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Reductions in Cesarean Rates for Low-Risk Patients

By Rebecca Alderfer, MPP

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How CPCQC is Responding to Rising Cesarean Rates

In 2024, the Colorado Perinatal Care Quality Collaborative (CPCQC) innovatively revamped its SOAR Primary Cesarean Reduction program into a one-year, intensive learning collaborative. This decision comes in response to a concerning trend observed since 2016: a steady increase in Cesarean rates among low-risk birthing individuals in Colorado, alongside growing disparities in Cesarean rates across different hospitals and providers.

Mobilizing Hospitals for Change: A Collaborative Approach to Cesarean Reduction

To address this issue head-on, our team successfully enlisted 23 birthing hospitals across Colorado, representing 40% of the state’s births, to join this year-long initiative. This collaborative is dedicated to tackling both systemic and direct factors contributing to unnecessary Cesarean deliveries. On February 9th, CPCQC organized an in-person forum at St. Joe’s Hospital for the participating hospitals. This event featured a virtual keynote speech by Dr. Neel Shah and concentrated on broad strategies for promoting safe vaginal births. Discussions covered the adoption of state-based quality measures, the expansion of the midwifery workforce in rural areas, and the integration of doulas to provide continuous support to birthing individuals.

The forum also provided a valuable opportunity for teams from various Colorado hospitals to network and share strategies. A panel featuring change leaders from Denver Health, Vail Valley, and St. Joseph Hospital offered insights and lessons from their experiences in reducing Cesarean rates. Hospital teams participated in working sessions to define their objectives for the year, identify key factors for Cesarean reduction, and start planning improvements in their labor and delivery units. The event concluded with an awards ceremony, recognizing the exceptional contributions of St. Joe’s Hospital and Banner Northern Colorado Medical Center with the Perinatal Luminary Award for their innovative approaches to enhancing birth safety.

Sustaining Progress: Continuing Efforts of the SOAR Collaborative

Moving forward, the SOAR collaborative will maintain momentum through monthly meetings, data analysis sessions, and quarterly personalized quality improvement coaching. We have an exciting lineup of guest speakers for these meetings, including the Clinical QI Lead from the California Maternal Quality Care Collaborative and a Denver-based expert on intermittent auscultation. Through these continued efforts, we aim to significantly increase safe births across Colorado in 2024.

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