As we continue to move towards lowering our cesarean section rate among our targeted patient population (nulliparous women at term with a singleton, vertex fetus, without contraindications to vaginal delivery and not admitted for scheduled cesarean), we have seen a 14.69% decrease in cesareans! This work truly represents a collaboration of hospitals as it is not the result of a few hospitals showing large changes, but a gradual decrease among multiple hospitals.
Our largest downward trend is the cesarean section rate of patients with one or more risk factors such as diabetes, obesity, advanced maternal age, or hypertensive disease (38.17% to 27.97%). We are also seeing that patients not in labor on admission have a 32.19% cesarean rate as compared to patients IN LABOR on admission (14.52% cesarean rate), meaning patients NOT IN LABOR on admission have over twice the likelihood of having a cesarean section.
There has been a slightly downward trend in documented labor support methods of assistance and support from families/friends. There has also been a decline in the 1:1 nursing care which may be related to this typically being the time of year with the highest volume of patients on most labor & delivery units.
