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Results of implementation of a hospital‐based strategy to reduce cesarean delivery among low‐risk women in Canada
Author(s) -
Shoemaker Esther S.,
Bourgeault Ivy L.,
Cameron Carol,
Graham Ian D.,
Hutton Eileen K.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12263
Subject(s) - medicine , significant difference , obstetrics , cesarean delivery , caesarean delivery , emergency medicine , caesarean section , pediatrics , pregnancy , genetics , biology
Objective To assess the cesarean delivery ( CD ) rate among low‐risk pregnancies before and after implementation of a hospital‐based program in Canada. Methods A prospective before‐and‐after study was conducted to assess the effects of the CARE ( CA esarean RE duction) strategy, which was developed and implemented at Markham Stouffville Hospital, Toronto, ON , Canada, in 2010 to reduce CD among low‐risk women. Hospital records were reviewed to identify changes in the proportions of CD performed during 12 months (April 2009–March 2010) before implementation of the CARE strategy versus 12 months after implementation (April 2012–March 2013) at Markham Stouffville Hospital and 36 hospitals of the same level in the same province. Results At the intervention hospital, 30.3% (964/3181) of women underwent CD in 2009–2010, compared with 26.4% (803/3045) in 2012–2013 (difference −3.9%, P< 0.001). By contrast, no significant difference was recorded in control hospitals (28.1% [23 694/84 361] vs 28.2% [23 683/83 895]; difference 0.1%, P= 0.5157). Conclusion Implementation of the CARE strategy reduced rates of CD among the target population.