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(left to right) Shirley McDuffie, CNM, Shanaya Recalde, CNM, WHNP-C, Lehka Sreekumar, WHNP-C, Carol Rose-Trzaska, CNM.MS, and Chantal Berry, CNM, WHNP-C visit a new mother and her baby.

Trinitas Low C-Section Rate Among State's Best

TRMC effort also combats maternal mortality

Joining with First Lady Tammy Murphy, the state Department of Health and hospitals across the state, Trinitas Regional Medical Center remains committed to improving the health of new mothers and newborns in New Jersey.

"The goals of the First Lady's Nurture NJ campaign and those of Trinitas align perfectly, and are, in fact, what we have been doing for many years," explained Gary S. Horan, FACHE, President & Chief Executive Officer.

One of the campaign's goals is the reduction of unnecessary Caesarean section births, which can increase the possibility of complications such as infection and bleeding. Trinitas' low C-section rate for first-time mothers results from the 24/7 presence of in-house nurse midwives in addition to board-certified OB/GYN physicians.

"Under the nurse midwifery model of care, the certified nurse midwife will stay with and encourage the mother at bedside through the entire labor and birth experience," stated Mary McTigue, RN, Vice President/Patient Care Services & Chief Nursing Officer at Trinitas.

"This highly personalized approach, combined with appropriate pain management, allows the mothers in our care to progress to a vaginal delivery when there is not a medical reason for a C-section. An obstetrician is always available if a higher level of care is needed," she added. Trinitas' 22.7% C-section rate among first-time mothers compares favorably with the 29.3% state-wide average. It is the sixth-lowest among New Jersey's 49 hospitals with maternity services.

Preventing first-time C-section births not only decreases the risk for maternal morbidity for that delivery, but for future deliveries as well, she explained.

Another focus of the partnership is a reduction in early elective deliveries – those classified as occurring in less than 39 completed weeks of pregnancy without a medical reason for early delivery. McTigue explained that letting a baby come to full term before delivery brings many benefits to both mother and baby. "The last few weeks of pregnancy are as important as any other phase. Unless there's a medical reason, deliveries that are induced prior to 39 weeks can put the baby at a higher risk for a range of health and developmental issues," she said.

The rate at Trinitas for births prior to 39 weeks is 1.8%, among the lowest in the state, which also compares favorably to the 5% or lower from the Leapfrog Group, an organization that rates/grades various healthcare programs and services.

To stay on top of the curve and to share knowledge, Trinitas participates in collaboratives such as the New Jersey Hospital Improvement Innovation Network. "We share and implement evidenced-based best practices. In the Obstetrics area, they cover things such as reducing C-sections in first-time moms, to patient safety practices to prevent hemorrhage and severe hypertension," she stated.

Key to all of these efforts is the elimination of health disparities among racial/ethnic groups, which can be significant. "It has been well-established that black women are more likely to experience pregnancy complications and cesarean births compared to white and Hispanic women," McTigue said. "These discrepancies can also be caused by social determinants of health care, such as lack of access to care because of no transportation or child care, impacting their health and the health of their newborns."

Mr. Horan reflected that Trinitas has long been an advocate for safe, quality care for all, regardless of race, ethnicity, religion or ability to pay. "Our community is a highly diverse community, and it has been that way for many years," he said. "In Elizabeth and Eastern Union County we offer a very successful model of building trust within the community. Through programs such as our Health Center, OB Practice and Nurse Midwife program, we can bridge any gaps that may exist."

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About Trinitas Regional Medical Center
Trinitas Regional Medical Center was established in 2000 following the consolidation of Elizabeth General Medical Center and St. Elizabeth Hospital. Trinitas, a major center for comprehensive health services for those who live and work in Central New Jersey, is a Catholic teaching medical center sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation. With 11 Centers of Excellence across the continuum of care, Trinitas has distinguished itself in cardiology, cancer care, behavioral health, renal care, nursing education, diabetes management, wound healing, breast health, seniors healthcare, women's healthcare and sleep medicine.

Posted: January 25, 2019

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