Reducing C-sections among low-risk, first-birth mothers
Birthing hospitals nationwide have been under pressure to reduce their C-section rates. According to the CDC, the overall C-section rate in the U.S. increased by 60% from 1996 through 2009, hitting a high of 32.8% from 2010 to 2012. But hospitals are making steady progress – the CDC reported that in 2020, 31.8% of all births were by C-section.
Although there is a heavy focus on driving down the C-section rate, OB hospitalists know there are situations where this delivery method is the safest option for mother and baby. Because a cesarean birth is surgery with potential complications, health professionals want to ensure that low-risk mothers are given the appropriate time and support to deliver vaginally. The rate of low-risk C-sections spiked to 28.1% in 2009 but has since come down to 25.9% in 2018.
Progressive efforts to improve C-section rates
Healthy People 2030 set a national target for low-risk, first-birth c-section deliveries at 23.6%, and many states are making great headway. California, for instance, has reached a statewide average of 24.5% for low-risk, first-time births. Although California has not quite reached the 23.6% target, 111 hospitals across the state met or exceeded this goal.
The concern around C-sections has reached a broad, national audience as mainstream media outlets have begun to report individual hospital C-section data. Families can now compare maternal care data online and make informed decisions about where they would like to deliver. In a study from the American Journal of Obstetrics and Gynecology, researchers found that the likelihood of a C-section can depend highly on the hospital in which the woman gives birth. Both large-scale and smaller community hospitals have become hyper-aware of their C-section rates and are beginning to monitor rates for OB/GYNs and OB nurses individually to ensure compliance and safety.
How OB hospitalists can support hospitals in reducing C-section rates
OB hospitalists play a special role on L&D teams and can make a direct and immediate impact on medically unnecessary C-section rates, effectively helping reduce C-section rates.
Here are some of the ways an OB hospitalist's presence can positively impact a hospital’s C-section rate:
- Because OB hospitalists do not have private practices and are in the hospital 24/7, they have the time to support women during vaginal labor under safe and low-risk circumstances. This eliminates the convenience factor that still exists among some OB/GYNs.
- OB hospitalists partner with hospital patients and families on a regular basis to help get them through labor and delivery via open and honest communication, helping to assuage anxiety and fear in expectant mothers.
- OB hospitalists help with admission and management protocols to ensure the L&D team doesn’t call for a C-section prematurely.
- Hospitalists support midwives, family medical doctors, and private OB/GYNs by acting as obstetric consultants.
- Being in the labor and delivery unit consistently, OB hospitalists are more comfortable with fetal heart rate monitoring strips and distinguishing tracings that can determine the need for a C-section.
- The American College of Obstetricians and Gynecologists (ACOG) Committee on professional standards guidelines suggests that decision-to-delivery interval (DDI) and emergency cesarean section (CS) should not be more than 30 minutes. By having an OB hospitalist on-site 24 hours a day, hospitals can meet this goal, increasing patient safety and reducing risk.
One of OBHG's hospital partners recently saw a substantial reduction in their C-section rate. OB hospitalists collaborated with hospital leadership and community physicians to lower the rate from approximately 40 percent down to 20 percent within a three-month span.
The team attributes this success to several initiatives, including:
- Increased awareness and visibility into C-section rates per OB/GYN and OB nurse
- Obstetrics nurses stepping up to become advocates for their patients
- Weekly team calls to review and discuss recent C-sections in the hospital
This OBHG hospital partner proved and agreed that making simple changes in communication can drastically move the needle on their C-section rates.
If your hospital is facing challenges of C-section rates in labor and delivery units, partnering with Ob Hospitalist Group could help improve and reduce these. Our experienced team of clinicians are determined to improve maternal outcomes for expectant mothers and reduce C-section rates in hospitals nationwide. Learn more about how our partnerships work and reach out to speak with us today regarding what a hospital partnership could provide your team.
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