Many hospitals across Kansas are participating in this program with the
help of the Kansas Foundation for Medical Care.  Our hospital's committee
includes OB and Nursery Nurses, OBs, lactation consultants, management and
childbirth educators (me).  Our biggest accomplishment was decreasing our
C/S rate from 21% to 16% in 3 months.  We're running about an 80%
successful VBAC rate.

Biggest frustration was MD participation.  The rest of us were nurses.  We
focused on what we could do to change our practices by offering non
pharmacological interventions to patients more often than an epidural
(birth ball, hydrotherapy, ambulation, intermittent auscultation etc.) and
look at what we accomplished!  On the docs side, even though they weren't
as active participants as the nurses, we were excited about their daring
attempts to birth breech babies vs. doing a C/S and they were successful
100% of the time!

Maurenne Griese, RNC, BSN, CCE, CBE
Birth and Breastfeeding Resources  http://www.childbirth.org/bbfr
Manhattan, KS  USA
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