Published Resources & Toolkits


SAFE REDUCTION OF PRIMARY CESAREAN BIRTHS BUNDLE

SUPPORT INTENDED VAGINAL BIRTH/ PHYSIOLOGIC BIRTH

LABOR PRACTICES

     A.      LATENT LABOR

Delay of Latent (Early) Labor Admission - For Providers & Hospitals  

Delay of Latent (Early) Labor Admission - For Patients

     B.      INDUCTION OF LABOR

     C.      INTERMITTENT FETAL HEART RATE (FHR) MONITORING OR                            AUSCULTATION

     D.      LABOR SUPPORT

     E.      coping with labor

F. DOULAS

PROVIDER EDUCATION

CESAREAN DELIVERY UTILIZATION REVIEW

PATIENT EDUCATION- LABOR & BIRTH

QUALITY IMPROVEMENT


SAFE REDUCTION OF PRIMARY CESAREAN BIRTHS BUNDLE

· Toolkit to Support Vaginal Birth and Reduce Primary Cesareans and Implementation Guide. CMQCC 2016.                                                                                                                      · Introduction to the Toolkit to support vaginal birth and reduce primary cesareans. Presented by Elliott Main and David Lagrew. CMQCC Webinar 2018.                                                          · Statewide Initiative to Support Vaginal Birth and Reduce Primary Cesareans. CMQCC Slides 2016.                                                                                                                                    · Safe Reduction of Primary Cesarean Birth (+AIM). Council on Patient Safety in Women’s Health Care.                                                                                                                                    · Safe reduction of primary cesarean births: supporting intended vaginal births. Council on Patient Safety in Women’s Health Care (2015). Slide Set.                                                                      · Safe reduction of primary cesarean births: supporting intended vaginal births. Council on Patient Safety in Women’s Health Care (2015). Audio Recording.

SUPPORT INTENDED VAGINAL BIRTH/ PHYSIOLOGIC BIRTH

·  Toolkit to Support Vaginal Birth and Reduce Primary Cesareans and Implementation Guide. CMQCC 2016.                                                                                                                      · Statewide Initiative to Support Vaginal Birth and Reduce Primary Cesareans Presented by Elliott Main and Anne Castles CMQCC Webinar 2016.                                                                        · Statewide Initiative to Support Vaginal Birth and Reduce Primary Cesareans. CMQCC Slides 2016.                                                                                                                                    · What is Physiologic Birth? Birthtools.org                                                                                · Reducing Primary Cesareans. Birthtools.org.                                                                            · Supporting Healthy and Normal Physiologic Childbirth: A Consensus Statement by ACNM, MANA, and NAPCM, 2012.                                                                                                  ·  Perinatal Quality Collaborative of North Carolina, SIVB: Supporting Intended Vaginal Birth, or "Support for Birth". Retrieved from: http://pqcnc.org/initiatives/sivb                                          · Good News for Women and Babies: New Toolkit Aims to Help Providers and Hospitals Support Vaginal Birth and Reduce Number of Unnecessary Cesareans. Maureen Corry, 2016. National Partnership for Women and Families.                                                                               · Physiologic Birth versus Cesarean Section. National Partnership for Women and Families (2015).                                                                                                                              · Leadership and cesarean section reduction. CMQCC slide.

LABOR PRACTICES 

A.   LATENT LABOR                                                                                                            ·  Latent Labor Management. Presented by Beth Stephens-Hennessy CMQCC Webinar 2017.        · Latent Labor Management. CMQCC Slide Set 2017.                                                              · The choice of progestogen for the prevention of preterm birth in women with singleton pregnancy and prior preterm birth. Society for Maternal-Fetal Medicine (SMFM) Publications Committee (2017), B11-B13                                                                                                                    · SMFM Preterm Birth Toolkit. Society for Maternal Fetal Medicine.                                        · Medically indicated late-preterm and early-term deliveries. American College of Obstetricians and Gynecologists. (2013) 560.                                                                                                  · Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. Society for Maternal-Fetal Medicine Publications Committee, Vincenzo Berghella (2012): 206(5): 376-386.                                                                                                                                · Timing of indicated late-preterm and early-term birth. Catherine Spong, Brian Mercer, Mary D’Alton, Sarah Kilpatrick, Sean Blackwell, George Saade. Obstetrics & Gynecology (2011). 118(2): 323-333                                                                                                                                · Preterm Birth: The Clinical Problem Epidemiology and Outcomes. Society for Maternal Fetal Medicine, Brian Mercer.                                                                                                          · CMQCC My Birth Matters campaign: Tips for a Healthy Birth: 5 ways to reduce your risk    of a C-section                                                                                                                              · Latent Labor Management. Presented by Beth Stephens-Hennessy CMQCC Webinar 2017.          · Latent Labor Management. CMQCC Slide Set 2017.       

Delay of Latent (Early) Labor Admission - For Providers & Hospitals

· ACNM Healthy Birth Initiative – Reducing Primary Cesareans – Promoting Spontaneous Progress in Labor Bundle · Calgary Health Region - Latent Phase of Labour Policy (includes home management of latent phase of labor and therapeutic rest policy) · Washington State Hospital Association Safe Deliveries Roadmap - Best Practice Bundles (Labor Management Bundle includes criteria for delayed admission, algorithm and checklist for spontaneous labor, and many more labor tools)

Delay of Latent (Early) Labor Admission - For Patient

· Lamaze International - Keep Calm and Labor On. Know what to Expect in Early Labor (infographic) · AWHONN Go the Full 40 Campaign (toolkit, grand rounds slide deck, and multiple patient downloads and infographics) · ACNM– Share with Women – Am I in Labor? (includes decision tree to assist women with deciding whether they are in labor and when to go to hospital)

B.  INDUCTION OF LABOR                                                                                                          · Induction of Labor Beyond the ARRIVE Trial. Presented by Elliott Main and David Lagrewl. CMQCC Webinar 2017.                                                                                                        · Induction of Labor Beyond the ARRIVE Trial. CMQCC Slide Set 2017.                                · Induction of Labor Webinar: Risk, Benefits, and Techniques for Increasing Success. Presented by Elliott Main and David Lagrewl. CMQCC Webinar 2017.                                                          · Induction of Labor Webinar: Risk, Benefits, and Techniques for Increasing Success. CMQCC Slide Set 2017.                                                                                                                      · Induction of Labor. Journal of Midwifery & Women’s Health, 2017. 62(4): 509-510.                  · Inducing labor: A way to avoid a cesarean? Toni Golen, Harvard Medical School (2018).

C.  INTERMITTENT FETAL HEART RATE (FHR) MONITORING OR AUSCULTATION · Intermittent Fetal Monitoring: A strategy for Reducing Primary Cesareans. Presented by Holly Smith CMQCC Webinar 2017.                                                                                        · Intermittent Fetal Monitoring: A strategy for Reducing Primary Cesareans CMQCC Slide Set 2017.                                                                                                                                    · Intermittent auscultation for intrapartum fetal heart rate surveillance. American College of Nurse-Midwives, CMQCC (2017).                                                                                                    · Fetal Heart Rate Monitoring in Labor. Journal of Midwifery & Women’s Health, 2014. 59(6).      · Assessment of Fetal Well-Being. Birthtools.org                                                                          · Fetal Heart Rate Monitoring During Labor. The American College of Obstetrics and Gynecologists.

D.  LABOR SUPPORT                                                                                                            · Coping with Labor. Birthtools.org                                                                                    · Promoting Comfort in Labor. Birthtools.org     

E. COPING WITH LABOR & LABOR SUPPORT

1.      Webinar by Dr. Leissa Roberts that introduces the Coping with Labor Algorithm©, explains why we need to think about pain differently for the laboring patient, and how to implement the algorithm.

2.      The Coping with Labor Algorithm© Roberts, L., Gulliver, B., Fisher, J., & Cloyes, K., (2010). The coping with labor algorithm: an alternate pain assessment tool for the laboring woman. Journal of Midwifery & Womens Health,55(2), 107-116. doi:10.1016/j.jmwh.2009.11.002

3.      CMQCC model policy Freedom of Movement. Copyright © 2014 Springer Publishing Company, LLC.

4.      BirthTools.org has a great section on coping with labor, including a toolbox of resources.  They provide topic related improvement stories, audit tools, model policies, algorithms, education and staff training resources, patient education, position statements and guidelines, and a promoting comfort in labor bundle.

5.      Effective January 1, 2018 the Joint Commission released their updated and revised pain assessment and management standards.

6.      ACOG Committee Opinion: Approaches to Limit Intervention During Labor and Birth.  Highlights continuous labor support as an evidence based means of increased coping with labor and associated reduction in cesarean delivery rates, as well as pharmacologic and nonpharmacologic techniques for coping with labor pain.

7.    Practical strategies for how nurses can support their patients: - Adams, Ellise D., and Ann L. Bianchi. “A Practical Approach to Labor Support.” Journal of    Obstetric, Gynecologic & Neonatal Nursing, vol. 37, no. 1, 2008, pp. 106–115., doi:10.1111/j.1552-6909.2007.00213.x. - Adams, Ellise D., et al. “A Nurse’s Guide to Supporting Physiologic Birth.” Nursing for Womens Health, vol. 20, no. 1, 2016, pp. 76–86., doi:10.1016/j.nwh.2015.12.009

8. Marin General Hospital. Pain Management Policy. Marin General Hospital (MGH)’S policy to assure that an obstetric patient be given accurate and current information regarding nonpharmacologic and pharmacologic interventions that are available to them when in labor.

9. Fairchild, E., Roberts, L., Zelman, K., Michelli, S., & Hastings-Tolsma, M. (2017). Implementation of Roberts Coping with Labor Algorithm © in a large tertiary care facility. Midwifery,50, 208-218. doi:10.1016/j.midw.2017.03.008 10. Horn G, D'Angelo D. (2017). Does the Coping Assessment for Laboring Moms (CALM) Scale Enhance Perception of Nursing Presence? Nurs Womens Health. 2017 Oct - Nov;21(5):360-371. doi: 10.1016/j.nwh.2017.07.002.

F.   DOULAS                                                                                                                                          · What is a doula? Mt. Diablo Doula Community 2016.                                                            ·  Doulas: Including doula practice in hospital care webinar recording. Presented by                              Michelle Nizza and Ana Paula Markel. CMQCC 2017.                                                          · What to Ask… A Doula Who May Provide Continuous Labor Support. Childbirth Connection, 2016.

PROVIDER EDUCATION   

· California Maternal Quality Care Collaborative toolkit for providers                                         ·   CMQCC Introduction to the Toolkit to Support Vaginal Birth and Reduce Cesarean Sections Educational Slide Set, 12/7/16                                                                                                  · How to Communicate with Mothers About C-Sections, The California Health Care Foundation (CHCF)

CESAREAN DELIVERY UTILIZATION REVIEW

· Readiness Assessment to support vaginal birth and reduce primary cesareans, CMQCC.                · Severe Maternal Morbidity Review (+AIM). Council on Patient Safety in Women’s Health Care, short and long forms.

PATIENT EDUCATION- Labor & Birth

· Created in partnership with the California Maternal Quality Care Collaborative (CMQCC) and Consumer Reports, the My Birth Matters campaign is part of a broader statewide effort to lower rates of low-risk, first-birth c-sections in California hospitals.                                                      1.       Talk to Your Doctor                                                                                                      2.       C-Sections and Vaginal Birth: What Every Pregnant Woman Needs to Know About                          Cesarean Birth reviews the benefits and risks of both a C-section and a vaginal birth.         3.       New Mom Explains C-Sections                                                                                      4.       Choose Your Care Providers                                                                                          5.       Choose Your Hospital

· Healthy Birth 101. Our Moment of Truth, 2016.·   Am I in Labor? Our Moment of Truth, 2016.  · How to Tell When Labor Begins. The American College of Obstetrics and Gynecologists.            · Preterm (Premature) Labor and Birth. The American College of Obstetricians and Gynecologists, 2016.                                                                                                                                    · Focus on Physiologic Birth toolbox. Birthtools.org                                                                  · Labor Induction. The American College of Obstetricians and Gynecologists, 2017.                      · New Professional Recommendations to Limit Labor and Birth Interventions: What Pregnant Women Need to Know. Childbirth Connection 2017.                                                                · Managing the Discomfort of Labor and Birth. Pour Moment of Truth, 2016.                              · Promoting Skin-to-Skin Contact. Our Moment of Truth, 2017.                                                · Birth Options after Having a Cesarean. Journal of Midwifery & Women’s Health (2016).

QUALITY IMPROVEMENT

· California Maternal Quality Care Collaborative developed a toolkit for providers, and is running a statewide quality improvement initiative for implementation in California hospitals.                      · Slide Set for Professional Education. CMQCC Slide Set 2016.                                                · Toolkit to Support Vaginal Birth and Reduce Primary Cesareans and Implementation Guide. CMQCC 2016.                                                                                                                      · Main EK, Morton CH, Melsop KA, Hopkins D, Giuliani G, Gould JB. “Creating a Public Agenda for Maternity Safety and Quality in Cesarean Delivery.” Obstetrics and Gynecology. 2012; 120(5):1194-8.                                                                                                        · What is High Quality Maternity Care? Birthtools.org                                                               · Quality Patient Care in Labor and Delivery: A Call to Action. The American College of Obstetrics and Gynecologists, 2011.                                                                                          · Implementing Quality Improvement Projects Toolkit. Council on Patient Safety in Women’s Health Care. V1 2016.                                                                                                            · The Quality Care for Moms and Babies Act: Improving Maternity Care for Women and Families. National Partnership for Women and Families (2015).                                                                · Measuring Obstetric Quality and Safety. Society for Maternal Fetal Medicine, Christian Pettker.