Hospitals Urged to Track Quality in Obstetrics

Across the country, many hospitals are launching their own campaigns modeled after the March of Dimes', with names like "Worth the Wait," targeted for pregnant women, or instituting policies like "Hard Stop," which means a hospital's labor and delivery unit receiving a physician's request for an early elective delivery without documented medical necessity will just say no.

"A baby's brain at 35 weeks weighs only two-thirds of what it will weigh at 39 to 40 weeks," says the website of the Oregon and Washington state chapter of the March of Dimes.

Leapfrog, an effort launched 11 years ago by large employers to measure hospital quality to aid consumers and plan contractors make wise healthcare purchasing decisions, isn't stopping with the delivery process. Leapfrog is adding several metrics to monitor quality of care for newborns and their mothers, and is investigating the idea of adding more measures for prenatal care.

For example, the group is looking at practices for newborns and deliveries beyond whether gestation is allowed for 40 weeks, including:

• Episiotomy rates, which vary widely in vaginal births across the country, will be added to hospital reports as of April 1, Rudolph says.