Hospitals Tighten Rules for Elective Inductions, C-Sections Ahead of New Joint Commission Reporting Requirements

October 29, 2009 — In anticipation of new quality reporting requirements that will take effect in the spring, some hospitals are tightening rules for elective inductions and caesarean sections, the AP/Google News reports. National guidelines from the American College of Obstetricians and Gynecologists discourage elective deliveries prior to 39 weeks' gestation, but many physicians and hospitals allow inductions and scheduled c-sections at 37 weeks, according to the AP/Google News. According to the Centers for Disease Control and Prevention, one in five pregnancies is induced, double the rate in 1990. There is little data on the percentage of inductions that are elective, though a Hospital Corporation of America study of nearly 18,000 births at its 27 hospitals placed the figure at 10% of all births before 39 weeks. Recent research shows that infants born prior to 39 weeks face a higher risk of breathing disorders and other problems than those who remain in the womb longer.

The Joint Commission, which accredits hospitals, this spring will begin requiring hospitals to report all elective deliveries to a public database. Hospitals will also have to report gestational age at induction and c-sections for first-time births, which can be linked with failed inductions. "We believe this will be a very important driver of improvement in prenatal care," Mark Chassin, the organization's president, said (Neergaard, AP/Google News, 10/27).