ArticleObstetrics and gynecology2021
Reduction in Cesarean Delivery Rates Associated With a State Quality Collaborative in Maryland.
Article in Obstetrics and gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of care bundles for reducing caesarean section safely: A systematic review and meta-analysis.PloS one · 2025Pooled it
- The Role of State Perinatal Quality Collaboratives in Addressing Maternal Morbidity and Mortality.Obstetrics and gynecology · 2026Article
- Perinatal Quality Collaboratives and Patient Safety Bundles: Key Contributors to Improving Maternal Health Care Quality across the United States.Obstetrics and gynecology clinics of North America · 2026Review
- Spatial and Racial/Ethnic Variation in the Prevalence of Cesarean Delivery in a South Carolina Medical Center.Journal of racial and ethnic health disparities · 2025Observational
- Evaluating the implementation of maternal safety bundles for obstetric hemorrhage and severe hypertension during pregnancy in Arkansas.BMC pregnancy and childbirth · 2025Article
- Relationships between internal facilitation processes and implementation outcomes among hospitals participating in a quality improvement collaborative to reduce cesarean births: a mixed-methods embedded case study.Implementation science communications · 2025Article
- Article
- Evaluation of Statewide Program to Reduce Cesarean Deliveries Among Nulliparous Individuals With Singleton Pregnancies at Term Gestation in Vertex Presentation.Obstetrics and gynecology · 2024Article
- Disentangling Safety Culture's Role in Reducing Cesarean Overuse: Creating a Revised Labor Culture Survey.Women's health reports (New Rochelle, N.Y.) · 2024Article
- Implementation research priorities for addressing the maternal health crisis in the USA: results from a modified Delphi study among researchers.Implementation science communications · 2023Article
- Implementation and outcomes of a system-wide women's health 'team goal' to reduce maternal morbidity for black women: a prospective quality improvement study.BMJ open quality · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo assess the extent to which hospitals participating in the MDPQC (Maryland Perinatal-Neonatal Quality Care Collaborative) to reduce primary cesarean deliveries adopted policy and practice changes and the association of this adoption with state-level cesarean delivery rates.
methodsThis prospective evaluation of the MDPQC includes 31 (97%) of the birthing hospitals in the state, which all voluntarily participated in the 30-month collaborative from June 2016 to December 2018. Hospital teams agreed to implement practices from the "Safe Reduction of Primary Cesarean Births" patient safety bundle, developed by the Council on Patient Safety in Women's Health Care. Each hospital's implementation of practices in the bundle was measured through surveys of team leaders at 12 months and 30 months. Half-yearly cesarean delivery rates were calculated from aggregate birth certificate data for each hospital, and differences in rates between the 6 months before the collaborative (baseline) and the 6 months afterward (endline) were tested for statistical significance.
resultsAmong the 26 bundle practices that were assessed, participating hospitals reported having a median of seven practices (range 0-23) already in place before the collaborative and implementing a median of four (range 0-17) new practices during the collaborative. Across the collaborative, the cesarean delivery rates decreased from 28.5% to 26.9% (P=.011) for all nulliparous term singleton vertex births and from 36.1% to 31.3% (P<.001) for nulliparous, term, singleton, vertex inductions. Five hospitals had a statistically significant decrease in nulliparous, term, singleton, vertex cesarean delivery rates and four had a significant increase. Nulliparous, term, singleton, vertex cesarean delivery rates were significantly lower across hospitals that implemented more practices in the "Response" domain of the bundle.
conclusionThe MDPQC was associated with a statewide reduction in cesarean delivery rates for nulliparous, term, singleton, vertex births.
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