SEATTLE — A recently published study reported the number of births via c-section have nearly doubled since the year 2000, but professionals at EvergreenHealth in partnership with Overlake Medical Center aim to reduce that number through a new program called The Team Birth Project.
EvergreenHealth and Overlake Medical Center are two of four pilot locations chosen to work Ariadne Labs' Delivery Decisions Initiative to address issues in women's care during the birthing process. The Initiative claims many c-sections are medically unnecessary and pose a risk to women's health.
"The Delivery Decisions Initiative is a toolkit to help hospitals reduce C-section rates, and hopefully above everything else, improve patient experience," said Dr. Angela Chien, an OBGYN at EvergreenHealth. "We are proud to be part of this national program."
The Team Birth Project is the centerpiece of the Delivery Decisions Initiative. The goal is for patients to have a better understanding of what's happening to them during their labor.
"If you talk to women who come in to labor and they hope for their vaginal birth, we want them to leave the hospital understanding what happens to them, especially if their plan doesn't go as they had hoped," Dr. Chien said.
"It's really giving the patients a voice and choice," said Perinatal Clinical Nurse Specialist at Overlake Medical Center Margie Bridges, "We really want to hear from the patient, we want to know their preferences and we really want to try to honor them throughout."
In accordance with the project, EvergreenHealth and Overlake Medical Center are incorporating whiteboards into the birth planning process with their patients to ensure that the patient is receiving care that's appropriate for their condition at all times. This allows nurses and doctors to keep updating the plan as labor progresses so all members of the birthing team, from the families to the medical staff, are on the same page, preventing overtreatment like c-sections.
The whiteboard includes a space for the names of all the members on the birthing team, including the patient, the patient's partner, the registered nurse, provider, and anesthesiologist.
"I think it's really important that you are a team member and that's really intentional," Bridges said. "It's saying that we value your opinion and we want your feedback."
Professionals at EvergreenHealth and Overlake Medical Center say they see the patient as a core member of the birthing team, who can bring information medical professionals wouldn't otherwise know about their birthing process.
The whiteboard includes a section labeled "Preferences" that lists what the patient hopes to happen on the day of their delivery, including whether their partner would like to be involved, if they want an epidural, and if they want the baby to stay in their room or go to the nursery after delivery.
"[The plan] can change, this is dynamic," Bridges said. "Just like labor and birth."
"The point is really to make a plan that you understand and your family understands so we don't use much medical lingo by intent," Dr. Chien said.
A basic plan for a patient at EvergreenHealth would be keeping the mother comfortable, continuously monitoring the baby and using the "wait and see" approach when it comes to labor, to see how the patient's body is responding before intervening in any way.
The whiteboard also lists the next time the doctor will check in with the patient.
"If I can't physically get there they'll put me on speakerphone," Dr. Chien said. "The patients really know that I'm there and part of the conversation with their nurse."