Reduction of the Primary C-Section Rate

Early in 2020, the Director of the Birth Center and the Quality Director observed a concerning rise in the Cesarean (C-Section) rate for nulliparous women with a term, singleton baby in a vertex (NTSV) position at Southwest Health. Their initial research revealed that since January 1, 2018, the hospital's primary C-Section rate had been significantly exceeding the state average. By the spring of 2020, when the project began, Southwest Health’s primary C-Section rate was averaging 43%, compared to the state average of 22% and a benchmark of 14%.

In response, the Director of the Birth Center, Chief of OB, Director of Quality Services, and Chief Clinical Officer collaborated closely with the OB Provider Committee to develop and implement an action plan. This plan underwent various Plan-Do-Study-Act (PDSA) cycles over the past three years. The initiatives included training, equipment upgrades, guideline reviews, policy updates, and the introduction of balancing metrics.



As a result of these efforts, Southwest Health has seen a consistent decline in its primary C-Section rate. In December 2020, the rate had decreased from 43% to 38%. The ongoing PDSA and Quality Improvement project further reduced the rate to 28.9% by December 2021, and to 20% by December 2022. By September 2023, the primary C-Section rate had dropped to 11.65%, well below the state benchmark.

Senator Howard Marklein commended the team’s efforts, stating, “Labor and delivery services cannot be taken for granted in rural Wisconsin communities. I enjoyed meeting with the Southwest Health quality improvement team in the state capitol to hear how they are working to improve outcomes for moms and babies in our area.”