When data shows unnecessary cesarean births are putting patient lives at risk, it’s up to us, as healthcare providers, to act on an institutional level.
Recently South Shore Hospital teamed-up with Ariadne Labs, a joint venture between Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, to implement the Team Birth Project, an initiative that aims to reduce the number of cesarean deliveries (C-sections) and improve the overall experience for mothers, their birthing partners, and their newborns. The hospital was chosen by the innovation group because of its strong desire to build a better system of care during childbirth.
Under this model, there’s an increased focus on empowering patients to make the best medical decisions for themselves and their babies through improved communication. By making a mother an integral part of their care team, we’re delivering better outcomes.
Why Reducing the Number of C-sections is Important
While, when medically necessary, cesarean deliveries can save the lives of both mothers and their infants, there is a point of diminishing returns. According to the World Health Organization, the ideal rate for cesarean deliveries is between 10% and 15% of births within a given population. More or less than that range and you begin to see an increase in fetal and maternal deaths.
Currently in the United States, 32% of all deliveries are done by C-section. This is thought to be a contributing factor to the rise in maternal morbidity and mortality rates. According to the Centers for Disease Control and Prevention, the number of pregnancy-related deaths has been steadily increasing – 7.2 per 100,000 live births in 1987 to 18.0 per 100,000 live births in 2014.
As a response, hospital systems across the country are actively attempting to reduce that rate and, quite frankly, save thousands of mothers’ lives.
How the Team Birth Project is Different
At its core, the Team Birth Project is our effort to ensure that every patient has a safe and dignified childbirth experience. This involves two critical elements: improved communication between labor and delivery teams and mothers and their birthing partners, and better decision-making tools to avoid unnecessary C-sections.
The centerpiece of this communication component is a simple whiteboard mounted in a birthing suite. On this board, the most important information is clearly laid out and easily accessible to staff and the patient: birthing preferences, team members, post-delivery plans for both mothers and infants, labor progress, and next steps. In addition, there are bedside huddles with the care team and patient in which information is discussed and decisions are made.
Labor and delivery teams also have access to tools to help decide whether a patient needs to be admitted to the hospital – generally, the longer a mother is in the hospital, the more pressure there is to have a cesarean delivery – as well as tools to help determine whether a C-section is appropriate or necessary given a patient’s individual factors.
By focusing on improved communication across the board, we’re making mothers active participants in their care and empowering them to play a central role in the decision-making process during childbirth, especially as it relates to cesarean sections.
How We’ve Moved the Needle
In the year we’ve been part of the Team Birth Project, we’ve seen some promising results. Cesarean sections for first-time, full-term mothers have decreased by nearly 4% and patients have reported a significant improvement in the quality of their overall birthing experience.
While we’d like to see the number of cesarean births decrease even more, it’s clear that communication is a piece of that puzzle. By giving mothers and their partners a say in what goes on in the birthing suite and direct line of communication with their labor and delivery team, we’re improving outcomes in meaningful ways.
Whether you’re a new mom, a mom-to-be, or a maybe-someday, learn more about the fertility, pregnancy and childbirth services available through South Shore Health.