St. Luke’s University Health Network has seen a meaningful decline in cesarean-section, or C-section, rates since introducing a nurse-led initiative focused on labor support and movement-based techniques.
The initiative, called SPARK—Supporting Physiological Approaches, Resilience and Knowledge—is a program designed to help mothers achieve successful vaginal births whenever safely possible. (Generally, vaginal delivery results in faster maternal recovery, lower risks of infection or severe bleeding and immediate skin-to-skin bonding. It also benefits babies, including by reducing breathing issues.)
One of the most common reasons for a C-section delivery is fetal malposition, particularly when the baby presents in the occiput posterior position, or what is often referred to as “sunny-side up.” In this position, the baby’s head is down but faces the mother’s abdomen rather than her spine, often leading to more painful labor, slower progression and a greater likelihood of surgical intervention. SPARK equips nurses with evidence-based strategies to position the mother-to-be in ways that help guide babies into more favorable alignment during labor.
St. Luke’s labor and delivery nurses Shana Price, Kearsten Force, Megan Smith and Michelle Hoffman developed the SPARK program at the Anderson Campus in early 2024, motivated by a shared goal of reducing unnecessary C-sections, says Dawn Seymour, Director of Patient Care Services for Labor & Delivery.
“By emphasizing education, hands-on support, and patient-centered care, SPARK underscores the powerful role our nurses play in improving outcomes for both women and their babies,” Seymour says.
Nurses in the department complete at least four hours of specialized training in targeted movements and techniques designed to guide the baby into an optimal position during labor. SPARK has since expanded to other St. Luke’s hospitals with birthing centers, including Allentown and Upper Bucks, where early results also have been impressive.
Patient participation has been a key factor in the program’s success. Seymour says most women in labor are receptive once the benefits are explained—particularly the potential to avoid surgery, reduce recovery time and improve the overall birth experience. While some patients may opt out, especially after receiving an epidural, the majority are willing to participate, she says.
Six months after the launch of SPARK, C-section rates among appropriate patients at the Anderson Campus had been reduced by nearly a third – to 17.5%, down from 24.8%.
SPARK – the initiative of labor and delivery nurses committed to continuous improvement – is an example of the special culture that differentiates St. Luke’s. This past fall, the U.S. Department of Health and Human Services ranked St. Luke’s #1 – ahead of Houston Methodist and Mayo Clinic, two of the nation’s most prestigious institutions – as the nation’s top health system for quality, safety, and patient experience. This objective recognition, based on public data reported to the government, reaffirms St. Luke’s preeminent position among the leading health systems in the country.
