From the Louisiana Dept. of Health and Hospitals
Louisiana Department of Health and Hospitals Secretary Bruce D. Greenstein gathered with the Louisiana Hospital Association (LHA), the Louisiana State Medical Society (LSMS), the American College of Obstetricians and Gynecologists (ACOG) and other Louisiana health care leaders at Woman's Hospital to celebrate the 20 Louisiana hospitals that have demonstrated a commitment to healthier moms and babies through their participation in DHH's 39-Week Initiative.
DHH introduced the 39-Week Initiative as a key component of the Birth Outcomes Project, which was established to combat Louisiana's historically poor birth outcomes. The 39-Week Initiative is a voluntary program in which hospitals agree to establish policies to end the practice of elective, non-medically necessary deliveries prior to 39 weeks gestation. DHH officials have been meeting with the state's largest birthing hospitals to teach them about the 39-week Initiative, encouraging them to adopt the initiative and providing support for its adoption.
"I was genuinely shocked to learn how many births were being done early that weren't medically necessary. Too many doctors and too many women just don't fully understand the risks, even in a healthy pregnancy. That's what makes the 39-Week Initiative so effective, as it brings the government and private sectors together toward a common goal that benefits everyone," Secretary Greenstein said. "I want to thank ACOG, LHA, LSMS, LAMMICO, Woman's Hospital and East Jefferson General Hospital for partnering with DHH on this initiative from the very beginning. And I want to commend the hospitals that have signed on. As the first state to implement this type of project, we are truly pioneers, and I am proud to have such innovative leaders with me on this endeavor. While there are no simple solutions to infant mortality and prematurity, this is one relatively easy step that just makes sense."
Babies' organs, including the brain and lungs, continue to develop during the last few weeks of gestation. Babies who are born premature have a greater chance of newborn health complications, such as breathing problems, and often must spend time in the NICU receiving costly specialized care.
Louisiana consistently ranks poorly when compared to the rest of the nation in most reports, rankings, studies and analyses of health status.
For birth outcomes, the state's rankings are particularly troubling. The National Center for Health Statistics ranks Louisiana 49th in infant mortality, preterm birth and in the percentage of low birth weight and very low birth weight babies. Additionally, Louisiana earned a failing grade on the 2010 March of Dimes Prematurity Report Card, and at 38 percent, has the second highest C-section rate in the country.
Also joining Secretary Greenstein today was State Rep. Regina Barrow, who has served as a staunch advocate for reducing infant mortality and prematurity. She also joined Secretary Greenstein in November when he announced specifics of the department's Birth Outcomes Initiative.
"Last November, after the March of Dimes announced Louisiana had earned an 'F' on the annual Report Card, Secretary Greenstein and I stood on the steps of the Louisiana State Capitol, and we vowed to do everything in our power to help Louisiana produce healthier moms and babies," Rep. Barrow said. "This initiative is a positive step toward that goal, and it is with great pleasure that I join Secretary Greenstein today to acknowledge our partners and these hospitals for their tremendous efforts toward improving the health of Louisiana's babies - our state's future leaders - and their mothers."
The following hospitals have signed on to implement the 39-Week Initiative, vowing to eliminate all elective, non-medically necessary deliveries prior to 39 weeks gestation:
• Baton Rouge General Medical Center, Baton Rouge
• CHRISTUS St. Frances Cabrini Hospital, Alexandria
• E. A. Conway Medical Center, Monroe
• East Jefferson General Hospital, Metairie
• Lake Charles Memorial Hospital, Lake Charles
• Lakeview Regional Medical Center, Mandeville
• Lafayette General Medical Center, Lafayette
• LSU Health Sciences Center Shreveport, Shreveport
• North Oaks Medical Center, Hammond
• Ochsner Foundation, New Orleans
• Ochsner Medical Center-West Bank, Gretna
• Rapides Regional Medical Center, Alexandria
• Tulane-Lakeside Hospital, Metairie
• Touro Infirmary, New Orleans
• West Jefferson Medical Center, Marrero
• Willis-Knighton Pierremont Health Center, Shreveport
• Willis-Knighton South & Center for Women's Health, Shreveport
• Woman's Hospital, Baton Rouge
• Women & Children's Hospital, Lake Charles
• Women's & Children's Hospital, Lafayette
"The Louisiana Hospital Association is proud to be a strategic partner in the Louisiana Birth Outcomes Initiative," said John Matessino, president and CEO of the LHA. "We are excited that so many Louisiana hospitals have embraced the initiative and taken the necessary actions to improve birth outcomes, including adopting a statewide policy to eliminate elective, non-medically indicated deliveries prior to 39 weeks. The LHA applauds Governor Jindal, Secretary Greenstein, and Dr. Gee in their commitment to the health of Louisiana's infants and mothers."
Two hospitals that implemented the initiative prior to the department launching the statewide initiative have already seen the benefits firsthand. From 2007 to 2010, East Jefferson General Hospital reduced the number of elective inductions prior to 39 weeks from 503 to 16. Since implementing the initiative at Woman's Hospital in September 2007, neo-natal intensive care unit (NICU) admissions dropped 20 percent.
"Because healthy babies are worth the wait, the obstetricians and nurses at Woman's have supported the 39-Week Initiative since 2007. As a result, the admission of premature babies into our NICU has declined by 20 percent," said Teri Fontenot, Woman's Hospital president and CEO. "I am pleased that our staff's commitment to improving newborn health is serving as positive proof of the impact on newborns to other Louisiana hospitals adopting this initiative." At 8,500 births a year, Woman's is the largest obstetrics hospital in Louisiana and among the top 20 in the country.
As an added incentive, LAMMICO, a mutual insurance company that provides malpractice insurance for most Louisiana doctors, has partnered with the Department to offer physicians who participate in a "39 Week" training course an hour of continuing medical education (CME) credit. LAMMICO-insured physicians also will receive an hour of credit toward the two-hour credit needed for a 10 percent premium reduction at the next renewal.
"LAMMICO is proud to partner with the Louisiana Birth Outcomes Project to help educate physicians who dedicate themselves to improving the health of mothers and their babies," said Kenneth E. Brown, MD, MBA, FACOG, member of LAMMICO's Board of Directors. We believe that the people of Louisiana deserve exposure to the nationally held best health care practices, and we are pleased to play a role in making that goal a reality."
F. Dean Griffen, MD, President of the Louisiana State Medical Society said, "As medical professionals, we have a duty to treat our patients using approaches that are evidence-based to yield the best outcomes. The Louisiana State Medical Society applauds these hospitals, as well as their employees and members of their medical staffs, for choosing to take a stand against elective deliveries before 39 weeks gestation. It is our hope that this initiative will have a domino effect that leads to improved health outcomes not only in our state, but for the entire nation."
"The March of Dimes - Louisiana Chapter is pleased to partner with DHH's Birth Outcomes Initiative, Woman's Hospital, ACOG and others to address the issue of elective deliveries, it is best to stay pregnant at least 39 weeks if medically possible for the health of the baby," said Knesha Rose, Director of Program Services and Public Affairs of the Louisiana Chapter of the March of Dimes. "We look forward to continuing to share any information and resources to both providers and pregnant women, to give every baby a healthy start."
Compounding poor health outcomes is the financial burden associated with high labor and delivery costs. According to the March of Dimes, the average cost for premature infants in Louisiana is $33,000 compared to the national average of $4,000 for full-term newborns.
Secretary Greenstein added, "Last year, 65,429 babies were born in Louisiana, and Medicaid - the taxpayers - paid for nearly 70 percent of them. With approximately 7,000 premature births covered by the Medicaid program, the excess costs to the state exceed $200 million each year. This is unacceptable. Not only do our state's families deserve healthier moms and babies, our taxpayers deserve a better return on their investment. I encourage the rest of our state's hospitals to join their peers - the leaders standing with me today - to take these simple steps to building a healthier Louisiana."