39-WEEKS DELIVERY CHARTER PROJECT

OPQC’s first OB initiative aimed to reduce unnecessary scheduled births at 36 0/7 to 38 6/7 weeks gestational age in the obstetrical units of 20 of the largest hospitals in Ohio.  This topic was selected because infants born between 36 0/7 and 38 6/7 weeks gestation have increased rates of morbidity and mortality compared to infants born at 39 – 40 weeks.  The rate of scheduled births between 36 0/7 and 38 6/7 weeks gestation without a documented medical indication declined from above 15% to less than 5% in participating OPQC hospitals between September 2008 and September 2010. During this same interval, birth certificate data indicates that inductions of labor without documentation of a medical or obstetrical indication between 360/7 and 386/7 weeks declined from 13% to 7.5% and have since remained stable. 

Ohio Department of Health (ODH) Vital Statistics (VS) data confirms the impact of this OPQC initiative. Births between 36 and 38 weeks declined, with a corresponding increase in births between 39-41 weeks coincident with the initiation of the Scheduled Birth project. An estimated 6,000 births have moved from before to after 39 weeks each year, avoiding 180 NICU admissions annually.  Currently, OPQC is working on spreading the 39-Week project to other maternity hospitals around the state.

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