Management of Stage I and Stage II Labor Arrest Disorder to Reduce Primary Cesarean Section Birth Rate for African American Women
School of Nursing
Date of Degree
Doctor of Nursing Practice (DNP)
Linda Cassar, DNP, RNC-OB, CNE; Loral Patchen, PhD, MSN, CNM, IBCLC
Cesarean Section, Primary, African American, First Stage Labor, Second Stage Labor, Disparities, Caregiver Education
Background: Cesarean section delivery rate in the United States has reached an alarming rate of over 30%. African American women experience a higher cesarean birth rate compared to Caucasian Women. The repeat c-section rate for all patients is greater than 80%. These findings underscore the need for intervention to reduce primary cesarean section deliveries in African American Women.
Objective: This quality improvement project aimed to implement caregiver education on the ACOG/SMFM definition of the first and second-stage labor arrest disorder to reduce primary cesarean section birth for African American women.
Method: This pre-and post-intervention quality improvement project was conducted on a Labor and Delivery unit at a large academic medical center. African American women between the ages of 18-40 who are nulliparous, full-term >37.0 weeks, and singleton pregnancy were included in the data collection. This was completed via retrospective chart review.
Results/Finding: The data was analyzed in SPSS using Pearson’s Chi-Square test. The pre-intervention sample size was 79 patients with 34 cesarean sections and 45 vaginal births. In the post-intervention sample, there were 62 patients with 23 cesarean sections and 39 vaginal births. The primary cesarean section birth rate decreased from 43% in the pre-intervention period to 37.1% in the post-intervention period. The p-value was 0.476 and while statistically not significant, there is a clinical significance to this finding.
Conclusion and implication: The reduction in the primary cesarean section rate of 5.9% indicates that the educational intervention was clinically impactful. A larger sample size is needed to demonstrate statistical significance.
©2023 Ariam Yitbarek. All rights reserved.
Yitbarek, A. (2023). Management of Stage I and Stage II Labor Arrest Disorder to Reduce Primary Cesarean Section Birth Rate for African American Women. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/134
Available for download on Tuesday, May 30, 2023