Maryland Reduces Early Elective Deliveries

Maryland currently has the 11^th highest cesarean section rates in the United States—about 35% of new mothers receive C-sections in the state which is 2% above the national average. But according to a recent report by the March of Dimes, one policy may be reducing those rates.

Since 2009 patient safety organizations in the state have worked to reduce rates of early elective deliveries, or births that voluntarily occur before 39 weeks of gestation either though elective labor induction or elective C-section.

According to the March of Dimes report, Maryland recently became the first state in the country to have all of its birthing hospitals work to reduce the rates of early elective deliveries and to drop elective delivery rates below 5% for six consecutive months. This recognition comes after many of the birthing hospitals in the state put a “hard-stop” on allowing mothers to choose an early elective delivery.

Up to 20% of all births in the United States occur before full term, or 40 weeks of gestation, which puts both the mother and baby at increased risk. The baby’s lungs, brain, and liver are some of the last organs to develop fully while the baby is in utero. The brain alone grows by one-third just between week 35 and 39. Babies born before 39 weeks can have temporary or permanent health problems, like lung and respiration issues, jaundice, and birth injuries.

Mothers who deliver preterm babies also face increased risks, especially if delivered through C-section. Mothers who have C-sections face a higher risk of excessive bleeding, infection, organ damage during surgery, problems breastfeeding, and even death. Most women will not be able to have a vaginal birth after a C-section.

Knowing the risks associated with premature delivery and C-sections can help reduce these rates of early elective deliveries. The rate of C-section in the US currently stands at 32.2%, about 20% above the rate recommended by the World Health Organization. Patients can look at studies, like the one by Consumer Reports, to research hospitals in their states with the lowest C-section rates.

The Consumer Reports study looked at over 1,500 hospitals in 22 states. The report noted the rates of C-sections in mothers who are expected to have a low-risk delivery, or women who haven’t had a previous C-section, are pregnant with only one child, and have a child who is properly positioned for natural birth, all making a C-section unnecessary.

The five Maryland hospitals rated the highest all came in at the middle of the scale (3 out of 5). They are:

• Garrett County Memorial Hospital
• MedStar St. Mary’s Hospital
• University of Maryland Medical Center
• University of Maryland Shore Medical Center at Chestertown Upper Chesapeake Medical Center
• Anne Arundel Medical Center

Reducing the rates of early elective deliveries will promote better health in new mothers and their babies. Shorter hospital stays and reduced risks will also lower healthcare costs associated with births. Maryland’s policy change takes the United States one step closer to healthier births.