December 10, 2014 — Almost 9% of births covered by Medicaid from 2010 to 2012 were elective deliveries that occurred before 39 weeks of gestation, according to a study published Monday in Health Affairs, Kaiser Health News reports.
According to KHN, Medicaid covers roughly 1.8 million deliveries per year, accounting for about half of all U.S. births. For the study, two state Medicaid medical directors and AcademyHealth looked at early elective delivery rate data from birth certificates and Medicaid in 22 states.
The study is the first large-scale study focused specifically on Medicaid births, KHN reports.
Overall, the study found that early elective deliveries accounted for 8.9% of all Medicaid singleton births between 2010 and 2012, representing about 160,000 deliveries annually.
Specifically, it found that 1.9% of all Medicaid singleton births were delivered for no medical reason before 37 weeks of gestation and that 7% were delivered before 39 weeks of gestation for no medical reason. By contrast, non-elective deliveries accounted for 67.7% of all Medicaid singleton births and full-term elective deliveries accounted for about 23.3% of such births.
According to the study, states' rates of early elective deliveries ranged from 2.8% to 13.7%. Individual rates for each state were not published. However, the researchers said that early elective delivery rates for the 12 states in which such data were available dropped from about 11% in 2007 to 8.2% in 2011.
Ideally, no deliveries should occur early without a medical reason, according to researchers and advocates.
The Altarum Institute's Tara Trudnak Fowler, lead researcher on the study, said, "A risk is being taken that doesn't need to be" when a delivery occurs early for no medical reason. She added, "Non-medically indicated [cesarean] sections and inductions performed less than 39 weeks are dangerous."
National Association of Medicaid Directors Executive Director Matt Salo said states should consider prohibiting reimbursements for early elective deliveries. According to KHN, South Carolina and Texas have already done so, while more than 20 states have established efforts to discourage the procedure (Galewitz, Kaiser Health News, 12/8).