South Shore Hospital lowers its C-section rate with “Team Birth Project”

One year after being chosen as the pilot site for a one-of-its-kind study, South Shore Hospital, part of South Shore Health, has seen a nearly 4-percent decrease in its first time cesarean section rate while continuing to improve communication, patient experience and outcomes during childbirth.

The study, known as the “Team Birth Project,” aims to empower all members of the birth team (including mother and her birth partner) to have an equal voice, communicate openly, and practice in shared decision-making throughout the labor and delivery process. The result has led to a nearly 4-percent decrease in C-sections for first-time/full-term mothers in labor at South Shore Hospital. Patient surveys also show a shift to more proactive care planning and improved patient outcomes and experiences during childbirth.

“As the first pilot site for this national project, South Shore Hospital continues to receive positive feedback and outcomes from mothers and their birth partners, as well as reduced numbers in unnecessary  C-Sections,” said Kimberly Dever, MD, FACOG, Vice President of Medical Affairs for South Shore Health and Chairman of the Department of Obstetrics and Gynecology at South Shore Hospital. “Anything we can do to provide better outcomes for our patients is something we believe strongly in.”

While most babies can be born by vaginal delivery, for some, surgical intervention with a C-section is necessary or lifesaving. The challenge, according to experts, is that modern health systems seldom make delivery decisions accurately. In the United States, nearly one in three women gives birth by Cesarean section. South Shore Hospital caregivers set out to change those statistics.

In April 2018, the hospital teamed-up with Ariadne Labs, a joint center between Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, to implement the Team Birth Project. The hospital was chosen by the innovation group because of its strong desire to build a better system of care during childbirth.

“We selected South Shore as the first hospital in the country to launch the ‘Team Birth Project’ because we found the perfect mix of capability and vision,” said Neel Shah, MD, MPP, director of the Delivery Decision Initiatives at Ariadne Labs. “The nurses, midwives, and obstetricians all bring deep expertise to this project while also recognizing the opportunity to build a better system of care where each woman in labor is at the center of a high performing team.”

Using a simple, modified whiteboard as a communication tool in the patient’s room, the entire birth team continually updates the board with information while making assessments, addressing concerns and planning during labor.

According to Dever, the implementation and response to this project have been overwhelmingly positive. Recent patient surveys reinforce the idea that better communication between patients and their providers during labor is essential to better outcomes. Patients feel they are being listened to and any concerns are routinely addressed and revisited during the birthing process. The ultimate goal of the project is to improve communication with the patient during labor and offer every woman a safe and dignified birth.

“As the first pilot site for this project, South Shore Hospital has had the opportunity to collaborate and provide feedback to Ariadne Labs which has resulted in modifications to the whiteboard and other delivery decision aids,” said Amber Weiseth, DNP, RNC-OB, Associate Director of the Delivery Decisions Initiative at Ariadne Labs. “Their experiences have also resulted in lessons learned for Ariadne’s subsequent implementations at three other pilot hospitals in the United States.”

As South Shore Hospital continues to embrace Team Birth, it is looking ahead to the next phase of the project including implementing two additional and distinct birth tools developed by Ariadne Labs:

1. The Admission Discussion and Labor Support Guide: a one-page reference tool to prevent premature admission of mothers who present in early spontaneous labor.

2. The Labor Support and Assisted Delivery Guide: intended to guide team discussion when considering an operative delivery.

South Shore Hospital delivers 3,000 infants every year—more than any other hospital in the region and has Southeastern Massachusetts’ only Level III Neonatal Intensive Care Unit.  To learn more about Ariadne Labs and the “Team Birth Project” visit: https://www.ariadnelabs.org/areas-of-work/delivery-decisions-initiative/