Recognized for low C-section rates — and why it matters

Between 1998 and 2008, C-section births rose from 22 to 33 percent, making it the most commonly performed surgical procedure in the U.S. The increase may be driven by a growing high-risk population — patients with diabetes, high blood pressure, obesity and advanced maternal age. There is also variation between regions, hospitals and providers, suggesting opportunities for improvement.

Multiple births, placental complications, fetal distress or when the baby is too big for the birth canal are possible reasons. Although the procedure can be lifesaving, it carries risk for bleeding, infection and psychological stress. C-section birth is also associated with increased pain and fatigue, longer hospital stays, longer recovery times and decreased breastfeeding success.

Subsequent pregnancies may also be affected; once a patient has had their first C-section, the risk of a future C-section increases by 90 percent, and the risk of uterine rupture and placental abnormalities increases. That's why it's important to prevent the first C-section to promote quality outcomes for the future.

A multidisciplinary approach focused on patient safety guides our hospital’s efforts, including a task force of obstetricians, nurses and administrative leaders who champion evidence-based strategies to promote vaginal birth.

A labor positioning handbook also was developed to give nurses, doctors and the care team a set of tools to support physiologic birth and promote safe vaginal delivery when clinically appropriate. The handbook encourages individualized support, including:

• Frequent position changes throughout labor to support fetal descent, improve maternal comfort and help labor progress.

• Encouraging mobility when appropriate, including walking, upright positioning and movement during early labor.

• Use of positioning tools such as peanut and birthing balls to support pelvic opening, fetal positioning and maternal comfort.

• Creative positioning techniques, including side-lying release, hands-and-knees positioning, throne position, lunges and other nurse-supported interventions tailored to the patient’s labor pattern.

• A comfort-focused labor environment, supported by a comfort cart with aromatherapy, massage tools, fans, lighting options and other items that help patients relax and cope with labor.

• A birth preferences menu helps the team understand what matters most to the patient and honor her wishes whenever safe and possible.

• An Early Labor Walking Path that gives patients a guided way to move through labor, with suggested stretches, relaxation techniques and staff support along the way.

• Ongoing bedside assessment and coaching by nurses to identify opportunities for movement, repositioning and labor support rather than relying only on chart review or retrospective audits.

U.S. News & World Report is considered a global authority in hospital rankings and consumer advice. Sharp Mary Birch Grossmont was designated “high performing” for uncomplicated, low risk pregnancies, reflecting strong outcomes in low C-section rates, newborn complications, breast milk feeding and low early elective delivery rates — all criteria linked to healthier outcomes for mothers and babies.

Newsweek, in partnership with the Leapfrog Group, also recognized the hospital for maintaining low C-section rates and other evidence-based maternity care practices. This includes meeting rigorous standards for safe, high-quality care — including low rates of C-section, episiotomy, and early elective deliveries.

Together, these recognitions — along with placement on California’s Health and Human Services Agency C-section honor roll from 2015-19, and again in 2022 — underscore our sustained commitment to safe, evidence-based maternity care.