SOAR is an annual, hospital-based quality improvement initiative to reduce unnecessary primary Cesarean births. SOAR is grounded in the national AIM (Alliance for Innovation on Maternal Health) Patient Safety Bundle for Safe Reduction of Primary Cesarean Births. SOAR supports interdisciplinary teams in adopting best practices that promote safe, person-centered labor management, shared decision-making, and respectful maternity care.

Through active engagement in SOAR—one of CPCQC’s quality improvement initiatives—hospitals can meet the quality improvement requirement set by Colorado Senate Bill 24-175.

Cesarean births, while lifesaving when medically necessary, carry increased risks of complications for birthing people and babies—especially with repeat procedures. In Colorado, Cesarean rates vary significantly across hospitals, with wide gaps by race, ethnicity, and payer. Reducing primary Cesareans is a critical strategy for improving maternal and neonatal outcomes, advancing health equity, and curbing rising healthcare costs. SOAR addresses these challenges by empowering hospitals with the tools and support needed to implement proven clinical and system-level changes.

The hospital where a person gives birth is one of the most significant predictors of whether they will undergo a Cesarean delivery—often outweighing individual clinical factors or medical history. This suggests that care decisions are frequently influenced more by institutional practices than by patient need, reflecting inequities in obstetric care. The SOAR initiative aims to ensure that all birthing people receive safe, evidence-based, and equitable care, regardless of their identity, socioeconomic status, or geographic location.