Reducing Early Elective Births Could Save $1B Annually

Cheryl Clark, for HealthLeaders Media , January 26, 2012

Leapfrog embarked on the labor and delivery project because despite increasing evidence that babies need at least 39 weeks of gestation for proper development, unnecessary Cesareans were the standard of care rather than an exception at some hospitals.

Even a few weeks prematurity can result in respiratory complications requiring expensive ventilation, nitric oxide therapy, placement on a heart-lung machine and problems with brain development. Experts suggest there is a 4% increased risk of mortality in babies born between 37 and 39 weeks.

In addition to increasing the risk of fetal development problems for their newborns, women who electively give birth prematurely to babies between 37 and 39 weeks in the absence of medical necessity dramatically raise the cost of care, even if there are no complications.  An uncomplicated vaginal birth was estimated to cost $9,415 in 2008, according to a Thomson Reuters analysis, while the cost of an uncomplicated Cesarean was $13,329.

If there are complications requiring an average of 11 days in a neonatal intensive care unit, that could cost an extra $33,000, said Billie Lou Short, MD, Chief, Neonatology, Children’s National Medical Center in Washington, D.C. Her hospital last year took care of about 143 newborns requiring intensive care because their mothers underwent elective early delivery, and about 20% were preventable. "It's close to $1 million (in extra costs) for these kids who are transferred here," she said.

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