About the NCMHEP
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) came together with more than 30 of the nation’s most prominent maternal health care provider associations, federal agencies, nonprofit maternal and child health organizations, and other partners to create the National Child & Maternal Health Education Program (NCMHEP). Our objectives are to identify key challenges in child and maternal health, review relevant research, identify research gaps, initiate activities, and propose solutions to advance the field. The NCMHEP coordinating committee chose late preterm birth and reducing elective deliveries before 39 weeks of pregnancy as its first topic. Visit the NCMHEP coordinating committee page for a full list of organizations.
About the Issue: Elective Delivery Prior to 39 Weeks’ Gestation
Between 1990 and 2006, the United States saw a 50% increase in deliveries at 37 to 38 weeks of gestation.1 During that period, the rise in rates for elective inductions outpaced the medically indicated induction rates.2 In a healthy pregnancy, it is safest for both baby and mother to allow the baby to remain in the womb at least 39 weeks. Non-medically indicated deliveries between 37 and 39 weeks’ gestation pose increased health risks for both mother and baby.
Key Messages of the Initiative
- Studies have shown that long- and short-term adverse outcomes may be avoided if a healthy pregnancy is allowed to continue until at least 39 weeks’ gestation.
- Clinical evidence shows that a fetus will have a significant amount of development and growth in several key organ systems between 37 and 39 weeks’ gestation.
- If mother and baby are healthy, wait to deliver until at least 39 weeks’ gestation. An infant born prior to 39 weeks faces a 20 percent greater risk of significant medical consequences.
Reducing Non-Medically Indicated Elective Deliveries Prior to 39 Weeks of Pregnancy
The NCMHEP is working to reduce the number of non-medically indicated elective deliveries by educating doctors and patients about the risks associated with elective delivery prior to 39 weeks. The first phase of outreach focused on educating health care professionals. The NCMHEP developed a continuing medical education (CME) course for nurses and doctors that discussed the latest research about and best practices surrounding reducing elective deliveries prior to 39 weeks. To complement the CME course, the NCMHEP created the Is It Worth It? videos about the risks of delivery prior to 39 weeks’ of pregnancy barring any medical indication. The videos will continue to be shared online and played in doctors’ offices across the country.
- Martin, J. A., Hamilton, B. E., Ventura, S. J., et al. (2012). Births: Final data for 2010. National Vital Statistics Reports, 6(1). Hyattsville, MD: National Center for Health Statistics.
- Zhang, X., Joseph, K.S., & Kramer, M.S. (2010). Decreased term and postterm birthweight in the United States: impact of labor induction. American Journal of Obstetrics and Gynecology, 203, 124, e1-7.G.