Gloversville, NY — Nathan Littauer’s Birthing Center has achieved a significant milestone in maternal care, reducing postoperative narcotic use by 67% among cesarean (c-section) birth patients in 2025 through the implementation of an Enhanced Recovery After Cesarean (ERAC) program.

This reduction reflects a direct comparison of cesarean deliveries within the same calendar year. Data was analyzed from the first 18 cesarean patients of 2025, prior to ERAC implementation, and compared with the most recent 18 cesarean patients following ERAC rollout between September and December 2025. Using consistent documentation and patient populations allowed for a reliable, same-year comparison.

A chart review of medication administration records revealed that overall postoperative opioid use decreased by approximately 67% after ERAC implementation. Notably, 33% of ERAC patients required no narcotics at all, while 28% only required one dose or less. Most patients achieved effective pain control using scheduled non-opioid medications alone.

Pictured (left) is our very own Obstetrician and Gynecologist (OB-GYN) Patricia Nguyen, MD as she celebrates this special moment with Kylea and her brand-new baby girl Blair, with OR scrub nurse Allison Sweer (right)! With the option of a clear drape, parents can witness their baby’s very first moments of life! 

“Our goal was never to eliminate pain, it was to improve pain management,” said Birthing Center Registered Nurse, Hanna Barnholt. “By prioritizing multimodal pain management and patient education, we’ve been able to support safer, gentler recoveries while still ensuring patient’s comfort.”

The success of the program is attributed to a multidisciplinary, system-wide approach, including standardized scheduled non-opioid medications such as Tylenol and NSAIDs, regional anesthesia techniques like TAP blocks, and comprehensive preoperative education that sets clear expectations for recovery. Nursing education, consistent medication timing, early mobility, hydration, warming, and recovery milestones also play key roles.

“Reducing narcotic use was a priority for our Birthing Center to enhance patient safety, minimize common opioid-related side effects such as nausea and sedation, support opioid stewardship during a national opioid crisis, and promote faster recovery and mobility after cesarean birth,” said Birthing Center Manager Maureen Mosher, RN, BSN. “Patients have also reported high satisfaction with pain management and recovery under the ERAC model.”

Patients benefiting from the ERAC program have experienced faster physical recovery, reduced grogginess and gastrointestinal side effects, earlier bonding and breastfeeding, and an improved ability to care for and connect with their newborns.

While narcotic medications remain available when clinically indicated, they are no longer the default option. Instead, ERAC emphasizes multimodal pain management combined with non-pharmacologic comfort strategies and realistic recovery education.

This achievement reflects close collaboration among Littauer’s Birthing Center nurses, obstetricians, midwives, anesthesiology department, nursing education, and leadership. Together, these teams shared a common goal of improving outcomes through evidence-based practice.

Nationally, ERAC programs are recognized as best practice, though adoption and results vary widely. A 67% reduction in postoperative opioid use places the Littauer’s Birthing Center in alignment with—and in many cases exceeding—outcomes reported by larger academic medical centers, demonstrating that high-quality, innovative maternal care can thrive in a community hospital setting.

Looking ahead, the Birthing Center plans to sustain and refine ERAC outcomes as additional data is collected, expand education around non-opioid and non-pharmacologic pain management options, and explore additional comfort and recovery tools—all while continuing to prioritize patient safety, comfort, and choice.

About Nathan Littauer

Nathan Littauer Hospital and Nursing Home is a full-service, 74-bed acute care hospital with an 84-bed skilled nursing home. Since 1894, Nathan Littauer has provided safe, high-quality health and wellness services with a focus on securing appropriate new technologies for people residing in Upstate New York. Over the years, the hospital has expanded its services in order to offer health care that is comprehensive, accessible, and relevant to the needs of the communities they serve.  More information can be found by visiting www.nlh.org or calling (518) 725-8621