Of the roughly 500,000 babies born in California every year, one-third are born via cesarean delivery, or C-section, although individual hospitals rates vary. Nationwide, C-section rates can run as high as 50 percent.
In certain instances, a C-section may be medically necessary - even lifesaving - but there are also serious risks involved. Doctors typically recommend the procedure because there may be a high-risk complication making a vaginal birth unsafe.
However, C-section rates are growing, with little evidence that the increase is resulting in better outcomes for moms and babies. The federal government took note and gave all U.S. hospitals a target to not to exceed a 23.9 percent C-section rate - for first-time mothers with low-risk pregnancies - by 2020.
Sharp Grossmont Hospital has worked diligently to lower its rates and earned a place on Newsweek's Best Maternity Hospitals 2021 list. The distinction recognizes U.S. hospitals that have excelled in providing safe, high quality care for mothers and newborns. This includes C-section rates that surpass the federal target aimed at reducing rates for first-time mothers with low-risk pregnancies.
In addition, the hospital was honored by the California health and Human Services Agency, which issues an annual C-section honor roll recognizing hospitals that also meet or surpass the federal target. According to Lisa DeLong, perinatal educator, Sharp Grossmont's labor and delivery team has made low C-section rates a priority. "Our rates have decreased from 32.5% in 2014 to 20.3% in 2020." she says.
DeLong goes on to explain more about C-section rates and why they matter:
Why have C-section rates increased in recent years?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 partially be due to a growing high-risk population - patients with diabetes, high blood pressure, obesity and advanced maternal age. There is also great variation between regions, hospitals and providers. This variation suggests there are opportunities for improvement in practice.
When should a C-section be considered? And what are the risks?Multiple births, placental complications, fetal distress or when the baby is too big to fit through the birth canal are all possible reasons to have a C-section. Although a C-section can be lifesaving, it carries increased risk for bleeding, infection and potential psychological stress. C-section birth is also associated with increased pain and fatigue, longer hospital stays, longer recovery times, and decreased breastfeeding success.
What steps has Sharp Grossmont taken to lower its C-section rates?The Labor and Delivery team at Sharp Grossmont undertook a multidisciplinary approach with patient safety as a priority. A task force was formed, including obstetricians, nurses and administrative leaders who championed evidence-based strategies to promote vaginal birth.
A labor positioning handbook was created for Labor and Delivery team members, which advocates for:
- Frequent position changes during labor
- Patient mobility during labor, including walking
- Use of a peanut ball - a peanut-shaped exercise ball known to help shorten labor
Focus was also placed on education, the creation of guidelines and the development of checklists to help patients, doctors and nurses make informed choices.
Why is it significant that Sharp Grossmont was honored by Newsweek and placed on the C-section honor roll?
Newsweek partnered with The Leapfrog Group, a national nonprofit organization that reports on the safety and quality performance of U.S. health care facilities. Hospitals must meet tough standards for excellence in maternity care to make the cut, including hospitals that have low rates of C-section, episiotomy, and early elective deliveries, and follow important protocols to protect moms and babies. Though these are standards aligned with medical research and best practices, not all hospitals achieve them. Newsweek's Best Maternity Care Hospitals are an elite group demonstrating the highest performance in the U.S.
Sharp Grossmont has further demonstrated its commitment to providing a safe environment for moms-to-be by earning a place on the California Health and Human Services Agency C-section honor roll for five consecutivefour years. The agency collaborates with Smart Care California, a public-private partnership working to promote safe and affordable health care, and the California Maternal Quality Care Collaborative, a multi-stakeholder organization committed to ending preventable morbidity, mortality and racial disparities in care. Every year, they publish a C-section honor roll which honors hospitals that meet or surpass the federal benchmark.
For the news media: To talk with Lisa DeLong about Sharp Grossmont Hospital's work to lower C-section rates for an upcoming story, contact Erica Carlson, senior public relations specialist, at email@example.com.