.

What happens during a preconception checkup?

A preconception checkup can help assure that a woman is as healthy as possible before she conceives. Her provider can identify and often treat health conditions that can pose a risk in pregnancy, such as high blood pressure, diabetes or certain infections. During the visit, the woman can learn about nutrition, weight, smoking, drinking alcohol and occupational exposures that can pose pregnancy risks. The provider also can make sure a woman’s vaccinations are up to date and that any medications she takes are safe during pregnancy. The woman and her provider can discuss her health history and that of her partner and family. If the woman or her partner has a history of birth defects or preterm birth or if either has a high risk for a genetic disorder based on family history, ethnic background or age, the provider may suggest seeing a genetic counselor.

What is a birth defect?

A birth defect is an abnormality of structure, function or metabolism (body chemistry) present at birth that results in physical or intellectual disabilities or death. Thousands of different birth defects have been identified. Birth defects are the leading cause of death in the first year of life.

See also: Common birth defects

What newborn screening tests does the March of Dimes recommend?

The March of Dimes would like to see all babies in all states screened for at least 31 health conditions. Many of these health conditions can be treated if found early.

All states require newborn screening for at least 26 health conditions. Some states require screening for additional conditions – some up to 50 or more. For more information, read our article on newborn screening.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).