Characteristics between the respondent groups were statistically compared using Chi-squared test for independence and the Fisher’s Exact Test. RESULTS: 220 medical students completed the questionnaire. 77% of medical students believed permission should be obtained from patients before the performance of pelvic examinations by medical students on anesthetized patients. Only 30% of respondents believed prior consent was usually obtained. 46% believed patients would agree to have EUAs performed. 85% of medical students believed patients would be upset if they were made aware a pelvic examina- tion by a medical student had been performed without their prior consent. 60% of medical students believed medical students should be allowed to examine anesthetized patients. 87% of medical students believed there was educational benefit. 53% would recommend to a female relative to allow a medical student to perform a pelvic EUA on them. CONCLUSION: Despite the perception of medical students that consent should be obtained before they perform pelvic examinations on anesthetized female patients, this does not usually occur. Almost 50% of medical students would not encourage their female relatives to consent to medical students performing pelvic examinations. There was no statistical difference between male and female medical students regarding percep- tions of student pelvic examinations on anesthetized female patients. Financial Disclosure: The authors did not report any potential conflicts of interest. OBSTETRICS Location, Location, Location: Hospital Level Predictors of Length of Stay Following Cesarean Section [21N] Alex Friedman Peahl, MD Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI Neil Kamdar, MPH, Michelle Moniz, MD, MSc, Sudipta Dasmunshi, BA, Lisa Kane Low, PhD, CNM, and Dan Morgan, MD INTRODUCTION: Length of stay (LOS) after cesarean delivery (CD) is poorly defined in different practice settings. We describe LOS in hospitals in a statewide obstetric collaborative, and evaluate for associations between LOS and hospital and patient characteristics. METHODS: Women who underwent CD in 2012-2016 for fetal malpresentation or prior CD were identified in an insurance claims database. LOS was defined as #2, 3, and $4 days. Multinomial logistic regression accounting for hospital clustering examined the influence of hospital and patient characteristics on post-surgical LOS. RESULTS: 16,218 women at 66 hospitals met inclusion criteria. LOS was #2, 3, and $4 days for 40.1%, 43.1% and 16% of patients respec- tively. Women were more like to have a longer LOS at hospitals with 3600 deliveries/year compared to hospitals with ,1200 (2 vs.3 days: .3600/year, RRR52.34 p50.005; 3 vs. 4 days: .3600/year RRR52.28 p50.001. LOS was longer for women with maternal comorbidities (2 vs. 3 days: RRR52.11 p,0.001, 3 vs. 4 days: RRR53.18 p.0.001), fetal comorbidities (3 vs. 4 days: RRR55.91 p50.035). LOS was also longer for women with severe maternal morbidity as defined by the NIH (2 vs. 3 days: RRR52.23 p,0.001, 3 vs.4 days: RRR53.74 p,0.001). CONCLUSION: LOS varies based on obstetric volume and comor- bidities. Clarifying the relationship between patient and hospital level factors may inform guidelines for safe discharge after Cesarean. Financial Disclosure: The authors did not report any potential conflicts of interest. MAMA’s Risk Stratified, Prenatal Medical Home Model Reduces Preterm Birth for African Americans in LA [22N] Emily Scibetta, MD LA County Department of Health Services, Los Angeles, CA Lisa Greenwell, PhD, Moraya Moini, MPH, Ashaki Jackson, MFA, PhD, Cassandra Trang, LVN, and Erin Saleeby, MD, MPH INTRODUCTION: MAMA’S Neighborhood (MAMA’s) in LA County (LAC) organizes prenatal care into a medical home model of wrap-around services. African American (AA) women are 48% more likely to experience PTB than non-Hispanic whites and expe- rience myriad social stressors; MAMA’s was designed to support women experiencing such stressors to reduce PTB risk. MAMA’s implemented risk assessments at intake for behavioral health, sub- stance use, housing/food insecurity and medical risk; and stratified risk groups to direct levels of care management and services to address these risks. METHODS: This is a retrospective cohort study, using single site data from a national demonstration project, to compare PTB rates for women in LAC during two phases: Phase 1: January 2014-August 2015, MAMA’s introduced a novel risk assessment for social stressors and Phase 2: September 2015-December 2016, implemented risk- stratified population health management and individualized care plan- ning. Multiple births were excluded. Multivariate logistic regression was performed and controlled for: medical comorbidities, smoking, race/ethnicity, age and prior PTB. RESULTS: Phase 1 included 441 women, compared to 435 in Phase 2. PTB among AA women dropped from 18% in Phase 1 to 9% in Phase 2. Regression reveals PTB among AA women was reduced when compared to controls with an adjusted odds ratio of 0.21 (CI 0.062- 0.708), p,0.02. CONCLUSION: MAMA’s made a clinically and statistically signifi- cant impact on PTB for AA women, a critical step in addressing the health equity gap. MAMA’s represents a promising value-based strat- egy leveraging multidisciplinary collaborative care with existing social services in the safety net to improve birth outcomes. Financial Disclosure: The authors did not report any potential conflicts of interest. Managing Women With Obesity in Pregnancy: Scope of Practice in the Wake of the Obesity Epidemic [23N] Shawna M. Stafford, MD Department of Obstetrics & Gynecology, University of Alberta, Edmonton, AB, Canada Ashley Demsky, MD, Richard Oster, PhD, and Helen Steed, MD INTRODUCTION: Obesity is a complex chronic disease affecting increasing numbers of reproductive aged women. Despite ongoing research efforts, many knowledge gaps remain when caring for women with obesity in pregnancy. Currently, there is no clearly defined, comprehensive standard of care for pregnant women with obesity. Consequently, obstetrical care providers have developed different approaches. In this study, we explored these approaches and how management of women with obesity differs from that of normal weight patients. METHODS: Qualitative concept maps were generated through individual in-depth mapping sessions with obstetricians (n57) in Ed- monton, Alberta, Canada. Concept maps were analyzed thematically and major themes and sub-themes used to inform survey development. Institutional ethics approval was obtained. RESULTS: Overall, seven dominant themes emerged from our thematic analysis: 1) Obstetricians define obesity differently; 2) Communication with patients with obesity should be “direct” and “honest ”; 3) Understanding fetal wellbeing is more challenging in patients with obesity in both the pre-natal and intra-partum period; 4) Obstetricians recommend induction of labor for large for gestational age fetuses but not maternal obesity; 5) Women with obesity have abnormal labor; 6) Obstetricians expect more complications, alter their surgical approach, and adjust their threshold for Cesarean deliveries in patients with obesity; and 7) Education and knowledge translation about obesity in pregnancy is inadequate. CONCLUSION: Concept mapping provided insights into how present-day obstetrical care is affected by obesity. This information has led to the development of a quantitative survey for obstetricians that will more broadly assess practice patterns for the management of women with obesity in pregnancy. 156S SATURDAY POSTERS OBSTETRICS & GYNECOLOGY © 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.