“The likelihood of first-time moms with low-risk pregnancies having a Cesarean section is most often determined by the hospital where they give birth.” — Michael Moxley, MD, OB/GYN, FACOG, Director of Obstetric Services.
In 2011, one in three women in the U.S. gave birth by Cesarean section, a 60% increase since 1996, according to the American College of Obstetricians and Gynecologists (ACOG). The rapid increase in Cesarean births raised concern that it was overused without clear evidence of improved maternal or newborn outcomes. New guidelines developed by ACOG and the Society for Maternal- Fetal Medicine in 2014 addressed how to safely reduce the rate of primary Cesarean births by allowing women to labor longer. (A primary Cesarean refers to moms giving birth for the first time for low-risk, uncomplicated deliveries.)
Over the past few years, Virginia Hospital Center has taken steps to significantly lower the number of primary Cesarean deliveries.
“Everybody came together, including OB/GYNs, maternal-fetal medicine specialists, midwives, our colleagues at Kaiser Permanente, hospital residents, labor & delivery nurses, and administrators and said we’re going to work hard at this. Their work included nurse and provider education focusing on first-time moms and allowing enough time for them to go into labor on their own.” — Mike Fernandez, MD, FACOG, Chair of OB/GYN.
And, that work has paid off. In 2014, Virginia Hospital Center’s primary Cesarean rate was 33%; currently, it’s 20.9% as of November 2016, compared to an average Cesarean rate of 32.7% at surrounding area hospitals.
“Our data shows that we were able to safely accomplish this without an increase in forceps, vacuum or episiotomies. There were no increases in birth injuries or admissions to the Neonatal Intensive Care Unit.” — Fran Williams, BSN, RN, RNC-OB, Patient Care Director, Labor & Delivery.
“This involved teamwork with administration, clinicians and staff working together with enormous determination to see results. The success of this effort was part of the reason the Hospital won the competitive Leapfrog Top Teaching Hospital award for 2016.” — Leah Binder, President & CEO of The Leapfrog Group, Forbes.com, December 2016.