Utilization Patterns in Family-centered Cesarean Deliveries: A National Survey of Providers [16H]

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Mothers undergoing cesarean delivery may experience later skin-to-skin contact, greater difficulty breastfeeding, and decreased satisfaction than mothers delivering vaginally. Mimicking a vaginal delivery, the family-centered cesarean section (FCS) allows a mother to watch the birth through a lowered or clear surgical drape and receive her baby immediately after delivery. We sought to document previously-unknown FCS utilization patterns through a nationwide survey.


Our survey targeted providers who deliver in US hospitals. Using a publicly-available sampling frame of 1,031 hospitals and a regionally-stratified two-stage random sampling design, we post-mailed invitations containing the web address of our anonymous 19-item online questionnaire to 2,324 providers at 250 hospitals. Patterns in awareness and use of FCS across provider, patient-population, and healthcare-setting characteristics were examined.


Survey respondents (n=130) were geographically distributed and suggested broadly-dispersed awareness/use of FCS, with 87% (105/121) reporting awareness, 58% (65/121) reporting facility use, and 55% (64/116) reporting personal observation/performance. Overall, 81% (94/116) of providers recommended future use, 65% (34/52) in those who had not experienced FCS and 94% (60/64) in those who previously performed/observed FCS. In facilities having performed FCS, 60% (38/63) of providers reported that ≤20% of all cesarean sections were FCSs. In facilities without prior FCS use, 27% (15/56) of providers reported facility consideration of future use. Awareness and use of FCS also differed regionally and showed strong associations with provider demographics and credentials, patient socioeconomic characteristics, and facility size.


Despite reporting moderate use of FCS, providers nationally suggest high levels of awareness and strong desire for future use.

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