A Collaborative Practice Initiative to Reduce the Rate of Cesarean Deliveries: The Vaginal Delivery Optimization Team

Our nurses now enthusiastically embrace and are consistently implementing current evidence‐based practices, such as active position changes that encourage fetal rotation, and descent and passive descent, and open glottis pushing, which decrease maternal exhaustion and improve fetal outcomes. With the incorporation of these measures, we have seen our primary cesarean delivery rate decrease from 25.1% in January 2012 to 18.3% in December 2012 for low‐risk nulliparous women with term singleton vertex fetuses.