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Warren Memorial Hospital recognized for reducing early elective delivery rate

From left, Warren Memorial Hospital President Patrick Nolan, women's care unit nurse Angel Jaquays, women's care unit Director Kim Shirley, women's care unit nurse Lisa Craft, Dr. Russell White and Dr. Robert Karmy of Shenandoah Valley OB/GYN, and nurse practitioner Mary Francis Turner, accept a banner from the March of Dimes recognizing the hospital's reduction in early elective deliveries. Katie Demeria/Daily (Buy photo)

By Katie Demeria

FRONT ROYAL -- A baby's brain doubles in size between the 36th and 39th weeks of the pregnancy, according to March of Dimes Community Director Lynn Downs.

Dr. Russell White of Shenandoah Valley OB/GYN said the lungs are not fully developed before the 39 week mark, either.

Some parents, however, choose to induce labor before 39 weeks, sometimes for convenience or because the mother is especially uncomfortable. Warren Memorial Hospital has been working to reduce the rate of early elective deliveries since 2009.

Early elective deliveries, according to Angel Jaquays, a nurse in the hospital's women's care unit, are cesarean sections or inductions done prior to the 39 week mark.

On Wednesday March of Dimes recognized Warren Memorial for reducing its early elective delivery rates to zero.

"I think it's amazing," Downs said. "For a hospital of this size, especially, it takes commitment."

Kim Shirley, director of the hospital's women's care center, has been working with the staff to reduce their rates since 2009.

The hospital developed a policy of refusing early elective deliveries except in special medical cases, such as when the mother has pre-eclampsia or severe asthma.

"Anything that can hurt the mom can hurt the baby," White said. "But the best incubator, whenever possible, is always the mother."

Warren Memorial's rate of early elective deliveries was steadily decreasing even when they absorbed the workload of Shenandoah Memorial Hospital's women's care unit after it closed in 2009.

"You can see, in 2009 when we went live, there was a spike in deliveries, but no increase in the rate of inductions," Shirley said.

Abraham Segres, vice president of quality and patient safety with the Virginia Hospital and Healthcare Association, said that out of the 53 hospitals in Virginia, 22 have met the March of Dimes' suggested goal of an early elective delivery rate of 5 percent.

Only around eight hospitals have entirely ended the practice though, he said, including Warren Memorial Hospital.

Segres said hospitals run into two major issues when trying to reduce their rates: their staff may not all agree that changing policies is the best route to go, and they may be battling a patient population that demands the service.

"Sometimes they have to work hard to balance patient satisfaction and safety," he said.

Downs said many people do not realize that pregnancies should last around 40 weeks, or 10 months. Waiting until the pregnancy is complete greatly reduces the chances of the child ending up in the neonatal intensive care unit.

"Labor is the best indication that a baby is ready to be born," White said. "Sometimes they just need to keep cooking."

Valley Health's Executive Director of Women and Children's Services Deena Lanham said Shirley's work has been taken to Winchester Medical Center, as well, the only other Valley Health hospital with a maternity ward.

Winchester Medical Center has not had any early elective deliveries since the middle of last year, Lanham said.

Downs said work like Warren Memorial Hospital's is vital in reducing the number of premature babies.

"We can never completely eradicate prematurity, but we can do what we can to reduce it," she said.

Contact staff writer Katie Demeria at 540-465-5137 ext. 155, or kdemeria@nvdaily.com

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