A meaningful partnership: Strong Start
ACOG was invited to partner with the HHS and the March of Dimes on an initiative designed to bring about a meaningful and lasting improvement in maternity care: ending early elective deliveries before 39 weeks’ gestation. At the press conference announcing this partnership on the Strong Start initiative, Dr. Lawrence stood with HHS Secretary Kathleen Sebelius and said, in part:
- An ObGyn’s job is one of the most rewarding jobs on the planet, bringing little babies into the world. This job carries enormous responsibilities, too, ensuring the highest levels of health and safety for every mom and baby.
- The American College of Obstetricians and Gynecologists is proud to partner with the Department of Health and Human Services and the March of Dimes on one of the most certain ways of helping babies get a good start in life: Babies should not be delivered earlier than 39 weeks, unless pregnancy complications require otherwise to keep mother and child safe.
- Such a simple change, but one that can tremendously benefit children, families, our health system, and our society.
- Our joint initiative will help bring this important information to women and physicians across the nation, and has enormous potential to make a real and lasting change in how we care for expectant moms, and more importantly, how expectant moms expect us to care for them.
The Strong Start initiative is an all-too-rare example of a wonderful partnership between government, medicine, and the public to lead and create important change. This initiative goes far beyond the original press conference. Dr. Lawrence and other leaders have participated in webinars and interviews to spread the word. ACOG has developed patient education materials tailored to the message of no early elective deliveries before 39 weeks unless there is a maternal or fetal medical indication. Strong Start has provided funding to innovative maternity care models, including centering and pregnancy medical homes.
Earlier this year, Dr. Lawrence convened a Strong Start summit of the heads of the American Hospital Association, AAFP, AAP, the American Women’s Health and Neonatal Nurses Association, the American College of Nurse Midwives, the March of Dimes, and our federal partners, the Centers for Medicare and Medicaid Services and the Center for Medicare and Medicaid Innovation.
This one-day summit had a clear goal: gain unanimous agreement and commitment from the maternal care community to move our clinical knowledge into practice, ending nonmedically indicated early elective deliveries before 39 weeks.
Since 1979, ACOG has emphasized that labor should be induced “when the benefits of delivery to the fetus or the mother exceed the benefits of continuing the pregnancy,” and that pregnancies should be maintained until at least 39 weeks unless medical indications make early delivery necessary. This guidance was based on sound clinical knowledge in 1979, and today’s data are only more compelling. Somehow, however, early elective deliveries are still common and, for a variety of reasons, usually not related to infant or maternal health. This Strong Start summit is our specialty’s way of leading through partnership to encourage every maternity hospital in America to have in place a practice policy supporting no nonmedically indicated early elective deliveries before 39 weeks.
In many important ways, Strong Start is an example of the best that partnership with government and our colleagues has to offer.
The difference between partnership and interference is easy to see. That’s why we say: Partnership, yes. Interference, no.
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