Perinatal Patient Safety: New Guidance on the Timing of Medically Indicated Births Before 39 Weeks Gestation
Kathleen Rice Simpson PhD, RN, FAAN

$3.95 		MCN, The American Journal of Maternal/Child Nursing
April 2012 
Volume 37  Number 2
Pages 136 - 136
 
  PDF Version Available!

ABSTRACT
Despite the national focus on eliminating elective births before 39 completed weeks of gestation, a list of maternal and fetal conditions recommended by the American College of Obstetricians and Gynecologists (ACOG, 2009) that may warrant early birth, and an algorithm for decision making from The Joint Commission (TJC, 2009) as part of the Perinatal Care Core Measures, controversies remain regarding what constitutes a medically indicated late preterm or early term birth. This issue often is a source of clinical disagreements when nurses are asked to take part in medically indicated labor inductions and cesarean births for which they do not support the indication as consistent with published guidelines and current evidence. At times the indication is contrary to ACOG recommendations such as macrosomia or request by the physician or patient. Other indications may seem "soft" such as "impending" preeclampsia with normal laboratory data. Nurses who are responsible for evaluating the medical

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