98 | SEPTEMBER 26 • 2019 

Huron Valley-Sinai Hospital works to 
enhance childbirth safety with fewer 
caesarean sections.

SHARI S. COHEN CONTRIBUTING WRITER

Health

C

aesarean sections, a 
surgical method to 
deliver babies, were 
once somewhat rare. Today, 
however, seemingly everyone 
knows someone who has had 
a C-section rather than a tra-
ditional vaginal delivery. The 
national C-section rate is 32 
percent, with Michigan only 
slightly lower at 31.9 percent.
While sometimes neces-
sary for the mother or baby’
s 
health, obstetricians are con-
cerned about the increases in 
C-sections because they pose 
some risks and disadvantages 
versus non-surgical deliveries. 
Efforts are under way nationally 
and locally to reduce the use of 
C-sections.
Danny Benjamin, M.D., 
chief of obstetrics and gynecolo-
gy at DMC Huron Valley-Sinai 
Hospital in Commerce, explains 
that mothers who have one 
C-section may then be subjected 
to caesareans for all future preg-
nancies. This potentially impacts 
the baby, he says, because “get-

ting squeezed out during a vag-
inal delivery results in compres-
sion that reduces fluids from the 
lungs.” C-sections eliminate that 
process and babies often require 
incubation as a result, delaying 
important early mother-baby 
interaction.
For mothers, C-sections 
increase the risks of breath-
ing problems, infections and 
embolism, resulting in a higher 
morbidity rate, says Chaur-
Dong Hsu, M.D., M.P
.H., spe-
cialist-in-chief of ob/gyn at the 
Detroit Medical Center (DMC) 
and chair of the department 
of obstetrics and gynecology at 
Wayne State University. 
Approximately 6,000 babies 
are delivered at the DMC’
s 
Hutzel, Sinai-Grace and Huron 
Valley-Sinai hospitals annually, 
and the C-section rates vary 
considerably. Benjamin says 
Huron Valley-Sinai Hospital’
s 
C-section rate is 13 to 17 
percent, the lowest within the 
DMC. “We want to create a 
structure to bring them all into 
a normal range,” he says.
Hsu attributes the rise in 
caesareans to an increase in 
patients’
 obesity, large babies 
and more twins. Also, some 
mothers don’
t want to try a vag-
inal birth after a caesarean. 

CHANGING PERSPECTIVE
The DMC’
s goal is to reduce 
caesareans for uncomplicated 
first pregnancies and Huron 

Valley-Sinai is leading the effort. 
 “Maybe the decision to 
have a C-section is made a 
little early,” Benjamin says. 
In the past, women whose 
cervixes were dilated only 1-2 
centimeters were considered in 
labor and could be admitted. 
Now, active labor is defined at 
a later stage by the American 
College of Obstetricians and 
Gynecologists.
“We are trying to keep moth-
ers from being fully admitted 
and then frustration sets in 
and then people start doing 
something, such as breaking the 
mother’
s water or administer-
ing Pitocin (a drug to induce 
or speed up labor),” Benjamin 
explains. 
During the early stages of 
labor, he says, “We are using 
comfort measures and keeping 
mothers mobile.” Studies show 
that women active in early labor 
have a shorter overall labor 
and better delivery experience. 
Walking also reduces the chanc-
es of a C-section because of less 
time spent in bed.
The hospital has created an 
indoor walking path with eight 
activity stations. “This is ideal 
for women coming in with 
early labor,” says Madonna 
Ladouceur, clinical nurse spe-
cialist at the hospital’
s Harris 
Birthing Center. “It can help 
with pain management and 
help move the baby into the 
ideal position, which helps labor 

progress.”
At each activity station, the 
mother is encouraged to do a 
certain exercise or watch a video 
about medication and lactation. 
Ladouceur says the walking path 
has been well-received.
Another new feature at 
Huron Valley-Sinai Hospital 
is the use of nitrous oxide to 
relieve anxiety and pain during 
labor. It is administered through 
a mask and can be used with 
other pain medications. 
“It provides a nice relaxation 
feel and a very minimal amount 
goes to the placenta,” Ladouceur 
explains. “It gives mothers a 
little more tolerance for their 
labor. A C-section is available, if 
needed.”
C-sections often result when 
the baby is believed to be in 
distress — as indicated typically 
by a fetal monitor. However, 
Benjamin says fetal monitoring 
can result in “false positives” 
depending on how it is being 
interpreted. He says it’
s import-
ant for nurses and physicians to 
have the same training so that 
data from fetal monitoring strips 
are accurately and consistently 
evaluated. 
Huron Valley-Sinai’
s prena-
tal classes include information 
about what can be expected of 
labor, options to reduce pain 
and the efforts to reduce 
unnecessary cesareans. 

Clinical Nurse Specialist Madonna 
Ladouceur with Dr. Danny Benjamin

A pregnant mom uses 
the meditation music 
station on the indoor 
activity path at Huron 
Valley-Sinai Hospital. 

New 
Initiatives