St. Joseph’s restricts early-delivery requests
TAMPA - A policy restricting scheduled births at St. Joseph’s Women’s Hospital is part of a renewed national push to get docs and moms to avoid deliveries of convenience. In 2011, St. Joseph’s was one of 25 hospitals across the country that stopped allowing obstetricians to schedule early-term induced labors and cesarean sections without a clear medical reason. Early-term deliveries are those happening in week 37 or 38 of gestation. A study released today in the journal Obstetrics & Gynecology found the hospitals were able to reduce scheduled births from 27.8 percent of their early-term deliveries to 4.8 percent in a 12-month period. The rate at the Tampa hospital dropped from 38.6 percent to 3.3 percent. Karen Howell, St. Joseph’s Women’s director of patient care services, said all early-term requests had to pass muster with a two-member obstetrician panel, which usually denied requests and encouraged colleagues to promote a full-term birth.“It was important to have a physician’s voice to say this doesn’t really merit” an early, scheduled delivery, Howell said of the policy, which was part of a national March of Dimes education plan. The Department of Health and Human Services says between 10 and 15 percent of the nation’s babies are delivered early each year without medical cause. The associated risks have prompted insurance companies and even the government to discourage the practice. The practice could result in potential financial penalties for hospitals with too many early elective deliveries. As a result, many hospitals in the Tampa area and elsewhere have started reviewing their policies. While just a few dozen of the almost 7,000 babies delivered at St. Joseph’s each year fall in this category, the medical and financial consequences of early deliveries are significant. Fewer babies were born with low body temperature, poor feeding ability and underdeveloped respiratory systems, Howell said. “These kids are fine at birth … it’s usually after eight to 12 hours that problems develop and obstetricians aren’t always aware,” she said. So far this year, St. Joseph’s hasn’t had a single scheduled early-term delivery, she said.
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