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    Maryland collaborative seeks to reduce elective cesarean deliveries
    Maryland’s rate for nonmedically indicated birth type outpaces national average
    Baltimore, MD (September 1, 2015) – The Maryland Department of Health and Mental Hygiene (DHMH), Maryland Hospital Association and Maryland Patient Safety Center, Perinatal-Neonatal Quality Collaborative will be working closely with hospitals on an initiative to reduce non-medically indicated cesarean deliveries in Maryland.
    Rising cesarean delivery rates are considered a major public health problem in the United States, where nearly one-third of births are now delivered by cesarean. Rates are even higher in Maryland, where 35 percent of births are cesarean deliveries, compared with 21 percent in 1998. In 2013, Maryland had the ninth-highest cesarean delivery rate of any state in the nation.
    Cesarean delivery is now the most common major surgery in the United States, and there is strong concern that it is overused. “There is no doubt that cesarean delivery can be life-saving,” says Dr. Howard Haft, DHMH Deputy Secretary of Public Health Services. “However, we need to remember that a cesarean birth carries all the risks of major surgery – along with higher maternal and infant complications, longer length of hospital stay and more difficult postpartum recovery.” 
    These risks may be compounded with subsequent cesarean deliveries. Up to 90 percent of women have a repeat cesarean. A primary focus of this initiative is to decrease the cesarean delivery rate among first-time mothers.
    “This is all about healthier moms and babies,” said Maryland Hospital Association President and CEO Carmela Coyle. “Hospitals work hard to make sure the care we provide is top-notch, and often the best way to do that is to let nature take its course. It’s important that delivery decisions be made between a mother and her doctor. But at the same time, we need to ensure that, when it comes to childbirth, nature and medical necessity trump convenience.”
    “Being part of this effort to reduce unnecessary cesarean deliveries is an important endeavor for our Center,” said Robert Imhoff, President and CEO of the Maryland Patient Safety Center. “We have been successful in affecting positive change in reducing unnecessary early elective deliveries without medical indication throughout our state over the past several years. We are eager to initiate a collaborative that will assist hospitals, clinicians and patients in implementing strategies to reduce the rate of cesarean deliveries in Maryland.”
    This initiative plans to adopt evidence-based strategies recommended by the American Congress of Obstetricians and Gynecologists (ACOG), Society of Maternal Fetal Medicine, Joint Commission and the U.S. Department of Health and Human Services.
    Strategies include the use of national perinatal quality-improvement measures at delivery hospitals, encouragement of vaginal births after cesareans, patient education about the health consequences of cesareans, and input from obstetric professionals and policymakers.
    For more information on maternal health, please visit DHMH’s Maternal and Child Health Bureau at http://goo.gl/uAO20c.
    The Maryland Department of Health and Mental Hygiene is the state government agency that protects Maryland’s public health and also works to help Marylanders make better health decisions for better health outcomes. Stay connected: www.twitter.com/MarylandDHMH and www.facebook.com/MarylandDHMH.