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HCA limits C-sections, see fewer NICU admissions

HCA limits C-sections, see fewer NICU admissions

Posted: Wednesday, February 3, 2010 8:01 pm
By: AP

 NASHVILLE, Tenn. (AP) — HCA officials say their hospitals have seen a 16 percent decrease since 2007 in neonatal intensive care admissions for fullterm babies. Dr. Steven Clark, HCA’s medical director of women’s and children’s clinical services, told The Tennessean the drop corresponds with a perinatal safety initiative that includes limiting elective C-sections and inductions for women who have not reached their 39th week of pregnancy. The initiative has led not only to later C-sections, but also fewer. The first-time C-section rate has dropped between 10 and 15 percent, he said. HCA’s “initiatives have led to a dramatic reduction in bad outcomes,” Clark said. “But more importantly, there is clear evidence these initiatives have improved the care for countless mothers and babies.” March of Dimes Associate Director of Program Services, Tamara Currin, said some women chose to have an elective C-section or induction as early as the 34th week. Doctors sometimes allow it if the baby’s weight is good, but the baby’s lungs and brain may not be fully developed, necessitating hospitalization. A recent March of Dimes report card gave Tennessee an “F” for a premature birth rate of 14.2 percent. In October, the March of Dimes recognized Nashville-based HCA’s initiative as a model at a national conference. A presentation by Clark at the conference noted, “As a profession, we have become sloppy and regularly violate the standard of care set by our professional organization.” The American College of Obstetrics and Gynecology wants more hospitals across the country to use the 39-week-and-greater rule for elective deliveries. HCA hospitals include those in the TriStar Health System and Centennial Hospital in Nashville and account for about 5 percent of the nation’s births each year. HCA also mandates that all its nurses and doctors deliver babies following a checklist of identical birthing procedures and rules for high risk situations. The checklist includes things like reading fetal heart monitors the same way and ensuring all doctors use the same methods to deliver babies whose shoulders get stuck during the birth process. Published in The Messenger 2.3.10


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