Posts tagged with 'vbac'

From the Field: Practice Guidelines for Trial of Labor after Cesarean

As a Patient-Centered Maternity Home, two components of our Maternal-Child Health Care are evidence-based practice and shared decision-making. While ACOG guidelines are not always evidence-based, they have recently released guidelines allowing us all to offer trial of labor to women with two prior cesareans or twins. Our cesarean rate is 19% and our VBAC rate is 50%. North Carolina Medicaid is currently reimbursing cesarean birth at the same rate as vaginal birth.They were proactive in setting the rates pretty close to each other in years past.

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Filed in Clinical controversies, Clinical practice guideline/policy change, New care delivery model, Performance measurement/reporting, Scope of covered services, Shared decision making, Stories from the Field on Tue., Sep 20, 2011

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From the TMC blog: Reasonable Choices for Bringing Back VBAC

As we shift the conversation from whether to do VBACs to how to enable more of them, focus on quality and safety in the context of VBAC is long overdue. According to new government statistics, nearly one in five of the more than 4 million births each year in the United States occur to women who have previously given birth by cesarean. If evidence supports VBAC as a “reasonable option” for most of this population and indeed the better option for many, it is time to be reasonable about how to make VBAC as safe, accessible, and satisfying as it can possibly be.

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Filed in Blog, Clinicians, Consumers, Costs - Charges - Value, Hospitals and Health Systems, New Reports and Resources on Mon., Sep 12, 2011

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From the Field: Empowering women with information and support

We want to change childbirth options in our area. Of the five local hospitals in our area only one will allow planned VBACs. Also, the c-section rate for first time moms with no complications during pregnancy is an average of 33% in our area. We want to change this! So we are reaching out to the pregnant and new moms in our area by hosting a monthly support group where we focus on the topic surrounding childbirth and the options that are actually available to them. We look to make a change one mom at a time and build a community of families that support each other and empower each other.

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Filed in Clinical controversies, Community education/outreach, Decision making and choice, Disparities, Shared decision making on Wed., Aug 10, 2011

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In the Literature: HCA reduces liability claims, cesarean sections with comprehensive patient safety approach

The general approach described in this article is the standardization of practices and protocols for several clinical situations associated with high risk of injury or harm, specifically use of oxytocin, misoprostol, or magnesium sulfate; operative vaginal delivery; and the management of shoulder dystocia and abnormal fetal heart rate tracings. In the period since the implementation of the comprehensive patient safety program, HCA saw a dramatic decrease in malpractice claims and loss rates. In addition, the primary cesarean section rate fell despite a generally liberal approach to operative delivery.

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Filed in Care coordination, Clinical audit, case review, or analysis of adverse events, Clinical practice guideline/policy change, Educational materials for health professionals, Health professions education, Improved liability system, In the Literature, Performance measurement/reporting, Risk management/liability reform, Team building on Tue., Mar 15, 2011

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