title: Changes in the indications for scheduled births to reduce nonmedically indicated deliveries occurring before 39 weeks of gestation.
abstract: OBJECTIVE
  To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation.
  
  
  METHODS
  Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were categorized as: strong medically accepted reasons for delivery; intermediate acceptability; and unnecessary before 39 weeks. We describe each of these indication categories as a proportion of all deliveries in the participating hospitals between October 2008 and December 2009.
  
  
  RESULTS
  The percentage of scheduled deliveries that were unnecessary before 39 weeks or had intermediate indications decreased over time (P=.03). There were 145 fewer with intermediate reasons and 265 fewer that were unnecessary when the first 4 months of the project were compared with the last 4 months. Strong medical indications as a percentage of all deliveries did not change significantly over time (P=.99).
  
  
  CONCLUSIONS
  Our quality collaborative reduced scheduled deliveries of medically unnecessary and intermediate indications for delivery at 36 0/7 and 38 6/7 weeks. However, scheduled deliveries with strong medical indication did not change significantly over time.
  
  
  METHODS
  III.
authors: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, and Center for Health Care Research and Policy, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA. jbailit@metrohealth.org
authors: Jennifer L
authors: JL
authors: Bailit
authors: Jay
authors: J
authors: Iams
authors: Angela
authors: A
authors: Silber
authors: Michael
authors: M
authors: Krew
authors: David
authors: D
authors: McKenna
authors: Michael
authors: M
authors: Marcotte
authors: Edward
authors: E
authors: Donovan
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005865:Gestational Age; D006801:Humans; D009820:Ohio; D011247:Pregnancy; D058996:Quality Improvement / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000706:statistics & numerical data / Q000639:trends*