A 31 year-old Gravida 6 Para 5 (6 pregnancies, 5 births) at 40 weeks gestation arrived at her local hospital with ruptured membranes and uterine contractions every 3-5 minutes. On exam by the nurse, the mother was 5 cms dilated, 75 percent effaced, cephalic presentation at -2 station. The amniotic fluid was clear and the fetal heart tone tracing was Category I (normal). She denied any significant health history or major surgeries, including prior cesarean births.
Under the Healthy People 2020 initiative, hospitals are encouraged to reduce rates of elective cesarean deliveries for low-risk, first-time births to less than 23.9 percent. Since 2016, Smart Care California has included hospitals that have achieved that milestone on its hospital honor roll. The honor roll — a collaborative effort among stakeholders that represent policy, purchases, providers and quality improvement organizations — will be announced the week of Oct. 22.
One of every eight babies born in the United States is born in California. Of those births, three in 10 are delivered by cesarean. Many California hospitals, big and small, have instituted processes to maintain low cesarean delivery rates.
HQI is offering registration scholarships for the 2017 HQI Annual Conference to the 30 birthing hospitals that participated in the Promoting Optimal NTSV Delivery Rates (PONDR) survey. There are a total of 10 scholarships available.
The HQI Annual Conference takes place on November 1-3 in Monterey, CA. Details about the conference are available by clicking here.
Case: A 28-year old G1 P0 (first pregnancy, no prior births) at 39 weeks is thought to have a large baby. The ultrasound estimated fetal weight (EFW) is 9 lbs. The patient was considered overweight with a BMI of 29 and the total weight gain during pregnancy of 45 lbs. The patient’s glucose screen was negative. The physician recommended a primary Cesarean delivery because the baby was “big” and the mother will most likely end up with a Cesarean regardless. At delivery the baby weighted 7 pounds, 8 ounces.
The California Maternal Quality Care Collaborative (CMQCC) is excited to announce the kick off of the 2017 statewide quality improvement collaborative “Supporting Vaginal Birth and Reducing Primary Cesareans.” Your hospital is invited to participate in this initiative at no cost thanks to funding by the California Health Care Foundation.
The American College of Obstetricians and Gynecologists (ACOG) District IX is pleased to announce an opportunity for hospitals in California to participate in a statewide quality improvement project to Promote Vaginal Birth and Reduce Primary Cesarean Births. The first 35 hospitals in the state to sign up will receive their training at no cost.
The Toolkit is a comprehensive, evidence-based “how-to” guide designed to educate and motivate maternity clinicians to apply best practices for supporting vaginal birth. Cesarean births among low-risk, first-time mothers have been the largest contributor to the recent rise in cesarean rates, and accounts for the greatest variation in cesarean rates between hospitals.
The Toolkit contains key strategies and resources to:
Secretary Diana Dooley of the California Health and Human Services Agency recognized 104 hospitals with a 2016 award for achieving the Healthy People 2020 goal for low-risk, first-birth Cesarean sections (C-sections). These hospitals reached the goal in 2015.