Waiting. In our daily lives, we greet it with frustration, and even irritation. But when it comes to childbirth, the time we spend waiting can affect whether a child is born healthy, or not, and sets a baby on a path toward lifelong health.
The U.S. Department of Health and Human Services (HHS) recently launched an important initiative, Strong Start, to prevent premature births, a public health problem that costs society an estimated $26 billion a year. That initiative aims to improve prenatal care for pregnant women, but its focus is also on curbing the unsafe practice of scheduling elective, medically unnecessary deliveries before the 39 week mark.
That's an important step, but more must be done to reduce the threat posed by elective deliveries of healthy babies before 39 weeks, which often are scheduled for reasons that have more to do with convenience than with health.
More than half a million infants are born prematurely in the United States each year, a number that has increased 36 percent since the early 1980s. We also know that 25 percent of those births are due to early elective deliveries -- either by inducing labor early, or by scheduling a cesarean section.
That's a dangerous trend that continues, despite a growing body of scientific studies that indicate that babies born before the 39 week mark run a high risk of underdeveloped organs, infections and other health problems that can lead to disabling conditions that can last a lifetime.
Some women mistakenly believe there's no harm in scheduling a C-section a few days or a few weeks early. That's part of the reason why HHS will, as part of the new initiative, launch a public education campaign. And to hammer home the message, HHS is partnering with a variety of professional and consumer groups, such as the American College of Obstetricians and Gynecologists and the March of Dimes.
The HHS Strong Start initiative will help to change a system that for too long has allowed healthy babies to be born before 39 weeks. Women and their doctors must stop scheduling early C-sections for non-medical reasons. In addition, hospitals and health systems must adhere to standards set by professional organizations that have tried to push for change. Since 2009, for example, the American College of Obstetricians and Gynecologists has recommended against unnecessary induction before 39 weeks, and for the last two years, the Leapfrog Group, a coalition of public and private purchasers of employee health benefits, has been publicizing information on specific hospitals and how well they do in delivering babies at full term.
Insurers are starting to take action as well. The Texas Medicaid program will not pay for early deliveries -- unless hospitals and doctors can prove they are medically necessary. And private insurers such as Aetna now ask hospitals to report their rate of early deliveries -- and post the rate on a public website.
Yet millions of medically unnecessary deliveries still get scheduled early before 39 weeks. That is a threat that's got to stop. The HHS initiative is a good start, but we all have to join in this movement: We can, and simply must, do a better job when it comes to giving babies this first shot at a healthy life.
Follow Deborah Klein Walker on Twitter: www.twitter.com/@DKWpublichealt