Reducing The Primary Cesarean Section Rate

3760 Words Jul 17th, 2015 16 Pages
Reducing the Primary Cesarean Section Rate in Nulliparous Women:
A Quality Improvement Project
Julie A. Javernick, CNM, MSN

Submitted to
Drs. Joan Nelson and Kathy Shaw of the University of Colorado College of Nursing in partial fulfillment of the requirements for NUDO 7018

Introduction
Background
Healthy childbirth is defined as a safe, natural process that rarely requires medical intervention (Goer & Romano, 2012). The medical model of care, however, often includes interventions that are not supported by the evidence and can increase a woman’s risk of having a cesarean section. These intrusions into labor and birth often lead to what has been called the “cascade of interventions” (DeClercq, Sakala, Corry, Applebaum, & Heerrlich, 2013). This cascade has resulted in cesarean section becoming the most common surgical procedure performed on women (MacDorman, Menacker, & Declerq, 2008). While no one would argue against this increased use to save the lives of mothers and babies, maternal and neonatal morbidity and mortality in the United States have not improved and, in fact, remain among the highest in the developed world (DeClerq, 2014). This suggests an overuse of the procedure.
Because of the increased use of interventions with no improvement in maternal and neonatal morbidity and mortality and concern about the rising cesarean section rate, several large professional organizations representing obstetric providers, nurses, and consumers have…
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