One of every eight babies born in the United States is born in California. Of those births, three in 10 are delivered by cesarean. Many California hospitals, big and small, have instituted processes to maintain low cesarean delivery
rates. To understand the practices of rural and community hospitals that have maintained a low cesarean delivery rate, the Hospital Quality Institute (HQI) received a grant from CHCF to study these California birthing hospitals and their processes in a project titled, Promoting Optimal NTSV Delivery Rates (PONDR).

The grant had two components with specific aims:

AIM 1: To study the practices of rural and community birthing hospitals in California with annual NTSV cesarean delivery rates at or below the Healthy People 2020 target of 23.9%.

AIM 2: To analyze cesarean delivery safety reports in the CHPSO Patient Safety Organization database.

The PONDR report is presented with recommendations and references that may be considered by all birthing hospitals looking to decrease their NTSV cesarean delivery rate and to develop accurate safety reporting.