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Non-Medically Indicated Deliveries <39 Weeks Provider Survey
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1.
Do you offer or perform non-medically indicated deliveries <39 weeks (deliveries done for non-medical reasons)?
(Required.)
Yes
No
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2.
When is the earliest gestational age that you feel it is safe to deliver for non-medical reasons?
(Required.)
<36 weeks
36 weeks
37 weeks
38 weeks
39 weeks
40 weeks
41 weeks
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3.
Please rank the top three reasons (1 = most often and 3= least often) your patients give when requesting or scheduling a <39 weeks delivery.
(Required.)
1- Most often
2
3- Least often
Scheduling convenience
1- Most often
2
3- Least often
Uncomfortable, tired of being pregnant
1- Most often
2
3- Least often
Prior pregnancy complications
1- Most often
2
3- Least often
History of rapid labor/lives far away
1- Most often
2
3- Least often
Wants to be delivered by her doctor
1- Most often
2
3- Least often
Not applicable - patients do not request elective deliveries
1- Most often
2
3- Least often
Other (please specify)
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4.
For healthy normal pregnancies do you present the option of an induction prior to 39 weeks gestation?
(Required.)
Yes
No
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5.
For healthy normal pregnancies do you present the option of a scheduled repeat cesarean section prior to 39 weeks gestation?
(Required.)
Yes
No
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6.
Do you think it is safe to delay scheduled non-medically indicated deliveries (elective inductions and elective cesareans) until after 39 +0 weeks?
(Required.)
Yes
No
7.
If you do not think it is safe to delay scheduled non-medically indicated deliveries until after 39 + 0 weeks, please explain why:
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8.
Which of the following do you think will occur if non-medically indicated deliveries <39 weeks are eliminated? (Check all that apply)
(Required.)
Increase in stillbirths
Increase in macrosomia and/or shoulder dystocia
Increase in preeclampsia
Decrease in stillbirths
Decrease in NICU admissions
Decrease in cesarean deliveries
None of the above
9.
Does the possibility of a malpractice lawsuit play a role in your decision for an early term induction?
Yes
No
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10.
Which of the following are valid medical indications for induction < 39 weeks according to ACOG?
(Check all that apply)
(Required.)
Maternal intolerance to late pregnancy
Excess edema, backache, indigestion, insomnia
Prior shoulder dystocia
Suspected fetal macrosomia
All of the above
None of the above
11.
In your opinion, what non-ACOG reasons exist for performing inductions <39 weeks?
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12.
What is your preferred method for calculating gestational age for your patients (Choose one)?
(Required.)
Last Menstrual Period
First Trimester Ultrasound
Second Trimester Ultrasound
Third Trimester Ultrasound
Doppler FHT + for 30 weeks
+hCG for 36 weeks
Other (please specify)
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13.
How do you manage patients who present late for care with a prior cesarean section? (Check all that apply)
(Required.)
Deliver at 39 weeks based on best available data
Perform amniocentesis for fetal lung maturity
Wait for onset of labor
Deliver at or after EDC
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14.
Is there consistency among practitioners at your hospital for calculating gestational age before scheduling a <39 weeks delivery?
(Required.)
Yes
No
Unknown
15.
Does your hospital currently have any of the below in place?
(Check all that apply)
Hospital policy to eliminate non-medically indicated deliveries <39 weeks
Standardized scheduling guidelines that outline the accepted medical indications for <39 weeks deliveries
Medical leadership which enforces hospital policy that denies scheduled deliveries <39 weeks which do not meet the scheduling guidelines
A quality improvement initiative to eliminate non-medically indicated deliveries <39 weeks
Procedure to collect data on <39 weeks non-medically indicated deliveries
Other (please specify)
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16.
If your hospital has a <39 weeks delivery policy, could a physician intentionally circumvent it?
(Required.)
Yes
No
Not applicable – my hospital does not have such a policy
17.
If yes, what reason(s) could be used? (Check all that apply)
Pain
Early labor
Deteriorating fetal status
Other (please specify)
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18.
Do you think your hospital performs too many early term inductions?
(Required.)
Yes
No
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19.
Rank the barriers that your hospital faces in trying to decrease < 39 weeks non-medically indicated deliveries. (1= Largest Barrier and 6= Smallest Barrier)
(Required.)
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Physicians’ knowledge of non-medically indicated early term delivery health outcomes vs. full term health outcomes.
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Staff knowledge of non-medically indicated early term delivery health outcomes vs. full term delivery health outcomes.
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Patient knowledge of non-medically indicated early term delivery health outcomes vs. full term delivery health outcomes.
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Providing real time data for hospital staff about rates of non-medically indicated early term deliveries
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Consistent support and enforcement by medical leadership.
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
Concern about establishing correct gestational age of the fetus.
1- Largest Barrier
2
3
4
5
6- Smallest Barrier
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20.
What best influences you to change practice especially on an issue like <39 weeks non-medically indicated delivery? (Rank the top three)
(Required.)
Most influential
Somewhat influential
Least influential
Published scientific research
Most influential
Somewhat influential
Least influential
ACOG published materials
Most influential
Somewhat influential
Least influential
Grand rounds or other professional education presentations
Most influential
Somewhat influential
Least influential
Hospital policy
Most influential
Somewhat influential
Least influential
Patient demands
Most influential
Somewhat influential
Least influential
Peer-to-Peer sharing
Most influential
Somewhat influential
Least influential
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21.
Please indicate the hospital level where you maintain privileges and perform most of your deliveries.
(Required.)
RPC
Level 3
Level 2
Level 1
I no longer practice obstetrics
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22.
How long have you been practicing obstetrics?
(Required.)
<5 years
6-10 years
11-20 years
21-30 years
>30 years
I do not currently practice obstetrics
23.
Which sub-specialty do you practice?
I am not a sub-specialist
Gyn-Oncology
Reproductive Endocrinology
Maternal-Fetal Medicine
Urogynecology
Other (please specify)
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24.
Which of the following communication techniques do you prefer to use? (Check all that apply)
(Required.)
Webinars
Conference calls
In-person off-site trainings
Hospital grand rounds
Hospital department meetings
Mailed documents
Emails with attachments
Newsletters
25.
Would you be willing to serve as an advocate for implementing a comprehensive program at your hospital to eliminate non-medically indicated deliveries < 39 weeks?
No
Yes
If yes, please supply your contact information below:
26.
The first 200 individuals to complete this survey will receive a $5 Starbucks gift card. Please include your name and mailing address below.
