CoIIN: Reducing Non-Medically Indicated Elective Deliveries Prior to 39 Weeks

Evidence suggests that non-medically indicated obstetrical procedures such as elective inductions and scheduled cesarean sections performed prior to 39 weeks have risen sharply in the United States over the past 20 years. Alabama is collaborating with multiple agencies to work toward the elimination of non-medically indicated elective deliveries across the state. The goal of the CoIIN initiative is to decrease to below three percent non-medically indicated deliveries in Alabama or for hospitals to have a hard stop policy in place.

Complications of non-medically indicated elective deliveries before 39 weeks gestation:

• Increased Neonatal Intensive Care Unit (NICU) admissions
• Increased risk of irregular heart rhythms
• Increased risk of respiratory distress syndromes (RDS)
• Increased risk of infection or sepsis
• Increased risk for the need for ventilator support
• Increased problems with feeding tolerance
• Increased risk of temperature instability

Resources

• Alabama Hospital Association
• Alabama Perinatal Excellence Collaborative (Alabama Medicaid Agency)
• Association of Women's Health, Obstetric and Neonatal Nurses
• Centers for Medicare & Medicaid Services: Strong Start for Mothers and Newborns Initiative
• Centers for Medicare & Medicaid Services: Strong Start for Mothers and Newborns Initiative Slideshow
• March of Dimes Week by Week
• March of Dimes: Pregnancy Time Lapse
• Initiative to Reduce Elective Deliveries Before 39 Weeks of Pregnancy Is It Worth It? (video)