Elective Delivery

What are we measuring and why?

 

MGH monitors the percentage of women who have an early elective delivery (EED) prior to 39 completed weeks of gestation. The final few weeks of a pregnancy are important for the development of a baby's vital organs, such as the brain, lungs, and liver. Between the 34th and 40th weeks of pregnancy, these organs grow as much as 50 percent. EEDs, in the form of a cesarean section (C-section) or induction without medical indication, are associated with an increased risk of neonatal complications such as:  

  • Neonatal intensive-care unit (NICU) admissions
  • Respiratory distress syndrome
  • Suspected and proven sepsis
  • Newborn feeding problems and other transition issues
  • Infant mortality

Medically unnecessary EEDs can also cause maternal complications, such as postpartum hemorrhage from labor induction, increased risk of infection, and increased risk of C-section (and repeat C-sections in future pregnancies). Additionally, the medication used to induce labor can have negative effects on both the mother and baby, which can interfere with the body's ability to recover from delivery and impact breastfeeding.

How are we doing and how do we compare to best practice?

Our performance for the latest reporting period, January to December 2016, was zero percent (0%). MGH achieved the best possible result.

  • Current Scores
  • Scores Over Time
  • Lower values are better
2% 0% 0%

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.

MGH: Jan - Dec 2016
CMS: Jan - Dec 2016

0 2 0 4 3 2 0 0 0

MGH Source: Hospital administrative data and chart review.
Comparison Group Source: CMS/TJC National Hospital Quality Measures.



What are we doing to improve?

While there may be circumstances that warrant an early elective delivery, MGH has made efforts to minimize these events by improving the accuracy by which estimated gestational age is tracked and requiring supporting documentation for early deliveries. Patient and provider education plays a major role in changing attitudes and behaviors to reduce the demand for EEDs.

MGH is committed to improving outcomes for both mothers and infants. In 2016, we were awarded the Baby-Friendly designation from Baby-Friendly USA, a credentialing program for hospitals that is part of an international breastfeeding initiative led by the World Health Organization (WHO) and the United Nations Children's Fund. You can read more about Baby-Friendly USA here.  Additionally, the Centers for Disease Control (CDC) conducts an annual survey of Maternity Practices in Infant Nutrition and Care (mPINC) for all hospitals that provide intrapartum care in the United States. For the most recent survey conducted in 2015, Massachusetts General Hospital achieved a score of 100, the highest possible result. You can learn more about the mPINC survey here and see our facility report here.

What can you do?

If you are considering an elective delivery before 39 weeks, it is important to discuss the potential risks and benefits with your health care provider, as well as your reasons for requesting this type of delivery. Women often request an elective delivery to relieve discomfort. Talk with your health care provider if you are experiencing these symptoms. They may be able to help you feel better and provide other suggestions and advice.

Sources

Adapted from

 

 

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