About the Issue: Elective Delivery Prior to 39 Weeks of Gestation
Between 1990 and 2006, the United States saw a 50% increase in deliveries at 37 weeks 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 until at least 39 weeks. Nonmedically indicated deliveries between 37 weeks and 39 weeks of gestation pose increased health risks for both the mother and the baby.
Key Messages of the Initiative
Studies have shown that long- and short-term adverse outcomes may be avoided or prevented if a healthy pregnancy is allowed to continue until at least 39 weeks of gestation.
Clinical evidence shows that a fetus has a significant amount of development and growth in several key organ systems between 37 weeks and 39 weeks of gestation.
If the mother and the baby are healthy, wait to deliver until at least 39 weeks of gestation. An infant born prior to 39 weeks faces a 20% greater risk of significant medical consequences.
Key Activities of the Initiative
The NCMHEP Coordinating Committee first began to explore the issue of risks associated with late preterm birth (34 weeks to 36 weeks of gestation) after the 2008 Surgeon General's Conference on the Prevention of Preterm Birth. Research showed that that there was an increased risk of negative outcomes for infants born prior to 39 weeks of gestation. Therefore, the Committee decided to create an initiative entitled Is It Worth It? to educate health care providers and patients about the risks associated with nonmedically indicated elective deliveries before 39 weeks. The first phase of outreach focused on educating health care providers. The NCMHEP developed a continuing medical education (CME)/continuing education (CE) 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/CE course, the NCMHEP created the Is It Worth It? videos for patients about the risks of delivery prior to 39 weeks of pregnancy without any medical indication. The videos continue to be shared online and played in providers' offices across the country.