Cesarean Sections Margaux Barlow, Jackie Engstrom, Rasika Kulkarni, Hillary O’Keefe.
Post on 18-Dec-2015
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Why is this topic relevant???
• Cesarean birth is the birth of the infant through an abdominal and uterine incision.
• As maternal and perinatal morbidity and mortality rates of cesarean births have decreased throughout the 20th century, cesarean births have increased.
• In 1965, they constituted 4.5% and by 2004 were 29%.
Significance:
• In the U.S. there is a fourfold risk of death compared to vaginal birth.
• In England, emergency cesarean birth has a ninefold risk of death when compared to vaginal and elective cesareans have a threefold risk.
• Women are twice as likely to be rehospitalized within 60 days of birth when compared with women who have a vaginal birth.
Figure 1. Cesarean Section Rate: OECD Countries Perspective 1971-1990
Source: OECD Health Systems: Facts and Trends 1960-1991in provincial hospitals in this study.
Sociological Influence
• A study in 2004 found that Austrailian women were choose C. sections because:
• 71.4% - “common for people to think that cesarean section offers an easier way of giving birth”
• 23.1% - “the media seems to portray cesarean section as a better option than vaginal delivery”
Cultural Influence
• Another study of Brazilian women in 2008 found that:
• Most (64%) private sector cesareans are scheduled, although many women would have preferred a vaginal delivery!
• In Brazil, one-fourth of all women deliver in the private sector, where the rate of cesarean deliveries is extremely high (70%).
And the United States?
• “The singer - who is expecting her first child with her music executive husband Jordan Bratman - has allegedly decided to go for the operation like many celebrities before her because she is too posh to push.”
Impact on Women’s Health
• Postpartum hemorrhage• Surgical & traumatic complications• Fever, Infection, Pneumonia & Thromboembolic
events• Maternal mortality• Pelvic floor disorder• Loss of reproductive capabilities
Reasons for Couples choose C-Section
• Concern for safety of infant• Fear of pain and pushing the baby• Perception that a C-section is safer than vaginal
delivery.• Social convenience• Damage to perineal floor• Prior complicated/traumatic births• Stress & anxiety
Nursing Implications
• In addition to vaginal
delivery mothers:
- Positioning- Anesthesia level checks- Urine checks Bloody urine may indicated surgical
trauma to the bladder.
Cesarean Impacts on Nursing
• Due to the increased risk of mothers return to the hospital after birth…
References
Davidson, M., Ladewig, P. & London, M. (2008). Maternal-Newborn Nursing & Women’s Health
Across the Lifespan.Upper Saddle River, NJ: Pearson Education, Inc.
Gezer, A., Simsek, YO. & Altinok, TA. (2007). Elective cesarean section: evolution of obstetrician to technician. Birth: Issues in Perinatal Care (BIRTH), 34(4): 357-9.
Miesnik, S., & Reale, B. (2007). A Review of Issues Surrounding Medically Elective Cesarean Delivery. AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses, 36(1): 605-15.
Organization for Economic Co-oporation and Development (OECD) Health System. Facts and Trends 1960-1991, Vol.1. Health Policy Studies No.3. Paris: OECD, 1993.
Potter, J., Hopkins, K., Faúndes, A., & Perpétuo, I. (2008). Women's autonomy and scheduled cesarean sections in Brazil: a cautionary tale. Birth: Issues in Perinatal Care, 35(1), 33-40.
Walker, R., Turnbull, D., & Wilkinson, C. (2004). Increasing cesarean section rates: exploring the role of culture in an Australian community. Birth: Issues in Perinatal Care, 31(2), 117-124.
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