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Rome Memorial Hospital’s C-Section Rate Declines -Counters national trend
ROME December 5, 2002 - At Rome Memorial Hospital, the percentage of babies born by Cesarian section has declined even as national rates jumped seven percent to the highest level in thirteen years.
According to the Centers for Disease Control, the national C-section rate was 24.4 percent in 2001, including repeat C-sections. Rome Memorial Hospital’s overall C-section rate in 2001 was 22% and it’s dropped another four percent to 18% through the first three quarters of 2002, according to Maternity Nurse Manager Cathy Destito, R.N.
“We’ve also significantly reduced our primary or first-time C-section rate from a high of 18% in 1999 to 13% in 2001,” Destito said. “This year our primary C-section rate has dropped to nine percent through September 2002. We now have one of the lowest C-section rates in our region.”
Babies at Rome Memorial Hospital are delivered by three obstetricians, Ankur Desai, M.D., Lauren Giustra, M.D., and Paul Temple, M.D; a family practitioner, David Kirk, M.D. (low-risk pregnancies) and four certified nurse midwives, Nancy S. Peek, NP, CNM, Marianne Stalteri, NP, CNM, Betty Guisinger, NP, CNM, and JoAnn Roberts, RN, MS, CNM, who joined Mohawk Valley Women’s Health Associates Nov. 4.
Several strategies were utilized to reduce the C-section rates. During prenatal care visits, the midwives and physicians focused on patient education to encourage a trial of labor for most women.
“The addition of midwives has also contributed to the decline in C-sections,” Dr. Giustra said. “We learn from each other so we have a broader range of techniques to help encourage women through the challenges of labor.”
“Almost two years ago, birthing balls and birthing stools were introduced into the hospital’s Maternity Department to foster the process of labor through natural positioning,” Dr. Temple noted. During labor, the expectant mother can sit on the stool or birthing ball, which puts her in a comfortable and natural position.
“The nursing staff is also taking a more proactive approach during the labor process to help facilitate a natural birth,” Dr. Desai said. “We’re all encouraging women to get out of bed, to walk and use the shower to help them relax. We’re getting both the mother and her partner more involved in the labor process and helping them with different labor techniques.”
“Having a baby is a joyous experience, but labor isn’t easy,” Destito said. “By being more proactive, we’re able to provide additional encouragement for the mother and help nature along.”
The physicians, midwives and nursing staff have been working together to reduce the C-section rate since it was identified as a priority three years ago by the hospital’s Quality Council and Board of Trustees.
A surgical delivery can be life-saving for a mother and her child if the baby is in distress, too large, or positioned the wrong way. However, a C-section is major abdominal surgery, so avoiding unnecessary ones is important.
Women who deliver by C-section have longer hospital stays, a higher risk of post-delivery infection and increased pain. Also, a women’s risk of death from C-section complications, although small, is three to seven times higher than during vaginal delivery, according to the American College of Obstetricians and Gynecologists.
“I’m delighted with the results. Three years ago, the hospital had one of the highest C-section rates in the region. Everyone can be proud of this turnaround. It shows dedication on everyone’s part,” said Richard H. Aubry, MD, MPH, the obstetrical co-director of the Central New York Perinatal Program.
Rome Memorial Hospital is one of 20 hospitals across 15 counties that participates in the Perinatal Program, which is dedicated to improving the outcomes of pregnancy in Central New York. The program was a resource to the hospital in its efforts to reduce its C-section rates. Now, Rome Memorial Hospital’s C-section rates are among the lowest in the region.
“This is a good example of how Regional Centers and community hospitals can work together,” Dr. Aubry said. “The hospital’s success is in the day-to-day decisions and it shows you how good people at the local level can do good work.”
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