“Don't Rush Me . . . Go the Full 40” as a Public Health Strategy to Promote Spontaneous Labor and Normal Birth

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Childbearing Poster Presentation Purpose for the Program The "Don't Rush Me…Go The Full 40" campaign of the Association of Women's Health, Obstetric and Neonatal Nurses' (AWHONN) seeks to increase the percentage of women who complete at least 40 weeks of pregnancy and wait for spontaneous labor and to improve the effectiveness of maternity care professionals in reducing elective inductions and cesarean births. Proposed Change Women and their infants benefit from an intricate cascade of endocrine events that leads up to and facilitates labor and vaginal birth when labor occurs spontaneously. The results are shorter hospital stays, lower infection rates, increased breastfeeding, and faster recoveries with fewer complications. However, the induction of labor rate has doubled in the United States in the past 20 years, and the cesarean rate has increased 50%. A significant number of labor inductions are not medically necessary. Leading experts say that the overuse of labor interventions is a public health problem that exposes women and infants to unnecessary risks in the perinatal period and long-term, and results in considerable and unnecessary health care costs. Overuse of inductions increases long- and short-term maternal and neonatal morbidity, including obstetric hemorrhage, neonatal intensive care unit (NICU) admissions, less breastfeeding, overuse of cesarean, and infection. Because of persistent prematurity, increasing labor interventions, and increasing perinatal morbidity and mortality, AWHONN launched "Don't Rush Me . . . Go the Full 40" in 2012 as a grassroots, public health campaign about the benefits of a full-term pregnancy and spontaneous labor. Implementation, Outcomes, and Evaluation The goals of "Go The Full 40" are aligned with AWHONN's Nursing Care Quality Measures and complementary to efforts in progress at The Joint Commission, American Medical Association Physician Consortium for Performance Improvement, and the Centers for Medicaid and Medicare Services (CMS) to increase patient safety and quality of care. More than four states have implemented the campaign as a public health message, and CMS includes the campaign in its Strong Start tools to help reduce early and elective births. We present the major components and outcomes to date regarding the campaign's goals and objectives, including resources and toolkits, a 40 Reasons article, Spontaneous Labor Pledge, and the "Go The Full 40" Champions group. Implications for Nursing Practice We demonstrate how AWHONN's "Go The Full 40" campaign promotes spontaneous labor to improve maternal and neonatal health by helping to reverse current trends in perinatal morbidity and mortality. This poster equips nurses to champion the campaign in their institutions and communities.