Finding Decision Aids For Mode Of Delivery Among Women Essay

Within Victoria there are multiple models of maternity care available to women. An initial discussion with the woman’s treating GP during the early stages of her pregnancy is critical in her decision-making about which model of care she will choose and this key discussion is essential in allowing a woman to make the first of many informed decisions throughout her pregnancy. According to a survey conducted by Stevens et al. (2010) only 43% of women felt ‘they were not supported to maintain up-to-date knowledge on models of care, and most reported that model of care referrals were influenced by whether women had private health insurance coverage.’ Many elements of these models of care differ: from location of care, degree of caregiver continuity, rates of intervention and maternal and infant health, outcomes access to medical procedure, and philosophical orientation such as natural or medical (Stevens, Thompson, Kruske, Watson, & Miller, 2014). According to the World Health Organization (1985) and Commonwealth of Australia (2008) there is a recognition that ‘85% of pregnant women are capable of giving birth safely with minimal intervention with the remaining 15% at potential risk of medical complications’ (McIntyre & Francis, 2012).

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

Carla Keirns dwells upon a problem of unnecessary cesarean deliveries performed only for urgent clinical reasons. As a diabetic expectant mother, she was going to deliver her first

Randomization was used to generate what patient went to which group. The way the patients were chosen eliminated bias because “Randomization was performed according to a computer-generated list by means of sequentially numbered, opaque, sealed envelopes which revealed the allocation of the subject to either induction or expectant management”(Nielsen et al. p. 60). This secure randomization added a great strength to the study. The sample size seemed fairly large, 226 patients were split into 116 for elective induction and 110 to expectant management, although the power analysis was disclosed in this study and determined that 600 patients were required. Only 226 patients were used and because it would take 4 years to reach the required amount of patients, the study was discontinued. This was both a strength and weakness because disclosing this information made the study more honest but the quota needed to reach the best answers was not attained. The study for the 226 patients was pretty standard with the 80% power and alpha at 0.05. T-test and chi square tests were used to compare the proportions between the groups of people. The women were chosen based on the inclusion criteria of being 39 weeks gestation or older, maternal age of more than 17, fetal cephalic presentation, singleton gestation, a candidate for vaginal delivery, and a Bishop score of 5 or greater in nulliparous women and 4 or greater for multiparous women. This inclusion criterion was a concern because both nulliparous women and multiparous women were being tested together. This was a weakness because the labor patterns of a nulliparous woman compared to a multiparous woman are very variable and sure to distort study data. It was also disclosed how gestational age was achieved which included the crown rump test measured in 6-12

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.

Bernadette Ward RN, Midwife, Grad Cert Ed, MPHandTM, MHlth Sci Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia. B.Ward@latrobe.edu.au Glenda Verrinder RN, Midwife, Grad Cert Higher Ed, Grad Dip Pub and Com Health, MHlth Sci Senior Lecturer, Faculty of Health Sciences, La Trobe University, Bendigo, Australia.

From the results, it is evident that the interventions were effective in increasing ANC coverage and improving other pregnancy related issues that emerged as a result of lack of or insufficient ANC. They addressed the common problems that affected the utilization of ANC, these included: maternal knowledge, accessibility to health care facilities and financial difficulties. Accordingly, as doctors and future practitioners, it is imperative that as we provide maternal and antenatal care, we structure the health care services we provide around the patient and cater to a patient's individual preferences, needs and concerns. We are advised to accommodate the patient as much as we can, which means providing them with care that is specific to them

The intent of this paper is to examine effective solutions for reducing cesarean deliveries. Cesarean deliveries involve more risk to both the mother and baby than vaginal births do. Cesarean deliveries have a higher potential of complications than vaginal births. Cesarean deliveries cost more, require longer hospital stays, and require more resources—both human and systemic—than vaginal births.

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

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)?

Elective inductions are becoming increasing popular and the old wait till you go into labor is becoming something of the past. Many woman want to predict when their future offspring will be here and be able to have a plan for when to take off of work. But one thing about having these elective inductions is the fact that they are more of a social event rather than a medical necessity. Studies have shown that the elective induction group makes up more than one third of the pregnant population (Jonsson 2012, pg. 198). This means woman are volunteering to make themselves go into labor before their body is ready. Not only are elective inductions increasing but being induced has been associated with a 3 to 4 fold increase in having a cesarean section (Yogev 2013, pg.1736). A Bishop Score is done before the start of any induction. This score is based off of cervical dilation, cervical effacement and the station of the babies head compared to the ischial spines. The number produced from this score shows whether or not the cervix is favorable or unfavorable. A favorable score is a score above 7. If the score falls below this, the cervix is not favorable. “Women who were closed dilation

For almost all of the previous 25 years roughly, the knowledge of pregnancy, labor, and delivery has changed little for some women. But change is arriving to the most traditional establishing, the hospital.

Student’s Role in Project: I was engaged in this project from the very inception and was involved in developing the project. In the developing phase of this project, patient needs, utilization, and costs were evaluated and two major priority needs areas were identified: non-emergent utilization of emergency department (ED) care and incomplete post-partum services, including well-baby visits. This project would help the discharge navigators connect with the frequent ED-utilizing and post-partum patients with a PCP and follow-up appointments. The goals of these discharge services are: (1) to minimize non-emergent use of ED services, thereby reducing cost and improving continuity of care with PCPs; (2) to ensure that pregnant patients schedule

This is a bright orange book that the woman carries around with her and to every visit. The purpose of the PHR is to encourage communication and initiate continuity of care. Having access to the information of their pregnancy means women get more control and fell more fulfilled with the care they receive. (WILKINSON and MILLER, 2007) The records can be used as a reference source, to help women have a better understanding and to feel well informed, reassured, and confident in collaborating with health professionals as explanations were encouraged. (Phipps, 2001) The popularity of PHR is increasing, this could be due to growing attention on continuity of care and women centred care models. Which focuses on the woman compared to the “clinical condition” (pregnancy). (Humphrey, Tucker and de Labrusse, 2013) The PHRs are designed for the diversity of every woman, as every woman is different with varied needs (physical, emotional, cultural and religious). This method is also applicable for all types of care e.g. high risk, low risk, midwifery led care, shared care, or obstetric-led care. (Humphrey, Tucker and de Labrusse, 2013) On the other hand, the PHR can be lost easily, compromising

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.