S.C. makes strides to save babies

South Carolina, which has struggled for years to reduce its high infant mortality rate, has successfully reduced the number of early elective deliveries across the state. Experts believe this continued effort will save babies.

Sarah and Justin Sweat will welcome their first child into the world on March 30 — that is, if she arrives on schedule.

In the meantime, there’s not much Mom and Dad can do but wait.

“It could be any day now,” Sarah Sweat said.

They’ve stocked up on diapers and picked out a name. Last week, the Sweats still needed to figure out how to install Marli’s car seat so that they can safely bring her home from the hospital when the time comes, but that’s about it.

“It’s been on our list for three weeks,” she said. “I feel like we’re ready as we can be.”

Technically, Sarah and her doctors at Roper St. Francis could schedule an early induction to eliminate the element of surprise — labor, after all, is inherently unpredictable. But this self-described “planner” said she’d rather play it by ear.

“I definitely want to wait until she comes on her own,” she said. “It’s kind of exciting, too, not knowing.”

It’s also safer for Marli. Most infants should remain in their mother’s womb for a full 40 weeks. Scheduling an induction, without a compelling medical reason, during the 37th or 38th week of pregnancy may be convenient for a patient and her doctor, but it will increase the likelihood that the infant is born too small. Disorders relating to short gestation and low birth-weight were the leading cause of infant death in South Carolina in 2013.

The Post and Courier’s five-month “Cradle of Shame” investigation found the state’s infant mortality rate remains significantly higher than the national average and the rate of infant death in some rural counties mirrors rates in many third-world countries.

Even so, state leaders have recently made encouraging progress. The state’s 2013 infant mortality rate was lower than it’s ever been.

A new report published this month by the University of South Carolina Institute for Families in Society shows hospitals in the Palmetto State reduced the rate of “early elective inductions” among mothers who were at least one week removed from their due date from 8.8 percent in 2011 to about 4.4 percent in 2013. In fact, the Institute found 60 percent of all birthing hospitals in the state have stopped performing early elective inductions completely.

“Early elective deliveries result in poorer health outcomes for infants and higher health care costs,” Christian Soura, director of the South Carolina Department of Health and Human Services, said in a prepared statement about the report.

Newer data, not included in the USC report, indicates the early elective induction rate in South Carolina dropped even further by the end of 2014 to 2.5 percent.

“We’re on calls with other states in the nation frequently and for us to be this low is really exceptional,” said BZ Giese, director of the South Carolina Birth Outcomes Initiative.

Credit for the reduction goes to Giese and her group. Three years ago, they convinced the largest insurers in the state — Medicaid and BlueCross BlueShield of South Carolina — to quit paying hospitals for elective inductions among women who had not reached the 39th week of their pregnancy. Now, unless a mother needs to deliver her baby before 39 weeks for some urgent medical reason, the insurers will not pay the hospitals for early inductions.

Forty-five hospitals in South Carolina deliver babies. Eighteen still occasionally perform early elective inductions, Giese said.

Some of them may be simply coding their bills incorrectly. Others could be inducing early delivery deliberately, even though they know they shouldn’t do it.

“We want to assume that all of our doctors and all of our hospitals do not want to harm the babies,” Giese said. She would not disclose which doctors or hospitals still induce labor before 39 weeks gestation without a medical reason because the information is protected by state law.

But they’ll know for themselves soon enough. Giese said the Birth Outcomes Initiative and the Medicaid agency will send these doctors and hospitals a series of letters next week in an effort to further improve the statewide rate.

“They are responsible for working on their own numbers,” she said.

Reach Lauren Sausser at 937-5598.