OBI 2019 Strategy to Reduce Primary Cesarean Delivery
The community of OBI hospitals will work to optimize care and support in the first stage of labor by focusing on the management of latent labor and arrest disorders for women at low risk for cesarean delivery as our strategy to safely reduce the primary cesarean delivery rate in 2019. Over the past three decades, evidence indicates that women admitted to the hospital during traditionally defined labor (<4cm) have a significantly higher risk of delivering by way of cesarean delivery than women who are admitted during active labor. Delaying admission until active labor can lead to 672,000 fewer epidurals, 67,232 fewer cesarean deliveries, 9.6 fewer maternal deaths, and an annual cost savings of $694 million (Tilden EL, Lee VR, Allen AJ, Griffin EE, Caughey AB. Cost-Effectiveness Analysis of Latent versus Active Labor Hospital Admission for Medically Low-Risk, Term Women. Birth. 2015;42(3):219-26).
OBI’s strategy supports the implementation of one of two evidence-based options:
Emphasizes timing of admission, shared decision making, and support in labor; and
Focuses on implementing approaches that support spontaneous progress of labor during the first stage of labor.
This first year of participation in OBI is about patient and provider education, as well as systems and relationship building.