Elective Delivery Study Press Release and Graphic

Sacramento, California | Friday, April 5, 2013

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Definition of language used in this news release:

  • Early term birth:   37-38 completed weeks gestation;
  • Full-term birth:  refers to 39 to  41 weeks completed gestation;
  • Preterm or premature birth:  before 37 completed weeks gestation;



Article in national health journal shows drastic drop in medically unnecessary, early deliveries

Sacramento, CA | APRIL 8, 2013 – A study published today in Obstetrics & Gynecology shows that multistate, hospital-based quality improvement programs, including those piloted in California, can be remarkably effective at reducing early elective deliveries of babies. 

The rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason) in a group of 25 participating hospitals significantly decreased from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline. California hospitals participating in the research study included Sutter Roseville Medical Center, Sutter Medical Center, Sacramento, Mills-Peninsula Health Services (Burlingame), San Gorgonio Memorial Hospital (Banning), Mission Hospital (Mission Viejo) and El Centro Regional Medical Center.  A graph representing the drop in early elective deliveries can be found at http://www.marchofdimes.com/california/news_10616.html.

The March of Dimes, which partly funded the initiative, says this is good news because babies delivered before full-term are at increased risk of serious health problems and death in their first year of life.

“This quality improvement program demonstrates that we can create a change in medical culture to prevent unneeded early deliveries and give many more babies a healthy start in life,” says Bryan T. Oshiro, MD, of Loma Linda University School of Medicine and lead author of the study.

“Reducing unnecessary early deliveries to less than 5 percent means that more babies stayed in the womb longer, which is so important for their growth and development,” says March of Dimes California Chapter Associate State Director Leslie Kowalewski. “Overall, this project saw a decrease in the proportion of babies born at 37 and 38 weeks and a corresponding increase in the 39-41 week range during the one-year period studied.”

A group of multi-state hospitals, including six in California, piloted a toolkit called “Elimination of Non-medically Indicated (Elective) Deliveries before 39 Weeks Gestational Age” to guide changes in early term delivery practices.  The toolkit was developed in partnership with the March of Dimes, the California Maternal Quality Care Collaborative and the California Maternal Child and Adolescent Division within the California Department of Public Health. It can be downloaded free from the Prematurity Prevention Resource Center at prematurityprevention.org.

“Across our entire Northern California network, we’ve partnered with expectant moms to hold off on elective deliveries before 39 weeks of pregnancy―because it is the best thing we can do for our mothers and babies,” said William Gilbert, M.D., medical director of Sutter Women’s Services for Sutter Health’s Sacramento Sierra Region. “Since 2010, we’ve seen a nearly 90 percent drop in electives deliveries before 39 weeks of pregnancy across Sutter Health. Our work means even more babies are born healthier and go home sooner.” 

These hospitals in California are among the first in the nation to participate in a multi-state collaborative of perinatal quality improvement advocates with state health departments, academic health centers, and March of Dimes chapters from the five most populous states in the country. 

“Mission Hospital saw a tremendous improvement in the reduction of early deliveries. While much effort was needed to change the mindset of our physicians, after realizing the overall benefits to the babies, the support was overwhelming,” said Marvin D. Posner, M.D., Medical Director of Maternal-Fetal Medicine at Mission Hospital. “Our staff worked diligently to achieve these results, and we are so proud to have been part of such an impactful study that not only benefits the lives of babies born here at Mission Hospital, but also sets a precedent for encouraging hospitals across the country to do the same.”

In California, more than 500,000 babies are born each year, accounting for nearly 13 percent of all births in the United States. Together with Florida, Illinois, New York and Texas these five states account for an estimated 38 percent of all births in the U.S.

The March of Dimes urges hospitals, health care providers, and patients to follow American College of Obstetricians and Gynecologists guidelines that if a pregnancy is healthy, to wait for labor to begin on its own.  The final weeks of pregnancy are crucial to a baby’s health because many vital organs, including the brain and lungs, are still developing.

 “A Multistate Quality Improvement Program to Decrease Elective Deliveries Before 39 Weeks,” by Dr. Oshiro and others, appears in the April 8 online edition of Obstetrics & Gynecology.

                The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org. Find us on Facebook and follow us on Twitter.


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About March of Dimes

March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs and provide education and advocacy so that every baby can have the best possible start. Building on a successful 80-year legacy of impact and innovation, we empower every mom and every family.

Visit marchofdimes.org or nacersano.org for more information. Visit shareyourstory.org for comfort and support. Find us on Facebook and follow us on Instagram and Twitter.