With six months of data now available (two baseline months in October and November 2010, and four months of data collection during the active phase of the initiative, February – May 2011), the effects of all the work being done at SIVB hospitals is beginning to be seen. The c-section rate among the target population (nulliparous women at term with a singleton, vertex fetus, without contraindications to vaginal delivery, not admitted for scheduled c-section) across all participating hospitals was 22.19% in May 2011, compared to 24.77% at baseline, representing a 10% decrease. We are hopeful that this trend will continue in future months!
The July webinar focused on the challenges SIVB teams have expressed in terms of engaging physicians in some of the strategies hospitals are considering in order to promote vaginal birth, such as limiting or eliminating elective induction of labor. These strategies appear to be more widely accepted when they address common interests, such as minimizing congestion in the L&D unit, allowing more scheduling flexibility for medically indicted inductions of labor. Given the shared interests of those physician practices participating in the CCNC Pregnancy Medical Home program for Medicaid patients, which focuses on the primary c-section rate, and the SIVB hospitals, teams may want to consider partnering locally with the OB physician champion and OB nurse coordinator from the CCNC network.
