Not Many Large Scale Studies Of The Safety Of Home Birth

This essay demonstrates significant factors, a midwife and the women may face within Australian public hospitals. As a midwife the key skills are understanding of what supports and impacts the normal physiological process of labour and birth. This essay will discuss two influencing factors that have a negative effect on the normal progress of labour and birth. This will be seen, firstly by discussing the cultural and environmental impacts of labour and birth. Then, examining how the midwife may best support and facilitate the adverse effects of normal physiological process. This essay also discusses a positive labour and birth environment within the Australian standard model of care.

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).

For hundred of years, women have wrestled with their womanhood, bodies, and what it means to be a woman in our society. Being a woman comes with a wonderful and empowering responsibility--giving birth. What sets us aside from other countries is that the process and expectations of giving birth has changed in our society; coming from midwifery, as it has always been since the early times, to hospitals where it is now expected to give birth at. Midwifery was a common practice in delivering babies in

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

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

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.

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)?

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.

Dr. Neel Shah, to start, is a certified medical doctor (MD) and also has earned a masters in public policy (MPP), all of which were obtained through Harvard Medical School. In addition, he is an accredited as a professional assistant professor of obstetrics, gynecology, and reproductive biology, through Harvard Medical School as well. Furthermore, Dr. Shah believes that home births and births that don’t occur in a hospital are for the best compared to if they were taken care of in a hospital.

The Center’s decision to contract Dr. Stuart will help community especially those who cannot afford quality healthcare. It is a good idea to give parents an option of home birth, it will minimize the cost while providing the needed care. Physicians at Tallahassee general hospital are concerned about the use of midwives and possibility of treating home-birth patients in the case of emergency. Child-birth have been performed for centuries at home and still are very common in many parts of the world. It is better to have a midwife who is working under the supervision of a physician than not have any health care, and there will be less chance of having an emergency situation in presence of midwifes.

The decline of home births began in the 1900’s. at the start of the century 95% of births were at home, in 1938 Half of births took place at home, and by 1955 less than 1% of births took place at home. During the early 1900’s hospitals began a smear campaign to make women believe that midwives were unfit to bring babies into the world. Women continued to go to hospitals also, for the access to painkillers, and cleaner environment, and the access to trained doctors. Now that is the way things are done. However even with the influx of technology into the medical practise, the United States have some of the highest infant and maternal mortality rates of a first world country.

The authors have done a thorough literature review and presented their findings by starting out with some important statistics about typical supportive care during the birth process, and elaborating on the last 50 years of research done on the types of pushing efforts and how they related to the outcomes of the births. It reflects on the role of midwives as being supportive of spontaneous pushing by the mother and the positive outcomes for those women and children. They did report on a recent meta-analysis which supported the use of spontaneous pushing and only recommended directed pushing in certain hazardous situations. The authors’ review of the current literature affirms their claim that there have been no studies done to analyze the role

According to the American College of Nurse-Midwives (ACNMb) (2015), home births account for 1.4% of all births in the U.S. In eight years the number of home births in the US increased by 41% (ACNM, 2015b). Providing home births falls within the scope of practice of midwives and is supported by the American College of Nurse-Midwives (ACNM, 2015b). A mother can have the option of a home birth as long as the home birth follows regulations set in place by the state and can provide a favorable safe environment for both mother and newborn (ACNM, 2015b). Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) state that the ultimate decision of having a home birth is a patient’s right, especially if she is medically well informed (Declercq, & Stotland, 2016).

The midwife’s role in a woman’s pregnancy becomes quite important during labour and birth. Even more so during a homebirth as the midwife assumes the position of a motivational coach, support system and a medically trained professional. A birth plan should be established already during the antenatal period between the midwife, woman and partner, in which it becomes the midwife’s responsibility to adhere to it as much as possible. The journal articles ‘Outcomes of planned homebirth with registered midwife versus planned hospital birth with midwife or physician’ and ‘Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to

Perhaps one of the most important and difficult decisions an obstetrics care provider attending births in a hospital setting can make is when to admit women to labor and delivery units. A literature review evaluating the PICO question: “In nulliparous women with singleton, vertex pregnancies, does admission to labor and delivery units in active labor, defined as cervical dilation of 4 cm or more and regular uterine contractions compared to admission in early labor, defined as cervical dilation less then 4 cm and irregular uterine contractions, reduce the incidence of primary cesarean section,” supplied sufficient evidence to support admission to labor and delivery units in active labor. Neal, et al., and Bailit, et al., used similar methods to evaluate the outcomes of low-risk women admitted in early labor versus active labor. They both reported that low-risk women admitted to labor and delivery units in early labor were more than twice as likely to have a cesarean section. They also reported that this group was more likely to have increased interventions. In a third, older study, McNiven et al., (1998), conducted one of the only randomized controlled trials to evaluate admission to labor and delivery units in