Question What were the rates of cesarean delivery for nulliparous, term, singleton, vertex (NTSV) births in California from 2014 to 2019 in the context of a mentor-led hospital collaborative intervention and statewide policy initiatives to reduce the rates of cesarean delivery?
Findings In this observational study of 7 574 889 NTSV births that compared the rates of cesarean delivery between 2014 and 2019, the rates in California had a statistically significant decrease from 26.0% to 22.8% (relative risk, 0.88). The cesarean delivery rate for NTSV births in the US (excluding California) was 26.0% in both 2014 and 2019.
Meaning Between 2014 and 2019, the rates of cesarean delivery for NTSV births in California decreased over time in the setting of a coordinated hospital-level collaborative and statewide initiatives designed to support vaginal birth.