Jan. 26 (UPI) -- Researchers from Beth Israel Deaconess Medical Center in Boston conducted a seven-year study of hospital-led interventions that showed a significant reduction in the rate of cesarean sections.
Cesarean sections, or c-sections, increase the risks of mortality, longer hospital stays and healthcare costs for mother and baby compared to vaginal delivery.
"The rate of cesarean delivery in low-risk women varies significantly from hospital to hospital across the nation, and such wide disparities suggest that some cesarean deliveries may be performed for reasons other than medical necessity," Dr. Mary A. Vadnais, a maternal-fetal medicine specialist, vice chair of the Obstetrics Quality Assurance Committee at BIDMC and first author of the study, said in a press release.
"Our research shows that quality improvement initiatives can significantly reduce cesarean deliveries in low-risk women, benefiting mothers and reducing health care costs."
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Researchers measured the impact a series of specific quality improvement interventions in hospitals had on the proportion of first-time mothers delivering single babies carried to at least 37 weeks in the vertex position delivered via c-section, known as nulliparous, term singleton vertex, or NTSV.
BIDMC obstetricians began implementing a series of interventions in 2008 that included interpretation and management of fetal heart rate tracings, provider tolerance for labor, induction of labor, provider awareness of NTSV cesarean delivery rates and environmental stress.
Results showed a reduction in NTSV cesarean rates from 34.8 percent to 21.2 percent, which is below the U.S. Department of Health and Human Services recommendation of 23.9 percent. The overall cesarean rate decreased from 40 percent to 29.1 percent.
"Since implementing these quality improvement measures, our department has seen a steady decline in our cesarean rate," Dr. Toni Golen, medical director of Labor and Delivery and Post-Partum at BIDMC and senior author of the study, said in a press release. "More importantly, with that decline we have not seen a clinically significant rise in complications among babies or mothers, which demonstrates the success of the interventions."
Because researchers used a series of interventions in the study, they could only determine a cumulative effect, not the impact of a single intervention.
The study was published in The Joint Commission Journal of Quality and Patient Safety.
