Grand Island, Neb. — While the percentage of cesarean section births has increased dramatically across the U.S. in recent years, the Family Birthing Center at CHI Health St. Francis is bucking the trend.
Currently, the rate of C-sections in Nebraska (19 percent) and the nation (25 percent) are well above the World Health Organization’s suggested rate of 10 to 15 percent. St. Francis has a C-section rate for first-time mothers of 10 percent.
Beth Deida, BSN, RNC, who is a nursing supervisor for Labor and Delivery at St. Francis, said a shared philosophy between physicians and Family Birthing Center staff is a major reason for the Grand Island hospital’s low C-section rates.
“Our physicians are very good about reading evidence-based research on when to do a C-section,” Deida said. “You sometimes hear where people say, ‘We just did a C-section because my doctor wanted to go home.’ The physicians at St. Francis are not like that at all. We have very close relationships with our physicians and they’re very accessible to us — day and night.”
According to a New York Times article published in January 2016, the No. 1 influence in determining C-section rates is the choice of hospital. In California, for example, a study revealed that rates for C-section births ranged from 11.2 to 68.8 percent at different hospitals.
Deida said physicians and staff at St. Francis are committed to giving mothers the full opportunity to have a vaginal birth.
“They will do the C-section if they believe the baby is in distress and they have tried every other option,” Deida said. “If there’s a question or the mother is having any issues with her delivery, we will sometimes huddle and discuss all of the options we have had success with from all of our years combined years of experience.
“Of course, we want to keep the mother and baby safe and sometimes that requires a C-section. Sometimes there are just factors out of the mother’s control, such as the baby is too big, but our ultimate goal is a vaginal delivery for the moms.”
In response to the rising trend of C-section births, hospitals like St. Francis are attempting to reduce medically unnecessary C-sections. Not only do C-sections pose more health risks for both mothers and babies, but they’re more expensive and require longer postpartum recovery time.
While having mothers deliver vaginally is the focus at St. Francis, experts remind us that every birth and every pregnancy is different. Terry Avery, BSN, RN-BC, C-EFM, who is the clinical supervisor for Maternal Child Services at St. Francis, said it’s important for mothers to talk to their physician before making any decisions.
Avery said another factor in reducing C-section births is avoiding unnecessary inductions. A study published by the American Congress of Obstetricians and Gynecologists (ACOG) determined that inducing first-time mothers was directly associated with an increased risk for C-section.
“The ACOG has also given a practice guideline that states that babies born at or after 39 weeks have the best chance at healthy outcomes compared to those born before 39 weeks,” Avery said. “Unless there’s a health risk to the mother or baby, it’s best to wait to deliver until reaching full term at 39 weeks. Our physicians are great about following the above recommendations and have supported our hospital policy of not allowing inductions less than 39 weeks unless there is a medical indication. By following these practice standards we are not setting the mothers up for increased chances of Cesarean Sections.”
Avery said another important influence on St. Francis low C-section rate for first-time mothers is the skill and experience of the hospital’s nursing staff in providing labor support and interventions.
“We promote the laboring patient to move around, change positions, hydrotherapy and family involvement to augment the labor process,” Avery said. “We have seen a change in the culture of our patient population to seek out this support and to have the desire to wait until closer to their due date to promote a healthy birth experience and outcome.”