Sutter Health strengthens maternal care through innovation and connection

High-quality maternal care is essential to protecting the health of both mom and baby during birth.

Sutter Health is taking a proactive, systemwide approach to maternal care — supporting a range of birth experiences while reinforcing the consistent use of evidence-based practices and clinical protocols. This includes a thoughtful approach to how and when cesarean sections are performed.

C-sections are an important and often lifesaving procedure in medically complex situations. At the same time, because they are major abdominal surgeries, avoiding those that aren’t medically necessary can help reduce the risk of complications such as infection or hemorrhage, support smoother recoveries and lower the likelihood of challenges in future pregnancies. 

In recent years, the California-based system deployed a coordinated framework across all 16 of its labor and delivery departments, increasing options for laboring mothers and reducing C-sections when it is safe to do so.

Central to Sutter Health’s progress is its Women’s Health Clinical Effectiveness Advisory Council, which brings together nursing and physician leaders from each hospital site for a monthly forum. Teams share successful practices, review comparative C-section dashboards and collectively identify opportunities for improvement.

Another pillar of Sutter’s strategy is strengthening the clinician-midwife partnership. The system expanded access to certified nurse midwives (CNM) and integrated midwife-supported birth as a standard option for lower-risk patients, aligning with evidence showing midwifery models can safely lower C-section rates. As a result, the CNM delivery rate at Sutter hospitals increased from 11.7% in 2023 to 16.7% in 2025. Sutter also increased access to doulas through both a pilot program and philanthropic partnerships, with a focus on communities experiencing disparities in health outcomes.

To support patients before birth, Sutter is expanding alternative prenatal care models, including group prenatal care, in which pregnant patients with similar gestational ages meet up regularly to learn from clinicians and each other while simultaneously building community. In 2025, nearly 300 Sutter patients participated in group care, convening eight times in total throughout their pregnancies.

With the launch of a new internally developed facilitator training program in 2026, Sutter anticipates doubling that number and adding at least five additional sites of care. This training, developed as a collaboration between Sutter Health University, clinical staff and service line executives, has a strong emphasis on facilitation and empowerment.

“By aligning teams around shared data, collaboration and evidence-based practices, we’re creating a culture of care that supports safer, more consistent birth experiences across our system,” said Jill Foley, M.D., Women’s Health Service Line Chair, Sutter Health. 

Sutter’s labor and delivery departments also use a clinical toolkit tailored for physicians, nurses and midwives that outlines best practices for safe, low-intervention labor management. The toolkit draws guidance from the California Maternal Quality Care Collaborative Coalition (CMQCC), and Sutter teams participate in monthly CMQCC seminars to stay current on emerging research and recommendations. Between 2022 and 2024, Sutter teams increased alignment with CMQCC guidelines for spontaneous labor by more than 15%, from 68.6% to 83.9%.

As Sutter expanded its quality improvement measures, it also saw encouraging feedback from the stakeholders who matter most: patients. Increasing access to midwives, doulas and group prenatal care enhances relationships between patients and care team members and supports person-centered care. These are all indicators of improved birth satisfaction. In 2025, two key patient experience metrics — doctors and nurses listening carefully — rose among labor and delivery patients from 77.8% to 90% and 77.9% to 84.3%, respectively.

“These efforts reflect a coordinated strategy that integrates clinical excellence with an understanding of the lived experiences that shape maternal health outcomes,” added Foley. “By aligning teams around shared data, evidence-based protocols and collaborative learning, at Sutter Health we’re reducing variation in care while supporting individualized birth experiences that prioritize safety for both mothers and babies.”