A new study published in Nursing Outlook reveals a significant connection: hospitals that maintain recommended nurse staffing levels in their maternity wards experience notably lower rates of cesarean births. This research provides crucial evidence supporting what many healthcare professionals have long believed about the impact of adequate nursing care.
Specifically, the study found that cesarean rates were 11% lower in labor and delivery units adhering to the Association of Women's Health, Obstetric and Neonatal Nurses' (AWHONN) standards. These guidelines recommend a ratio of one nurse per patient during parts of delivery, two nurses at birth, and one nurse for each mother-child pair in the hours immediately following birth.
Valuing Nursing for Better Outcomes
'While nurses intuitively know that having enough nurses to provide the attentive care that mother and babies need and deserve improves outcomes, research has been minimal in linking maternity nurse staffing and patient outcomes,' stated Kathleen Rice Simpson, a perinatal clinical nurse specialist at Mercy Hospital St. Louis and a study author. She expressed hope that these findings will encourage hospitals to recognize the immense value of consistent nurse staffing in achieving healthier outcomes for both mothers and babies.
The study surveyed 2,786 nurses across nearly 200 hospitals in 23 states regarding their maternity unit staffing levels in 2018 and 2019. By matching these responses with hospital data on C-section and vaginal birth rates, researchers established a clear link: better staffing was associated with lower C-section rates and higher vaginal birth rates, even among women with previous C-sections.
Beyond Cost: Nurse Staffing as an Investment
Despite common perceptions that increased staffing translates to higher costs, the study's authors emphasize that adequate nursing levels can actually lead to cost reductions. This is achieved by preventing unnecessary C-sections, which often result in longer hospital stays and potential complications.
'Nursing care is looked at as a cost center as opposed to a revenue center in hospitals, so it’s often one of the first things cut when hospitals are trying to keep costs in line,' explained Audrey Lyndon, the Vernice D. Ferguson Professor in Health Equity and executive vice dean at NYU’s Rory Meyers College of Nursing. 'But research continues to show that nurse staffing is a key contributor to patient safety across departments.'
The authors advocate for the Centers for Medicare and Medicaid Services (CMS) to incorporate nurse staffing standards into its 'Birthing-Friendly' designation, which aims to identify high-quality maternity care. They argue that when staffing is insufficient, labor nurses are forced to prioritize immediate medical tasks, potentially compromising other crucial aspects of care.
Source: American Nurse Journal | February 13, 2025