In Improving Birth

The past few years have seen a flurry of reports and guidelines aimed at improving the quality of maternity care. These include “Supporting healthy and normal physiologic childbirth: a consensus statement by ACNM, MANA, and NACPM,” “Toolkit to Support Vaginal Birth and Reduce Primary Cesareans: A Quality Improvement Toolkit,” “Vision for a High-Quality, High-Value Maternity Care System,” “Mother-baby friendly birthing facilities,” “Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide,” “Joint policy statement on normal childbirth,” and “Safe prevention of the primary cesarean delivery.” It remained to be seen, however, if these would have any practical effect, but it seems that we might be moving from “talking the talk” to “walking the walk” at last. The past few weeks have seen:

  • A commentary in JAMA floating the idea of linking free-standing birth centers with hospitals as a means of reducing unnecessary intervention, improving satisfaction, and reducing costs.
  • A promo by a hospital that it will be participating in an American College of Nurse-Midwives’ program aimed at reducing cesareans.
  • An announcement that as of January, New York State regulations will require hospitals to institute policies and practices consistent with The Ten Steps to Successful Breastfeeding as recommended by the World Health Organization. These include mandating skin-to-skin contact after birth unless contraindicated and prohibiting handing out free samples of formula or coupons.
  • The publication of an Honor Roll of California hospitals that meet the Healthy People 2020 federal goal for cesarean rates in 1st-time, low-risk mothers, which resulted in two articles, one from Fresno and one from San Diego, calling out hospitals that didn’t meet the goal and a press release from a hospital trumpeting that it did.

May this truly be the beginning of the turn of the tide.


Learn more about preventing the preventable cesarean .

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