Harmonizing Provider Actions with Patient Messages: Reducing Cesarean Birth Rates

While lifesaving in limited circumstances, cesarean birth brings serious risks for babies and mothers. National efforts and consensus guidelines for reducing non-medically indicated cesarean births are promising. Yet... [ view full abstract ]

While lifesaving in limited circumstances, cesarean birth brings serious risks for babies and mothers. National efforts and consensus guidelines for reducing non-medically indicated cesarean births are promising. Yet significant, unwarranted variation in U.S. hospital cesarean birth rates ranging from a low of 12% to a high of 70% remains. Research suggests that physician and hospital-level factors play a key role in determining the probability that a woman will have a cesarean birth. In a statewide effort to reduce the variation in cesarean birth rates we will harmonize actions health care providers are willing to taking to avoid a cesarean birth and messages tailored to expecting mothers of specific racial, ethnic and socioeconomic backgrounds. In order to achieve this, we will interview OB/Gyns, family physicians, and midwives to identify the actions they recommend for expecting mothers in order to support a vaginal birth. Within this sample, we will seek to interview OB/Gyns and family physicians with high, medium, and low cesarean birth rates. Themes from these interviews and results from a survey about women’s preferences and attitudes toward birth technology and intervention will be brought together to create a coherent and consistent message campaign for expecting mothers. This will ensure that messages developed for expecting mothers, who have a preference for a vaginal birth, are consistent with actions health care providers are willing to take and will support.