One of the most precious times in a family’s life is when they bring a child into the world. With that excitement comes a mountain of pressure and decisions – everything from selecting a nursery color to choosing the best baby products and gadgets. But families also face another, more critical decision – where to have their baby. But what should prospective parents look for?

Location is an important criterion for expectant mothers who want great care as close to home as possible. Thankfully, Rhode Island has great maternity options for mothers to ensure they receive the best possible care – top-notch, high-quality service and state-of-the-art technology – all in their very own backyard.

In addition, Rhode Island is fortunate to have multiple maternity care facilities that have been recognized as Blue Distinction Centers, a rating awarded by the Blue Cross Blue Shield Association (BCBSA). Blue Distinction Centers are nationally designated hospitals that demonstrate improved patient safety and better health outcomes based on objective measures developed with input from the medical community.

In 2016, BCBSA announced the Blue Distinction® Centers for Maternity Care program, a designation to help prospective patients find hospitals that deliver quality, affordable maternity care. This program evaluates hospitals on several quality measures, including the percentage of newborns that fall into the category of early elective delivery, an ongoing concern in the medical community. In addition, hospitals that receive a Blue Distinction Center for Maternity Care designation agreed to meet requirements that align with principles that support evidence-based practices of care, as well as having initiated programs to promote successful breastfeeding.

Hospitals in Rhode Island identified as Blue Distinction Centers for Maternity Care include:
• Kent County Hospital
• South County Hospital
• Women & Infants Hospital

It was recently announced that these hospitals achieved a 32 percent lower cesarean section (C-section) rate for first-time mothers compared to hospitals that are not in the Blue Distinction Center program. Blue Distinction Centers have an average C-section rate of 23.7 percent, which surpasses the Healthy People 2020 federal goal to reduce C-section rates for first-time, low-risk mothers in the U.S. to 23.9 percent by 2020.

To qualify as a Blue Distinction Center for Maternity Care, a hospital must achieve a C-section rate of 27 percent or lower, among other patient health outcomes and quality measures. Compared to other hospitals, Blue Distinction Centers also have 70 percent fewer early (37-39 weeks) elective deliveries and 53 percent fewer episiotomies.

For low-risk pregnancies, C-section delivery can pose a greater risk of maternal morbidity and mortality than vaginal deliveries due to complications that can occur, including hemorrhage, blood clots and/or major infection. There are also long-term risks associated with C-section deliveries if a woman has additional children. With each subsequent C-section delivery, the incidence of placental abnormalities such as placenta previa and placenta accreta increases and can lead to adverse neonatal outcomes and even perinatal death.

In addition to higher complications for babies and mothers, C-sections that are not medically necessary also raise overall costs to the healthcare system. For commercially insured Blue Cross and Blue Shield (BCBS) members, the average cost difference between vaginal and C-section deliveries was $4,157 ($13,325 versus $17,482), according to a Blue Cross Blue Shield Health of America Report.

Minimizing the rate of primary C-section is an important part of improving safety and delivery of care. Blue Distinction Centers for Maternity Care are leading the way toward providing better, higher-quality maternity care nationally, encouraging collaboration across care teams, and acknowledging the need for consistent standards and improved systems to provide better care for women and their babies.

Cathleen Newman is the director of network contracting and alternative payments at Blue Cross & Blue Shield of Rhode Island.