Supporting Vaginal Delivery For Low Risk Mothers (SOAR)

SOAR is an initiative to reduce unnecessary cesarean delivery for low-risk pregnant people. This in turn decreases maternal morbidity and mortality and reduces health care costs. The initiative targets patients who meet the criteria of “NTSV”: Nulliparous (this is their first birth), Term (gestational age beyond 37 weeks), Singleton (just one baby), and Vertex (optimal, head-down position). The NTSV birthing population is the ideal group to target as they are the least likely to warrant a cesarean delivery. At 19.5%, Colorado has a NTSV cesarean delivery rate that is better than the national average. But, there are broad differences in rates among Colorado hospitals, ranging from 7% to 45%.

Nearly 1 in 3 births in the United States are by cesarean section rather than vaginal delivery. While cesarean birth can be life-saving, cesarean deliveries are also associated with higher risk of maternal morbidity, including hemorrhage, uterine rupture, anesthesia complications, venous thromboembolism, infection, and wound disruption or hematoma. CPCQC works with participating hospitals and obstetric providers to assure that recommendations from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine are consistently practiced. 

To accomplish this, we are adapting and adopting tools from a toolkit developed by the California Maternal Quality Care Collaborative and implementing the Alliance for Innovation on Maternal Health’s Safe Reduction of Primary Cesarean Birth Patient Safety Bundle. CPCQC provides customized quality improvement coaching and technical assistance, data support and insights, and provider education in order to help hospitals meet their cesarean reduction goals. CPCQC offers quarterly SOAR webinars which are open to any hospital anywhere, regardless of SOAR participation.

Community Impact

  • SOAR participating hospitals account for approximately 40% of Colorado births. 
  • In the last year, participating SOAR hospitals averaged an NTSV Cesarean birth rate of 24.5% compared to the national average of 25.9%.
Elizabeth McDaniel wearing a blue zip-up sweater smiling at the camera

“I am so proud of the work our physicians and nurses at Vail Health are doing as we participate in SOAR. Being a part of this project with other Colorado hospitals has given us the support and spirit to invigorate the work we do at Vail Health. For the past three months, the cesarean rate for our first-time, low-risk mothers has been below 13%. We are making a significant difference in the lives of families in our community, helping to prevent maternal morbidity and mortality.”

—Elizabeth McDaniel, BSN, CNML, RNC-OB, Clinical Nurse Manager, Family Birth Center, Vail Health Hospital

Learn More About Participating in SOAR

Any Colorado hospital labor and delivery unit is eligible to participate in SOAR.