OHCA Cesarean Section Quality Initiative

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Over the last two decades, the Cesarean section (C-section) rate has continued to steadily and consistently increase without a corresponding improvement in maternal or neonatal outcomes. Professional sources report a range from 3% – 30% for operative deliveries performed without medical indication.

The Oklahoma Health Care Authority (OHCA) shares this concern for our members. In an attempt to lower the primary C-section rate performed without medical indication, OHCA has initiated an ongoing quality initiative.


 Reduction of Primary Cesarean Sections Without Medical Indication.


  • Beginning in January 2011 and continuing over the subsequent 8 months through August 2011, every contracted OHCA in-state provider & hospital that performed a minimum of 2 SoonerCare deliveries per a month received a letter with their primary C-section rate and total C-section rate every month. After August, 2011, rates have been reported quarterly. The rates are computed as follows:
  • Primary C/S rate = Primary c-sections divided by the sum of primary c-sections + vaginal deliveries
  • Total C/S rate = All c-sections divided by all deliveries
  • Exclusions = Assistant surgeons and VBACs


SoonerCare Rates SFY 2009* SFY 2017   SFY 2018   SFY 2019  

Total C-Section Rate


30.0% 31.3% 31.1%

Primary C-Section Rate


15.5% 16.2% 16.5%

*Rates prior to Cesarean Section Quality Initiative

Details of the initiative have been mailed to both obstetrical providers and hospitals. If you have questions or comments please submit to CSectionFeedback@okhca.org, Jaclyn Mullen, MSN, RN, CPC.



Cesarean Rates Release Schedule 

Cesarean Reports


Individual Provider Rates 
  • Sorted by Region/Confidential ID number  


Hospital Rates 
  • Sorted by Region/Name  
  state_icon Rates by Region