Appropriate Nurse Staffing Tied to Lower Cesarean Birth Rates

TUESDAY, Feb. 11, 2025 (HealthDay News) — Better labor and delivery staffing during labor predicts lower cesarean birth rates, according to a study published online in the March-April issue of Nursing Outlook.

Audrey Lyndon, Ph.D., R.N., from the New York University Rory Meyers College of Nursing in New York City, and colleagues examined the relationship between labor and delivery staffing and hospital cesarean and vaginal birth after cesarean (VBAC) rates. The analysis included survey responses from 2,786 U.S. labor nurses (from 193 hospitals in 23 states) in 2018 and 2019.

The researchers found that the mean cesarean rate was 27.3 percent and the median VBAC rate was 11.1 percent. Adherence to staffing standards was relatively high (mean, 3.12 of possible 1 to 4 score). Nurse staffing was an independent predictor of hospital-level cesarean and VBAC rates when adjusting for hospital characteristics (incidence rate ratios, 0.89 and 1.58, respectively).

“Concern about cesarean section rates in the United States has been high for many years, and there has been little progress toward improvement. This study points us toward one important solution: aligning labor and delivery nurse staffing with consensus- and expert-developed guidelines,” coauthor Joanne Spetz, Ph.D., from the Institute for Health Policy Studies at the University of California, San Francisco, said in a statement. “While increasing nurse staffing during a period of shortage can be challenging, this investment could reduce overall costs by reducing rates of surgical cesarean sections and longer-term adverse outcomes for mothers and babies.”

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