Worldwide, the rate of cesarean section is increasing. According to the CDC, in 2012 the rate of cesarean sections comprised 32.8% of all births in the United States (CDC, 2013). Between 1996-2009 the cesarean section rate has risen 60% in the U.S (CDC, 2013). According to the World Health Organization (WHO), more than 50% of the 137 countries studies had cesarean section rates higher than 15% (WHO, 2010). The current goal of U.S. 2020 Healthy People is to reduce the rate of cesarean section to a target of 23.9%, which is almost 10% lower than the current rate (Healthy People 2020, 2013). According to a study conducted by Gonzales, Tapia, Fort, and Betran (2013), the appropriate percentage of performed cesarean sections is unclear, and is dependent on the circumstances of each individual birth (p. 643). Though often a life-saving procedure when necessary, the risks and complications associated with cesarean delivery are a cause for alarm due to the documented rate increase of this procedure across the globe. Many studies have revealed that cesarean deliveries increase the incidence of maternal hemorrhage and mortality and neonatal respiratory distress when compared to vaginal deliveries. As a result, current research suggests that efforts to reduce the rate of non-medically indicated cesarean sections should be made, and that comprehensive patient education should be provided when considering an elective cesarean delivery over a planned vaginal delivery.
There is no clear definition for elective cesarean delivery (ECD). Every study reviewed had a different set of guidelines used to define what an ECD includes. Many researchers defined the term broadly; with definitions ranging from performing a cesarean section before ...
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...fter late pre-term and term cesarean delivery.Pediatrics, 123(6), 1064-1071. doi:10.1542/peds.2008-2407
Reddy, U. M., Zhang, J., Sun, L., Chen, Z., Raju, T. N., & Laughon, K. (2012). Neonatal mortality by attempted route of delivery in early preterm birth. American Journal of Obstetrics & Gynecology, 207(2). doi:10.1016/j.ajog.2012.06.023
Vered, N., Nadir, E., & Feldman, M. (2012). Late better than early elective term cesarean section. Acta Paediatrica, 101, 1054-1057. doi:10.1111/j.1651-2227.2012.02772.x
Zanardo, V., Svegliado, G., Cavallin, F., Giustardi, A., Cosmi, E., Litta, P., & Trevisanuto, D. (2010). Elective cesarean delivery: Does it have a negative effect on breastfeeding? Birth, 37(4), 275-279. Retrieved from http://web.a.ebscohost.com.summit.csuci.edu:2048/ehost/pdfviewer/pdfviewer?sid=f4eb05fd-f93d-45bf-aa4d-ef5c14821ea7%40sessionmgr4004&vid=4&hid=4207
When pregnant, many expecting mothers are faced with a very tough decision, the decision to have an epidural during labor or to have a natural birth. Both methods have negative and positive aspects. This topic has such conflicting views that about 50% of women decide to get an epidural when going into labor and the other 50% of women choose the alternative: natural childbirth. It is important for an expecting mother to look into both options thoroughly to ensure they make the best choice for both themselves and for their child. With all of the speculations circulating about both options, it is hard for mothers to see the truth about both epidurals and natural childbirth.
Asfour, V, and S Bewley. 2011. Cord clamping practice could affect the ratio of placental weight to birth weight and perinatal outcomes. BJOG: An International Journal of Obstetrics & Gynecology 118 (12): 1539–40. Retrieved November 8, 2014
Upon viewing “More Business of Being Born” (Epstein, 2011), I learned a lot about the different pros and cons of Vaginal Birth After Cesarean (VBAC). Women are often deprived of the choice of the method of delivery of their children after they’ve previously had a cesarean birth. The cause of this is that there exists medical fright about a rupture of the uterus which often leads to death of mother and baby (Epstein, 2011). In the mid twentieth century, it became a common saying that “once a cesarean, always a cesarean” came about. This saying perpetrated the fear and understanding that women have to go about having another cesarean, depriving them of choice (Epstein, 2011).
Birth is a normal, physiological process, in which a woman’s body naturally prepares to expel the fetus within. It has occurred since the beginning of time. Unfortunately, childbirth has gradually evolved into what it is today - a highly managed whirlwind of unwarranted interventions. Jennifer Block, a journalist with over twelve years experience, has devoted herself to raising awareness regarding the authenticity of the Americanized standard of care in obstetrics, while guiding others to discover the truth behind the medical approach to birth in this country. In her book, Pushed: The Painful Truth About Childbirth and Modern Maternity Care, Jennifer Block brings forth startling truths concerning this country’s management of birth.
Epidurals also have been linked to an overall increase in operative deliveries: cesareans, forceps deliveries, and vacuum extractions. A meta-analysis of the effects of epidural anesthesia on the rate of cesarean deliveries was undertaken by a group of physicians who examined, categorized, and analyzed all available literature.
According to Leah Albers, Certified Nurse Midwife, three-quarters of all of the deliveries are performed with women in a supine position, or lying on their backs (Keen, DiFranco, Amis, & Albers, 2004). However, as evidenced throughout history women across all cultures have used both upright and “gravity-neutral” or supine positions to give birth to their babies. Before the introduction of the forceps in the 17th century, women were rarely shown to be giving birth in a supine position. Earlier in history women were encouraged to give birth guided by their own “inner wisdom” in a position that was most comfortable for them; a position which was rarely lying on their back (Keen et al., 2004). The majority of women today, especially in Western society, deliver their babies in supine positions because it is the most preferred position of the midwife or nurse and has been a tradition for many years (de Jonge, Teunissen, van Diem, Scheepers, & Lagro-Janssen, 2008). On the contrary, the use of supine positions rather than upright positions is not the most optimal modes of delivery for the mother and the baby. Thus, to change the clinical practice on labor and delivery units, it is the responsibility of the nurse to continue to seek evidence-based practice research and obtain knowledge through education to guide the mother through informed choice, in choosing a birthing position during the second stage of labor that is most comfortable to her and will yield the most optimal outcomes for herself and her baby.
Mulder, P. J. (2006,). A concept analysis of effective breastfeeding. JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35, 332-339. http://dx.doi.org/10.1111/j.1552-6909.2006.00050.x
Breastfeeding rates are continually increasing. The nutritional benefit of breast over formula is a long established fact. “According to the latest numbers from the Centers for Disease Control and Prevention, breastfeeding rates improved nationwide in 2000-2008, and some of the greatest improvement was among black women. However, only about 59 percent of black mothers breastfed in 2008, compared to 80 percent of Hispanic mothers and about 75 percent of white mothers. For 2008 rates of breastfeeding at a baby’s first birthday, the number was about 23 percent overall but only 12.5 percent for black mothers. That low rate still marks a near doubling of rates among black mothers compared to the year 2000” (Currie, 2013).It is the recommended method of feeding an infant for at least the first six months of life. Breastfeeding has benefits to both mothers and their babies. The baby receives immunity to protect it from disease. Financially, breastfeeding can significantly reduce the burden of having a new child. Many mothers initiate breastfeeding in the hospital; however, the number of women who breastfeed until six months is very low (Guyer, Millward, & Berger, 2012). Breastfeeding is highly favored over bottle feeding. Yet, mothers still do not choose to continually breastfeed their infants. Do mothers who breastfeed during hospitalization have limitations or no desire to continue versus mothers who breastfeed for the recommended six months or longer at home?
Malloy, Michael H. (2004). Sudden Infant Death Syndrome among Extremely Preterm Infants: United States 1997 – 1999. Journal of Perinatology, 24, 181-187.
Many women today are doing more C-sections, also known as cesarean, than they are natural. Whether the reasons being because it’s more convenient or that some moms did not really have a choice, the percentage is still growing. “The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery (National Partnership for Women & Families, 201.)” There are many things to consider when deciding which is the right or safer choice. With both choices comes risks for the baby like, possible respiratory problems with a C-section. The mom has many risks to worry about for herself as well, like possibly hemorrhaging. There is also the recovery and the long-term effects that a woman has to put into consideration. They both have their pros and cons that should not be taken lightly.
Cesarean delivery is not as complicated as many people may think. The process is very safe and quick. It is most commonly used in emergency situations and when vaginal delivery is not option. When it’s planned in advance it’s in the best interest for the mother and baby. Vaginal birth after cesarean is possible if the incision made was a horizontal cut, but there are still risks to be considered. There are advantages and disadvantages to the baby and mother, that does not mean the procedure is not safe. The disadvantages are not life threatening and are minor issues that time will heal. Next to vaginal non-medicated birth I believe that cesarean delivery is the next best thing.
Rear Admiral Galson, S. K. (July 2008). Mothers and Children Benefit from Breastfeeding. American Dietic Association Vol 108 Issue 7 , p 1106.
Okay, so if you’ve lived under a rock your whole life and don’t know what a cesarean section, aka c-section, is, let me explain.
Breastfeeding provides a wide array of health benefits for both baby and mother, while simultaneously enhancing the bond between mom and her baby. Mothers who breastfeed have a lower risk of ovarian and pre-menopausal breast cancer. Their babies see a boost in cognitive development, as well as lowering their chances of being obese as adults, unlike formula fed babies. Consequently, a lower risk of obesity correlates to a lower incident of a wide array of comorbidities such as
Preterm birth is defined as ‘any neonate whose birth occurs before the thirty seventh week of gestation’1 and represents approximately eight percent of all pregnancies1-4. It is eminent that these preterm infants are at risk of physical and neurological delay, with prolonged hospitalisation and an increased risk of long-term morbidity evident in prior literature3, 5-13. Innovative healthcare over the past thirty years has reduced mortality significantly14, with the survival rate of preterm infants having increased from twenty five percent in 1980 to seventy three percent in 200715. Despite, this drop in mortality long-term morbidity continues to remain within these surviving infants sparking a cause for concern15, 16.