Comprehensive Obstetrical Care

Obstetrics

Obstetric outcomes are reported for births attended by staff, private physicians and midwives at Cleveland Clinic Health System regional hospitals and main campus. In 2020, 80.8% of births in the system were attended by Cleveland Clinic staff physicians or midwives.

NTSVᵇ Cesarean Delivery Rate

2017 - 2020

Source: Joint Commission National Quality Measures Perinatal Care-02

ᵃCleveland Clinic Target: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Reduce cesarean births among low-risk (full-term, singleton, and vertex presentation) women. Healthy People 2020. Washington, DC: 2010

ᵇN is the total number of low-risk, first-birth women (ie, nulliparous, term, singleton, vertex presentation)

Successful Trial of Labor After Cesarean Delivery

2017 - 2020

ACOG = American Congress of Obstetricians and Gynecologists

ᵃCleveland Clinic target: ACOG practice bulletin. Vaginal birth after previous cesarean delivery. Number 5, July 1999. Clinical management guidelines for obstetrician-gynecologists. American College of
Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1999 Aug;66(2):197-204.

ᵇN is the patients with prior cesarean delivery who underwent trial of labor

Episiotomy Rate

2017 – 2020

ACNM = American College of Nurse-Midwives

Source: National Perinatal Information Center

ᵃAmerican College of Nurse-Midwives (ACNM) Benchmarking Project 2010: Practices with > 500 deliveries per year.
www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001539/ACNM_BenchmarkingProject_1012.pdf

ᵇN is the number of vaginal deliveries

Third- and Fourth-Degree Lacerations in Vaginal Deliveries Without Instrument Assistance

2017 – 2020

Source: Obstetric Trauma Rate — Vaginal Delivery With Instrument, Patient Safety Indicator #18, Provider-Level Indicator,
AHRQ Quality Indicators, Version 4.3, August 2011. qualityindicators.ahrq.gov/Downloads/Modules/PSI/V2018/TechSpecs/PSI_18_Obstetric_Trauma_Rate%E2%80%93Vaginal_Delivery_With_Instrument.pdf

ᵃCleveland Clinic target: derived from review of peer organization members of Vizient. Data from the Vizient Clinical Data Base/Resource Manager™ used by permission of Vizient. All rights reserved.

ᵇN is the total number of spontaneous vaginal deliveries

Early Elective Deliveries

2017 - 2020

Elective deliveries between 37 weeks and 38 weeks 6 days gestational age.

ᵃN is the total number of deliveries.

Postpartum Readmission Rates

2017 – 2020

N is the total number of deliveries.

Postpartum Depression Screening

2017 – 2020

The Ob/Gyn & Women's Health Institute screened more than 82% of postpartum patients for depression in 2020. This was accomplished by incorporating screening for postpartum depression into an electronic questionnaire that was developed within the electronic medical record for all 6 week postpartum encounters. A two-item patient health questionnaire is used to evaluate all postpartum patients. If either question is answered yes, a complete Edinburgh Postnatal Depression Scale is administered.

With this screening and provider education, patients with symptoms of depression are identified, and opportunities for treatment and intervention are maximized.

N is total number of visits.

Severe Maternal Morbidity (SMM) Rate

2017 – 2020

To identify delivery hospitalizations with SMM, the chart used the International Classification of Diseases (ICD) diagnosis codes listed in CDC’s web site at https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm

N is the total number of deliveries.

NTSV Cesarean Rates on Midwife Patients

2017 – 2020

Women considered to have midwife care saw a midwife for the majority of their OB visits.

N is the total number of Low-risk, first-birth women (ie, nulliparous, term, singleton, vertex presentation) whose prenatal care provided by midwives.

Nulliparous Preterm Birth Rates on Midwife Patients

2017 - 2020

N is the total number of midwife deliveries in the year.

Nulliparous Preterm Birth Rates by non-Midwife Providers

2017 - 2020

N is the total number of non-midwife deliveries in the year.