Cesarean Delivery Paper

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

Johnson et al. emphasize lower cesarean section rates of physician-mothers under physician-induced demand (2). One reason concerns higher reimbursement of surgical births rather than vaginal deliveries, which functions as a non-medical factor. Financial incentives are imposed on uninformed patients so that cesarean deliveries become more frequent in the health environment. Despite the non-medical factors applying cesarean sections should be regarded in terms of maternal mortality and morbidity. In addition, performing the vaginal delivery safely could involve more resources and treatment of any arising complications during the birth. Patients’ knowledge about interventions could achieve larger cuts in cesarean section

Cesarean section (C/S) births can occur in the hospital for several reasons. Some women choose to have elective C/S birth and others require C/S births out of infant or maternal safety, complications, or by necessity. This paper discusses both elective and emergency C/S deliveries and reviews both National Guideline policy and Carilion Clinic policies on C/S births. The problem statement is: in pregnant women (population), does C/S delivery following National or Carilion policies (IV: exposure vs. none-exposure) differ in terms of patient care and outcomes concerning maternal and neonatal health (DV)?

In many cases, a patient increases their odds of a cesarean section if they chose to be induced without causation. A study was conducted between the years of 1999 to 2000 with 3215 nulliparous women. The findings of this study showed that nulliparous women are at a significantly higher risk of needing a cesarean section if they were electively induced (Luthy et al., 2004). Multiple studies have looked at nulliparous versus multiparous women and have found that elective inductions do not look to increase the odds of a woman needing a cesarean section in multiparous women. Researchers have begun to look at other possible relationships between patients who undergo an elective induction that results in a caesarean section and they have found

The conclusion was ultimately reached that medical or elective induction of term women was associated with an increased risk of cesarean delivery and that estimate was determined heavily based on the Bishop Scores attained The study closes by advising that induction of labor, whether it is medical or electively induced, should be avoided because a low Bishop score means that the cervix is unripe and even with cervical ripening agents, the study showed that the risk of cesarean delivery for nulliparous women remained unchanged. Their advice is to allow the mothers to spontaneously go into labor if they have an unfavorable Bishop score because it will lower cesarean delivery rates (Vrouenraets et al. 2005). This rationale directly correlates

According to “Human Sexuality: Diversity in Contemporary America,” women and couples planning the birth of a child have decisions to make in variety of areas: place of birth, birth attendant(s), medication, preparedness classes, circumcision, breast feeding, etc. The “childbirth market” has responded to consumer concerns, so its’ important for prospective consumers to fully understand their options. With that being said, a woman has the choice to birth her child either at a hospital or at home. There are several differences when it comes to hospital births and non-hospital births.

Yet, these preterm births and the deaths can be stopped and prevented with established, low cost involvements. There is a prominent, noticeable and

Although nurse midwives do complete the task of aiding in the delivery of newborns, “they also provide health care and wellness care to women, which may include family planning, gynecological checkups, and prenatal care” (nurse.org). Nurse midwives also assist along with physicians during c-sectional births. Certified Nurse Midwives or CNMs are advanced nurse practitioners; however, nurse midwives must earn an advanced degree, a special certification, and training in order to practice midwife duties. CNMs offer similar care to that of an OB/GYN doctor; therefore they make different financial earnings. “Nursing Economics, found that when midwives work in collaboration with physicians, the birth is less likely to end in a C-section” (nurse.org). If less c- sections are performed in hospitals, it could help lower the medical costs due to paying for medication during the labor and delivery, of a natural vaginal birth. To illustrate, nurse midwives should be more prevalent in hospitals, in order to lower the financial status of medical

Vaginal birth after caesarean (VBAC) is the name used for identifying the method of giving birth vaginally after previously delivering at least one baby through a caesarean section (CS). A trial of labour (TOL) is the term used to describe the process of attempting a VBAC. An elected repeat caesarean (ERC) is the other option for women who have had a caesarean in the past. The rates of women choosing to deliver by means of an ERC has been increasing in many countries, this is typically due to the common assumption that there are too many risks for the baby and mother (Knight, Gurol-Urganci, Van Der Meulen, Mahmood, Richmond, Dougall, & Cromwell, 2013). The success rate of VBAC lies in the range of 56 - 80%, a reasonably high success rate, however, the repeat caesarean birth rate has increased to 83% in Australia (Knight et al., 2013). It is essential to inform women of the contraindications, success criteria, risks, benefits, information on uterine rupture and the role of the midwife in relation to considering attempting a VBAC (Hayman, 2014). This information forms the basis of an antenatal class (Appendix 1) that provides the necessary information to women who are considering attempting a VBAC and can therefore enable them to make their own decision regarding the mode of birth.

The increase in the rate of CS will result in higher possibilities of future complications. Of course, there’s a reason behind increasing the rate of CS (Chalmers et al., 2010). Some studies showed that planned route of delivery leads to differences in neonatal morbidity, which decreases in vaginal delivery (Geller et al., 2010). Despite a surgical procedure that is performed to protect maternal and fetal health, caesarean section (CS) has recently become a delivery method preferred by expectant mothers beyond a medical or obstetric modality ordered by specialists, if

Maternal mortality represents more than the loss of lives for individual women, as it also reflects the larger value and prioritization of women 's health and threatens the health and survival of families, young children, and even the communities in which they live (Royston and Armstrong, 1989). Maternal mortality is unacceptably high (WHO, 2015b). Globally, approximately 830 women die every day from pregnancy- or childbirth-related complications (ibid.). The causes of maternal mortality are predominately preventable and can be classified into three fundamental causes: (1) medical - consisting of direct medical problems and pre-existent/coexistent medical problems that are aggravated by pregnancy, (2) underlying - social and legal conditions, and (3) health systems laws and policies that address availability, accessibility, and quality of reproductive health services (PHP et al, 2011).

With technological advances, many United States women are turning to home births rather than hospital births. Avoiding unnecessary medical interventions, previous negative experiences, and mistrust of traditional providers are just some of the common reasons why mothers do not choose hospital births (Boutcher, Bennett, McFarlin, & Freeze, 2009). Home births provide an environment that feels familiar and safe and the mother has an increased sense of control. Even though home births have acceptable safety percentages, they are not well supported by the government, society, or insurance companies (Boutcher et al., 2009).

Over the years birthing methods have changed a great deal. When technology wasn’t so advanced there was only one method of giving birth, vaginally non-medicated. However, in today’s society there are now more than one method of giving birth. In fact, there are three methods: Non-medicated vaginal delivery, medicated vaginal delivery and cesarean delivery, also known as c-section. In the cesarean delivery there is not much to prepare for before the operation, except maybe the procedure of the operation. A few things that will be discussed are: the process of cesarean delivery, reasons for this birthing method and a few reasons for why this birthing method is used. Also a question that many women have is whether or not they can vaginally

Ones upon a time, women got the cesarean section in birth complexities or when the normal delivery was not possible. But nowadays women are attracted to the unnecessary cesarean section. This is one of the reasons of increasing the rate of cesarean section. Women’s decision of birthing is related with her social, cultural, economic and religious aspects.

Figure 2: Percentage of newborns discharged early from vaginal deliveries without complications in California 1995-2000