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Amid rising evidence revealing the overuse of labor-inducing drugs for preterm births and other common delivery room practices increase the risks of cerebal palsy and other birth defects, hospitals are implementing new programs to make childbirth safer.
Hospital groups are conceiving new policies to discourage or prohibit inducing births before the 39-week minimum recommended by experts, unless it's medically necessary. Limiting the use of drugs such as oxytocin to speed up contractions, as well as curtailing the use of vacuums and forceps to coax infants from the birth canal will also help reduce birth risks that can cause devastating harm to newborns.
New programs aimed to increase teamwork and communication in delivery rooms to ensure both doctors and nurses interpret fetal monitors and other fetal distress signals are also being implemented.
In recent years, there has been a huge rise in elective inductions. Researchers have found that delivering babies even several days early is linked to higher rates of emergency c-sections, neonatal intensive-care unit admissions, respiratory complications, and other long-term conditions such as cerebral palsy.
Various hospital groups including the nonprofit Institute for Healthcare Improvement and Kaiser Permanente perinatal patient safety program offer a streamlined set of practices and safety programs to improve the outcome of childbirth.
Kaiser's training program for doctors and nurses involves drills of simulated fetal or maternal emergencies with a mechanical baby. “Emergencies are rare events in labor and delivery, so it's hard to keep your skills up,” says Annie Herlik, Kaiser Permanente director or national risks management.
Hospitals have also begun educating expectant mothers on the risks of early inductions as well as the use of oxytocin, a hormone given during labor to speed up contractions, which can slow blood supply and oxygen to the fetus causing life-long disabilities such as cerebral palsy.
According to the Institute of Healthcare Improvement, reviews of medical malpractice cases show oxytocin is involved in over 50 percent of birth traumas.
These new practices have already helped hospitals meet or exceed targets of decreasing birth injuries. The rate of birth trauma has fallen to almost zero from three per thousand. Furthermore, doctors utilize forceps and vacuums only 4 percent of the time compared with 7.5 percent before the programs were launched.
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