Natural childbirth may not always be convenient. But when it comes to delivering a baby, every week makes a difference.

Evidence shows an unborn baby requires at least 39 weeks in the womb to develop fully. But the evidence has failed to slow the steady climb of elective preterm inductions and C-sections for convenience.

“Much of the care that women receive is not consistent with best evidence, despite the unprecedented body of comparative effectiveness research that is available to us in the field of maternity care,” said Maureen Corry, MPH, Executive Director of Childbirth Connection at Quality Quest’s annual board social held August 10 at Lakeview Museum. (Corry writes about her experience in Peoria in the Childbirth Connection blog.)

“That research is there to guide practice and policy, but the uptake is slow,” she said.

Women and providers need to break some bad habits associated with the most common hospital procedure, according to Corry. The rate of early elective deliveries exploded in recent years, with 18 percent of deliveries nationally in 2010 occurring too early, according to data released by the Leapfrog Group. The average for Illinois jumps to 23 percent.

The Leapfrog Group, an employer-driven hospital quality watchdog group, added the rate of elective pre-term births as a category to their 2010 annual hospital survey.

We are seeing the effects of a “socially engineered foreshortening of human gestation,” writes Carol Sakala, Corry’s colleague at the Childbirth Connection. Sakala continues: “Today’s healthcare delivery system is engaged in a sweeping uncontrolled experiment with our most precious resources.”

Important development takes place in the last few weeks of pregnancy. A baby’s brain at 35 weeks weighs only two-thirds of what it will weigh at 40 weeks. In the last six weeks of pregnancy, the baby adds connections needed for balance, coordination, learning and social functioning.

Babies born prior to 40 weeks are more likely to have problems with learning, behavior, feeding, and breathing. They are more likely to spend time in the Neonatal Intensive Care Unit (NICU) or die from Sudden Infant Death Syndrome (SIDS).

Such issues are associated with increased cost. At the same time, there is a perception among women and providers that scheduling delivery is cost-effective, in addition to convenient. Women also like the idea of ensuring their babies are delivered by their provider of choice, often unaware of the consequences.

In a 2009 survey, only 8 percent of 650 insured women correctly identified that 39-40 weeks was the earliest point in pregnancy where it is safe for a healthy woman to deliver a baby.

 “We have a lot of work to do to educate women that healthy babies are worth the wait,” Corry said.

Earlier this year, Quality Quest for Health of Illinois launched the Healthy Babies, Healthy Moms project to prevent elective preterm deliveries in Illinois. Quest’s goal is to expand on the Leapfrog data by reporting early delivery rates by clinician.

 “Robust performance measurement and reporting are critical to payment reform efforts to align financial incentives to quality care,” Corry said. Public reporting is essential in realizing change by shining a light on those that do comply with best care standards.

“Our maternity care system too often treats pregnancy and birth in healthy women as medical conditions or disease states rather than a normal life process,” Corry said. “The maternity care system in the US pays limited attention to ensuring that millions of healthy women receive appropriate care — high quality, high value care — and we know it is possible.”