A recent study offers yet another push for hospitals to lower elective C-section rates. Research published in the Journal of Allergy and Clinical Immunology, has found a link between C-sections and an increased risk of food allergies.
C-sections are performed in nearly a third of U.S. births, and half of these surgeries are considered avoidable. Thus, the pressure to lower the rates of this procedure – and it's accompanying risks, which range from infection to excessive blood loss and even maternal death – is mounting from all sides. The Joint Commission, the Centers for Medicare and Medicaid Services (CMS), the National Quality Forum and independent hospital rating firms (such as Leapfrog, which reports on them by hospital) all care about C-section rates. Even media organizations such as Parents.com are weighing in.
All of this puts hospitals in the delicate situation of discouraging elective C-sections, while keeping those patients who request the procedure – without fully understanding the risks – satisfied with their care. Yes, hospitals want to keep their expectant patients happy, but their biggest priority here is maternal and child safety.
So what can hospitals do to help lower C-section rates?
A cesarean section is the most common surgical procedure performed in the U.S., according to the Agency for Healthcare Research and Quality (AHRQ). The “2020 Initiative” by Healthypeople.gov (the federal Office of Disease Prevention and Health Promotion) wants the C-section rate to drop to 23.9% by 2020.
Why Are C-Section Rates So High?
If you work in obstetrics, you can probably rattle off some common factors that contribute to C-sections (beyond medically urgent situations when the surgery is needed to protect the life of mother or infant):
- an expectant mother hoping to avoid labor pain or potential complications (such as incontinence) from vaginal childbirth
- an obstetrician ordering the procedure out of compassion for a tired, distraught mother experiencing an exceptionally long labor
- early response to high-tech monitors indicating an elevated fetal heart rate (which may or may not be due to fetal distress)
The reasons could also be a combination of any of these and other factors. Despite how some have tried to frame the C-section debate, there is no one singular cause. It truly is a complex issue with many factors.
Educating Patients Earlier About C-Sections
What we do know is that the more educated patients are, and the earlier that hospitals set patient expectations, the more successful those hospitals can be in promoting behavior change and guiding patients toward a desired health outcome – in this case, avoiding unnecessary C-sections.
Patient engagement solutions that educate expectant women during pregnancy can help set expectations and reinforce your hospital’s protocol on C-sections. This is especially true when you engage patients on their mobile devices – the preferred mode of communication for today’s childbearing generation.
Topics that your digital education should cover include:
- Information about when C-sections are medically necessary and when they’re not
- Risks involved in having a C-section
- How to prepare if a C-section becomes medically necessary
- How to recover at home following either C-section or vaginal delivery
Providing this education during pregnancy – rather than in the hospital when patients are under stress – creates opportunities for patients to talk about the potential for a C-section and expectations around this procedure with their healthcare providers. That, in turn, leads to improved patient confidence, outcomes and satisfaction.
Lowering C-section rates is just one area where more effective, efficient patient education and engagement can help hospitals achieve desired health outcomes. Mobile health technology has also shown an impact on clinical outcome metrics, including readmissions and length of stay, class enrollment and care team efficiency by reducing phone calls and unnecessary appointments.
Bringing patients into the conversation early (and on the mobile devices they prefer), to set their expectations and guide them toward healthy behaviors, offers great promise in improving maternal-child health.