Skip to main content

OHCA Cesarean Section Quality Initiative

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   SFY 2020 SFY 2021
SFY 2022
Total C-Section Rate 32.16% 30.0% 31.3% 31.1% 30.4% 31.4% 30.6%
Primary C-Section Rate 20.3% 15.5% 16.2% 16.5% 16.1% 17.3% 16.8%

*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, Jaclyn Mullen, MSN, RN, CPC.

Cesarean Reports

Last Modified on Feb 16, 2023