Editor's note: This story is part of Southwest Michigan Second Wave's On the Ground Battle Creek series.

BATTLE CREEK, MI — With cesarean sections on the rise nationwide, one Michigan hospital is turning the tide — delivering safer births by reducing unnecessary surgeries.

Bronson Battle Creek Hospital was recently recognized as one of the top 10 hospitals in Michigan for its success in lowering C-section rates, coming in well below the national average. At a time when maternal health disparities and surgical overuse are under growing scrutiny, the hospital’s efforts are making a measurable difference for mothers and babies alike.

While natural births are the preferred method of delivery, cesarean section (CS) births date back to ancient times. The earliest known records of the procedure date to ancient Egypt around 1500 BC, according to the National Library of Medicine.

Evolutions in modern medicine have included a focus on bringing down the rates of CS. The Bronson Birthplace in Battle Creek was recently recognized for coming in under the national average for this procedure, placing it among the top 10 hospitals in Michigan because of its work to reduce the rates of CS there.

“As of February 2025, the hospital’s cesarean birth rate for first-time moms with full-term, single, head-down babies was 18.4% — lower than the national goal of 23.6% set by Healthy People 2030, according to a press release from the hospital.

“I would attribute this to our participation in OBI (Obstetrics Initiative), which is Michigan’s quality collaborative that focuses on improving maternal care and a decrease in the number of C-sections,” says Letishia Hill, System Director of Women and Children’s Services, Bronson Healthcare.

Letishia Hill, System Director of Women and Children’s Services, Bronson Healthcare“Bronson’s work with OBI shows our dedication to safe, fair, and high-quality care for mothers,” said Mahmood Siddiqui, MD, physician and obstetrics department lead at Bronson Battle Creek Hospital. “This program helps reduce unnecessary C-sections and improve care. Thanks to strong teamwork, smart use of data, and proven best practices, we’ve made real progress for families in our community.” 

Bronson delivers over 4,000 babies each year at its two locations. Of these, Bronson Battle Creek has about 900 annually, says Marcie McCann, a Communications Specialist with Bronson Healthcare.

Hill says the reasons to initiate a C-section vary.

“We’re pretty much looking at the status of the mother or the infant. There could be a fetal emergency where the heart rate is declining. It could be a prolapsed umbilical cord, a placental abruption, or even the condition of the mother. Her body could be having a reaction, and her status could be declining. It’s really anything that could threaten the mother or infant.”

The increase in cesarean section (CS) rates, whether they are classified as unnecessary or elective, has globally raised significant concerns due to the associated risks involving maternal and neonatal outcomes,” says an article on the National Institutes of Health website.

“Although CS can be a lifesaving operation in specific medical cases, its overuse is exposing mothers and neonates to complications like hemorrhage, infections, and long-term consequences such as uterine scarring, infertility, and future pregnancy problems,” the article says. “The contributing factors include maternal preferences for convenience, fear of labor, and financial incentives within the healthcare systems that favor surgical interventions. Defensive medical practices and private healthcare providers further exacerbate this trend.”

Hospitals aim for a lower C-section birth rate because vaginal births are generally safer for low-risk pregnancies. C-sections are major surgeries and carry higher risks of complications like infection, blood clots, and longer recovery times for mothers, as well as breathing problems for babies, according to a Bronson press release.

“This is a higher-risk procedure. We only want to do it when it’s medically necessary. Lowering the rate of C-sections improves the health of the community overall,” Hill says.

CourtesyDr. Mahmood Siddiqui, obstetrics department lead at Bronson Battle Creek Hospital.At the same time, she says Bronson is also focused on addressing racial disparities in the healthcare space. Bronson Battle Creek recently entered into a partnership with the Southwestern Michigan Urban League to advance community health in the city’s African American community through education and initiatives that encourage proactive wellness and prevention.

Hill calls these disparities “very alarming.”

“We have done some implicit bias training with our staff to work on that issue,” she says. “We also have relationships with trusted partners in the community that have relationships with our Black patients.”

With respect to CS, she says Black women have higher rates of this procedure.
Among the reasons are a lack of trust between Black women and their healthcare providers and stressors like a lack of proper food, housing, or insurance, Hill says.
In the United States, Black women are three times more likely to die from a pregnancy-related cause than white women, highlighting the stark health disparities between Black and white mothers,” according to an article on Northwestern University’s website. 

“Even wealthy Black women like Serena Williams and Beyoncé aren’t immune from these risks. In 2018, they both told Vogue that they delivered by emergency caesarean section (C-section) after experiencing pregnancy complications.”

These kinds of stories, the article says, point to a trend: Black women are more likely than white women to deliver their babies by C-section.

Bronson offers prenatal education, which Hill says, “really teaches people about the labor process and how the delivery portion can take hours. We’re educating about the process and the risks associated with it. We’re not assuming that people know. Every woman is different in how they respond to pregnancy and delivery.

“Our OBI provider champions led the way,” Hill says. “They implemented new tools, educated staff, kept everyone on track, and made sure we celebrated our progress. Watching the numbers drop really inspired the team. It shows how committed we are to safer births and better outcomes for families.” 

A brief history of C-sections

In the Roman Empire, it was believed that a pregnant woman who died during childbirth should be cut open to save the baby. This procedure was called the "caesarean section" because it was performed on women who were "caesaris" (belonging to Caesar).

Key Developments in C-section History:

• Ancient Times:  The procedure was known and practiced, though survival rates for both mother and child were low due to infection and bleeding. 
• 1500s: The first documented successful C-section took place where both mother and infant survived, and is attributed to Jacob Nufer, a Swiss sow gelder (a spayer of female swine), on his wife. 
• 19th Century: The introduction of anesthetics and antiseptics dramatically reduced mortality rates and made the procedure more common. 
• Late 19th/Early 20th Century: Urbanization and the growth of hospitals led to C-sections becoming more integrated into medical practice, particularly within the field of obstetrics. 
• 20th Century: Advancements in surgical techniques, such as the Pfannenstiel incision, and the use of antibiotics to combat infection further improved outcomes. 
• Modern Era: C-sections are now a common and generally safe surgical procedure, though they are also associated with potential risks and complications.