TCHMB’s Obstetrics Subcommittee is focused on improving perinatal health care for women and their families. It aims to change practice through clinical quality improvement projects.
Previous work created an evidence-based toolkit for induction of labor as a strategy to assist with lowering the cesarean rate. The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) jointly published recommendations for strategies to lower cesarean rates in 2014. This project addressed the recommendations that could be applied in a standard fashion and had strong evidence to support the value of their implementation, through decreasing cesarean rates and increasing safety for the mother and neonate. The toolkit reviews indications for and scheduling standards of induction of labor, intrapartum management, diagnosis of failed induction of labor, and use of oxytocin.
This toolkit was posted on the ACOG District XI web site upon release. We propose that use of these types of measures become standard in all maternity facilities, similar to institution of Surgical Care Improvement Project (SCIP) measures.