First-time moms-to-be have a lot on their plates—a new pregnancy,
concern for the health of their unborn baby and wondering how their pending
childbirth will play out. At Torrance Memorial Medical Center, the goal
is to do everything possible to help first- time mothers achieve a vaginal
delivery rather than a cesarean section (C-section or surgical birth)
if medically possible.
The national goal for first-time moms with normal circumstances present,
known as NTSV, is 23.9%, and Torrance Memorial is working toward that goal.
What is NTVS? It means Nulliparous (a woman who has never given birth),
Term (a baby born at or beyond 37 weeks gestation), Vertex (the position
of the baby’s head is down and not in a breech or transverse position),
and Singleton (a single baby, no twins or beyond).
Pulse recently spoke with Mary Wright RN, MSN, RNC-OB, CENP, vice president of
nursing at Torrance Memorial and Natalie Salmon, RNC-OB, BSN, CLE, nurse
manager of the Mother-Baby and Labor and Delivery departments, to get
a better perspective on the important work being done to reduce C-section
rates for first-time moms.
“It’s important to avoid unnecessary C-sections for first-time
moms (and all moms). I encourage moms to partner with physicians in this
discussion,” says Wright.
“It’s a community effort. We hold a monthly meeting that includes
nurses, physicians and the chief of obstetrics, to review the number of
C-section births from the previous month. We want to know if there is
anything we could have done better,” says Salmon.
Wright and Salmon highlighted some of the strategies used to help laboring
moms increase their chances of having a vaginal delivery: using a fetal
monitoring system called Monica, which allows moms to walk during labor
rather than requiring them to stay in bed; using a “peanut ball”
(a peanut-shaped exercise ball) for better positioning during labor to
help expand the pelvic diameter so labor can progress; and Torrance Memorial’s
participation in a statewide association called CMQCC (California Maternal
Quality Care Collaborative), which supports vaginal births by identifying
best practices in obstetrics.