[pamamidwife]

In a time where more and more hospitals are seeing rising cesarean rates as a positive thing, this is a perfect example of a hospital doing the best thing for their patients. I'm highly impressed:

Wisconsin Hospital Reduces Already Low C-Section
Rates

A methodical, proven approach to reducing
Cesarean section rates has paid off at Community
Memorial Hospital of Menomonee Falls in
Wisconsin. Using the QI Project's Indicator VI data
and quality improvement techniques learned by
participating in the Institute for Healthcare
Improvement (IHI) Breakthrough Series
Collaborative in Boston, MA, Community Memorial was
able to reduce their C-section rate from 14.8
percent to 10.6 percent in less than a year. At the
same time, they increased their Vaginal Birth
After Cesarean (VBAC) rate from 38 percent to 68
percent.

read the whole article online at
http://www.qiproject.org/TargetQuality/TQ1297.asp

 

[stafl]

That's great... considering.
But really, is 14.8% a low c-section rate to begin with, or is it just in comparison with the 26% national average that it looks good?

 

[1jooj]

My sister is a nurse at this hospital...but they only get sent to ob when census is low on their floor and high in ob.

The hospital I had ds at said their rate was between 12 and 13%. I thought that was pretty good, considering national averages and uninformed consumers.

Their VBAC improvement seems to be marked.

"therapeutic rest with morphine" for early labor seems kind of scary...but I know with my ds, had I been able to rest in early labor, I would have done better in the late stages. I KNOW this.

It's also good to know a hospital is doing something about the "dystocia" epidemic.

 

[pamamidwife]

I think that giving women something to rest in early labor vs augmenting with Pitocin, breaking the water, etc., is much more beneficial in the long run. Especially first time moms that have been up with each contraction all night. Typically, some good rest and they wake up in active labor.

I was impressed by the education of the docs and nursing staff that they require. They also sound like they want their staff to be committed to lower c-section rates and successful VBACs. That's pretty remarkable in today's environment, IMO!

 

[Greaseball]

Something I read: if the hospital has a CNM-staffed birth center attached, they often figure the center's c/s rates into their own, thus producing a lower rate. So, if the hospital rate is 19% and the birth center is 1%, the hospital can average these and then claim to have a rate of 10%. I also heard that some hospitals do not figure repeats into the statistics, and others omit either the electives or the emergencies.

Also, is it true that those other countries with the 5% c/s rates have high rates of forceps deliveries?

I hear that in hospitals with low c/s rates, they have high rates of episiotomies, just to make sure that either way they are going to cut you.

:

I have a plan to further reduce the rate: make a law that all elective c/s must be done at 3:00 a.m. on Saturday morning.

 

[mountainmommy]

greaseball...that was my chuckle of the night!!!! I wholeheartedly agree!

also of course, it would probably further reduce the rate to mandate that all c-sections must be immediately followed by skin-to skin time for mommy and baby, and a good nursing session, during which the ever- so -patient doc must politely twiddle his thumbs and wait for mom to say, "okay, you have my permission to cut the cord now, and I'm ready for you to wiegh my baby" etc etc...that'd probably assure that he was up until 4 or 5 or so, just for good measure