I’m so pleased to report on our perinatal unit’s success in reducing repeat cesarean sections, which is being accomplished through its innovative program called the “Vaginal Birth after Cesarean (VBAC) Improvement Project.” This effort received the Quality Leaders Top Honors Award from the California Association of Public Hospitals and Health Systems (CAPH) and its quality improvement affiliate, the California Health Care Safety Net Institute (SNI) this past December. The acknowledgement comes as more attention is being paid to the serious increase in C-sections – 50 percent in California in the past decade – and the efforts to reduce potentially dangerous early births, often due to labor inductions or scheduled C-sections.

The concern with pursuing a vaginal birth after a cesarean is the slight but serious risk of a uterine tear during labor. But our perinatal unit, led by our medical center’s ob/gyn chair, Judy Bliss, MD, has put a system in place that allows for the safest possible outcome for women who want to consider the VBAC option. In collaboration with the Institute of Healthcare Improvement, the team developed a series of interventions, known as a “bundle,” and other protocols that include ensuring that there is 24/7 coverage by a coordinated, trained team ready to respond to any situation that might arise.

This effort has required constant communication and vigilance, and has enabled our providers to feel confident they can assure their patients that all safety precautions have been taken. We now have many more new moms bonding faster with their newborns and leaving the hospital sooner without the recovery time that surgery would require. The program has passed its two-year mark, and I couldn’t be more proud of the unit’s continuing efforts to provide patient-centered care to our expectant mothers and their families. Our perinatal team was determined to respond to the needs and wishes of our patients while keeping safety as the number-one priority.

For more details please see our link to information and the video we’ve produced about our VBAC project.



Anna Roth, RN, MS, MPH
Contra Costa Regional Medical Center and Health Centers