Early Elective Deliveries in Mississippi: Impact on Health and Medical Care Costs

The growing practice of early delivery of infants for non-medical reasons is associated with higher rates of newborn admissions to hospital intensive care units and neonatal deaths.  As a result, the American College of Obstetricians and Gynecologists recommends scheduling elective deliveries until at least 39 weeks of gestation.

The Center for Mississippi Health Policy partnered with the Mississippi State Department of Health to analyze the available data on early elective deliveries in Mississippi. Data on birth trends, medical care costs, and best practices in use by other states were reviewed.  Key findings and policy considerations are outlined in an Issue Brief and highlighted below.

KEY FINDINGS

  • Mississippi reflects trends found nationwide, as all births at 37 and 38 weeks of gestation climbed significantly (p<0.01) from 2001 to 2011.  During the same time frame, all births at 39 weeks or later — elective or not — declined significantly (p<0.01).
  • From 2001 through 2011, early elective deliveries doubled statewide.
  • Babies born electively in Mississippi during 37 and 38 weeks of gestation had significantly higher death rates (p<0.05) within the first month of life compared to babies born at 39 weeks.
  • National data document higher neonatal intensive care admission rates for babies born electively during 37 and 38 weeks of gestation.
  • Some states have established policies which resulted in declines in the rate of early elective deliveries among Medicaid beneficiaries and have projected millions of dollars in cost savings as a result.

POLICY CONSIDERATIONS

The American College of Obstetricians and Gynecologists and the Association of State and Territorial Health Officials recommend the following policy options to address the health and cost impacts related to the practice of early elective deliveries:

  • Modify state payment policies to encourage health care providers to postpone elective deliveries until at least 39 weeks of gestation (e.g. payment withholding, penalties and/or bonuses);
  • Encourage hospitals to adopt policies to end elective, non-medically necessary deliveries before 39 weeks of gestation;
  • Partner with medical malpractice carriers to reduce premiums when providers receive education on the importance of reducing elective deliveries; and
  • Collect and report data on early elective deliveries in order to measure and monitor progress of policy changes.

Copies of the issue brief can be downloaded HERE. Printed copies of the issue brief are available by contacting the Center for Mississippi Health Policy at 601-709-2133 or by e-mail at info@mshealthpolicy.com.