Safe Care for Patients with a Previous Cesarean Birth Initiative


The number of women giving birth with a previous cesarean annually is just under 600,000, or approximately 15 percent of the birthing population. This percentage is three-fold higher than in 1980, and the number has risen steadily as cesarean rates skyrocketed in the United States. Reported rates of Placenta Accreta Spectrum disorders and severe maternal morbidity resulting from postpartum hemorrhage have risen parallel to the overall cesarean rate, with current estimates indicating that 1 in 272 pregnancies in 2016 had an accreta diagnosis.

In late 2018, the Maternal Safety Foundation headquartered in Rogers, Arkansas, launched the Safe Care for Patients with a Previous Cesarean Birth Initiative with a goal of improving maternal health and safety for this population. In addition to creating a novel data set of hospital-level VBAC rates, we worked with high-risk obstetricians, an OB anesthesiologist, nurses, midwives and patient advocates and submitted a patient safety bundle to the American College of Obstetricians and Gynecologists for consideration in May 2019 and were invited to present the bundle to the Council on Patient Safety in Women’s Health Care on July 30, 2019 [pending Council approval]. Members of the MSF Advisory Board serve on numerous national committees that provide an opportunity to advocate for closing the measurement and practice gaps that result in preventable harm to this population.

The Maternal Centers of Excellence program’s initial focus is to increase awareness of the urgent need for safe, accessible, risk-appropriate care for every pregnant person with a previous cesarean birth. We are launching Accreta Centers of Excellence and VBAC Centers of Excellence on September 17, 2019.

Maternal Safety Foundation is a 501(c)(3) nonprofit organization (Tax ID 82-5018868) headquartered in Rogers, Arkansas.