NH Hospitals Review Efforts to Reduce C-section Rate

An article in the New Hamsphire Business Review extrapolates new guidelines, Safe Prevention of the Primary Cesarean Delivery, from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, to efforts underway in NH to reduce the rate of cesarean surgery births. Local hospitals named in the article, Dartmouth-Hitchcock and Elliot Hospital are aware of and already implementing much of the guidelines which include considering:

• Prolonged early-phase labor
• Cervical dilation of 6 cm rather than 4 cm as the start of active labor
• More time for labor to progress in the active phase
• Longer pushing (for 2 to 3 hours or longer depending on situation)
• Assist techniques for vaginal delivery, such as forceps.

The effort is being driven more from a cost-saving perspective than a patient safety one. The article cites statistics from a 2011 NH Insurance Department study that:

“the amount paid for C-sections in New Hampshire is 64 percent higher than for vaginal deliveries. The study also showed that the New Hampshire C-section rate grew from 28 percent in 2005 to 32.5 percent in 2008, and that the statewide rise is consistent with national trends."

Please see the full article on NHBR.com: New effort seeks to stem rise of C-sections in N.H.