The Support for Birth initiative was officially launched this month through two learning sessions for participating hospitals. The first session was held by webinar due to winter weather interfering with plans for hospital teams to travel to Winston Salem. While we regret not having the opportunity for teams in the western part of the state to interact in person, those teams presented key challenges to improving the vaginal birth rate and areas to focus their work over the next several months. At the second session in Raleigh, teams demonstrated strong commitment to implementing changes and making an impact on the rate of c-section among the NTSV (nulliparous, term, singleton, vertex) population.
Baseline data is in, and teams have received individual reports as well as a report of the aggregate data for the entire cohort of hospitals participating in this initiative. The PQCNC team will continue to mine the baseline data for associations that suggest specific courses of action. The baseline data suggests that many women are admitted “in labor” at cervical dilations of 3cm or less, and that many c-sections for failure to progress are performed without having assessed adequacy of contractions using an IUPC or, among those deliveries where an IUPC was used, without having reached 200 Montevideo units for a minimum of 2 hours. Consistent with large studies in the literature, the c-section rate among patients admitted for induction is significantly higher than for those admitted in spontaneous labor.
