Safe Care for Patients with a Previous Cesarean Initiative
The number of women giving birth with a previous cesarean annually is 600,000, or 15 percent of the birthing population. That 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. Our preliminary data analysis of hospital-level data on VBAC (vaginal birth after a previous cesarean) showed that VBAC is routinely available at only half of hospitals.
In addition to creating a searchable database of hospital-level VBAC rates, we are in the process of gathering professional consensus on a possible patient safety bundle on safe care for all patients with a previous cesarean birth, including input from high-risk obstetricians, anesthesiologist, nurses, midwives and a diverse group of patients. In January, the Maternal Safety Foundation voiced its concern that VBAC was omitted as a population health objective for 2030 by the Healthy People Advisory Committee and MSF’s Executive Director serves 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.
UPDATES: This bundle was submitted to AIM for consideration in May 2019. Council on Patient Safety in Women’s Health Care invited us to present the bundle at its July 29-30 meeting. We are awaiting news of a vote on adoption of the bundle.
maternal Centers of Excellence
Originally launched as CesareanRates.com on February 9, 2012, the site was renamed CesareanRates.org on April 20, 2018, with a goal of providing educational information for clinicians and hospital leaders on cesarean birth rates, measurement and reporting, dashboards of progress toward meeting national goals, as well as serving as a resource of actionable information for consumers to use for selecting a hospital. This program was featured in a Vox.com article by Julia Belluz.
Phase I (September 2018): Using a special report from Centers for Disease Control and Prevention (CDC), our organization published state dashboards with information on maternal morbidity characteristics of labor and delivery not currently accessible in CDC WONDER. This program launched in partnership with the Patient Safety Movement Foundation. Read press release
Phase II: Research and publication of a hospital-level VBAC/repeat cesarean birth rate guide. VBAC Access Guide.
Advocacy & Policy
The Maternal Safety Foundation's staff and advisory board members are engaged in professional service throughout the country, including service to the National Quality Forum’s Perinatal and Women’s Health Standing Committee, the Ariadne Labs Delivery Decision Initiative, CMQCC’s Maternal Data Center Steering Committee and the Medicaid Core Measure Set Workgroup convened by Mathematica. Contact us if you need a patient/consumer representative to partner with your organization or to speak at an event.
outreach & Community
Our organization received a grant from California Health Care Foundation to administer an outreach program to California hospitals and providers from October 2018 through November 2019.
The Maternal Safety Foundation actively maintains a combined social media presence of more than 50,000 consumers and advocates. Topics include access to care, VBAC, patient rights, news on quality improvement efforts in maternity care and more. Contact us for information on how we can help with your campaigns related to maternity care.