Midwives are Making a Real Impact on Reducing the Rates of C-Sections in California

For years C-section rates in the United States continued to escalate, rising 60 percent between 1996 and 2009. In 2011 the procedure topped the list as the most common operation in the country.

The North Bay area of California is on a mission to reduce the number of C-section procedures performed in its hospitals – and they’re relying on midwives to help. Studies have shown that C-section rates are significantly lower at hospitals that embrace midwifery services and retain nurse-midwives on staff. Nationally, C-sections are performed in 32 percent of all births, while in California it’s just 26 percent.

Hospitals in North Bay have seen a steady decline in C-sections since making the decision to implement midwives into its birthing programs. Ukiah Valley Medical Center in Ukiah has the lowest rate at just 16 percent.

Marin General Hospital in Greenbrae adopted its midwifery program when it took control of the county birth center, which provided care to patients with public insurance. Midwives were used at the birth center and hospital administrators chose to continue the services and expand operations to the privately insured sector.

The hospital saw an almost immediate drop in C-sections going from 32 percent to 27 percent. Overall it has seen a 10 percent reduction in a three year period. The rate is now down to an estimated 18 – 22 percent of the 1,400 births that take place at the hospital each year.

The University of California in San Francisco examined Marin’s midwifery program while studying the success rates of vaginal births among mothers who had previously had a C-section. Results of the study showed a 9% increase in the number of successful vaginal births for these women when a midwife was attending the birthing process.

“I think that doctors have embraced the outcome of the study and see us as a positive influence on lowering the C-section rate,” said Sheri Matteo, director of midwives at Prima Medical Group in Novato. She called obstetrics a team sport and said that midwives have become accepted members of the team.


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