KINGSTON, N.Y. (November 9, 2016) — HealthAlliance Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), has been accepted into the American College of Nurse-Midwives’ “Reducing Primary Cesareans Project” to improve the health of mothers and babies by reducing the incidence of first C-sections in low-risk women who’ve never given birth.

The project is part of ACNM’s Healthy Birth Initiative, a long-term effort with leading maternity-care organizations. The initiative promotes evidence-based practices that support healthy births based on a pregnant woman’s own physiology. Encouraging a consistent approach to birth practices, it also focuses on reducing practices that are not evidence-based.

“HealthAlliance is honored to be part of this multistate initiative among hospitals that ACNM handpicked for providing the highest quality of labor and delivery care,” said Family Birth Place Director Robin Stevens, a master’s-prepared registered nurse.

“C-sections can, of course, be lifesaving,” said Family Birth Place Medical Director Dr. Dominique Delma, who’s board certified in obstetrics and gynecology. “But in women with low-risk first pregnancies, C-sections with no medical justification have reached alarmingly high rates, with no associated health improvements for mom or baby. In fact, in those low-risk cases, the procedure is more likely than a vaginal delivery to lead to disease, disability or even death.”

Under the Reducing Primary Cesareans Project, funded by the Transforming Birth Fund, maternity health professionals and health systems agree to take action steps called “bundles.” Each bundle brings about a change aimed at reducing the number of primary, or first, C-sections.

HealthAlliance will implement at least one of three bundles, based on a data-driven analysis of the major reason low-risk women at the hospital have first C-sections.

  • Those bundles involve:
    Improving care and comfort in labor.
  • Promoting natural, spontaneous labor progress.
  • Using “intermittent auscultation” as the standard for fetal assessment instead of continuous electronic fetal monitoring. With intermittent auscultation, a nurse or midwife monitors the fetal heart rate and rhythm at periodic intervals during labor with a handheld Doppler ultrasound device or a type of stethoscope called a fetoscope. For low-risk pregnancies, the intermittent monitoring is just as safe as continuous monitoring and is less likely to lead to a C-section or a forceps and vacuum delivery, ACNM says. Women whose babies are monitored with intermittent auscultation are also less likely to need pain medication.

“We look forward to working with ACNM and the multihospital quality collaborative, and feel proud of the role we will play as champions of reducing first-time C-section rates in low-risk women who’ve never given birth,” Stevens said.

About HealthAlliance, a member of the Westchester Medical Center Health Network
HealthAlliance of the Hudson Valley operates a 315-hospital bed healthcare system comprising HealthAlliance Hospital: Mary’s Avenue Campus and HealthAlliance Hospital: Broadway Campus in Kingston, New York, and Margaretville Hospital in Margaretville, New York. It also operates Mountainside Residential Care Center, an 82-bed facility in Margaretville. As Ulster County’s largest employer, HealthAlliance is committed to attracting the best-qualified medical and support staff; providing outstanding, responsive, coordinated, compassionate patient- and family-centered care; excelling in clinical outcomes and patient experiences; and ensuring patient rights, privacy and respect are honored at all times, while improving the overall health and well-being of the diverse communities it serves. For more information about how HealthAlliance is delivering the promise of medicine, visit or follow or

About the American College of Nurse-Midwives
The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. With roots dating to 1929, ACNM sets the standard for excellence in midwifery education and practice in the United States and strengthens the capacity of midwives in developing countries. Our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews research, administers and promotes continuing education programs, and works with organizations, state and federal agencies, and members of Congress to advance the well-being of women and infants through the practice of midwifery. For more information about ACNM, please visit our website at

Dr. Dominique Delma, medical director of HealthAlliance Hospital’s Family Birth Place, smiles at the baby of Dr. Marta Sanchez, who gave birth in the Family Birth Place.

Dr. Dominique Delma, medical director of HealthAlliance Hospital’s Family Birth Place, smiles at the baby of Dr. Marta Sanchez, who gave birth in the Family Birth Place.