Measure Status: Active
Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=alliance&NPM=2&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/2-cesarean.php).
Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)
Service Type: Public health services and systems level of pyramid
Essential Public Health Services: 5. Create/champion/implement policy
Service Recipient: Activities related to systems-building
Goal: Increase the number of birthing hospitals participating in Michigan AIM
Numerator: Number of birthing hospitals participating in Michigan AIM
Denominator: N/A unit is Simple Count
Significance: For some medical indications, like placenta previa, cesarean birth is the safest delivery method and at times can be a life-saving measure. However, for most low-risk pregnancies, a cesarean delivery increases preventable risks for maternal mortality and morbidity outcomes. Such outcomes include mortality due to hemorrhage or morbidities such as infection, uterine rupture, cardiac arrest and anesthesia complications. A low-risk delivery is often defined as full-term (at least 37 completed weeks of gestation), singleton pregnancy (not a multiple pregnancy), with vertex presentation (head facing downward position in the birth canal). From 2012-2016, 15.3 % of pregnancy-related deaths in Michigan were due to hemorrhage and 54.2% of pregnancy-related deaths were deemed preventable. In 2018, the percentage of low-risk cesarean deliveries in Michigan was 28.7%, which is above the Healthy People 2020 goal (24.7%) and the average in the United States (25.9%). In addition, Michigan also has a higher percentage of low-risk cesarean deliveries in women of color.
To address the high percentage of low-risk cesarean deliveries, including the disparate numbers among women of color, Michigan will increase the number of birthing hospitals participating in Michigan AIM. It is expected that birthing hospitals engaging and participating in Michigan AIM will experience improved birth outcomes.
Data Sources and Data Issues: Michigan AIM
Unit Type: Simple Count, Unit Number: 80