Methods to decrease Cesarean Section (C/S) rates during birth.

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Cesarean Section Delivery

Cesarean Section (C/S)

• According to the Mayo Clinic (2012), a C/S is defined as a “surgical procedure used to deliver a baby through an incision in the mother's abdomen and a second incision in the mother's uterus”.

• C/S have reached an all time high, in the United States, at 31.8% of deliveries in over 50 years (Gillman, 2011) Most are done elective for repeat or elective by the patient.

Methods to decrease C/S rates

• Maternal education about labor and birth

• Avoid induction of labor

• Limit use of medications during labor

• Research provider reference

Maternal Education

• Signs and symptoms of labor• What to expect during the labor process• When to call your provider• Vaginal birth versus C/S birth

Avoid Induction

• Induction of labor is the process by which labor is attempted to be started by artificial means. Often times done for social/elective reasoning and there are instances where induction is done for medical reason. All of which increases the risk of having a c/s delivery.

• Some mothers choose to have a social/elective delivery because they are tired of being pregnant or for convenience for the patient and/or provider. Neither reason should not be used for induction of labor.

Avoid induction (cont’d)

• An induction not only increase the risk for C/S deliver but can cause complications like abnormal fetal heart rate, shoulder dystocia, increase the risk of the baby being admitted to the neonatal intensive care (NICU) because of immaturity of the fetus, and these are just to mention a few of the possible complications (Weiss, 2014)

Limit use of medications• The laboring mother does have a right to be as pain

free as possible during her admission.• Education on pain management should began during

the preadmission stage. Methods and options of pain control that can be used include: intravenous medications, breathing and relaxation techniques, back rubs, and last but not least the epidural.

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Limit use of medications (cont’d)

• An epidural, for pain management during labor and delivery, can increase the length of labor, if given too early.

• If given to early, the epidural can also slow down or cause the labor to result into arrest of dilatation and increase the risk for C/S birth.

Limit use of medications (cont’d)• Oxytocin is one of the medications most often used in the

labor and delivery unit to assist with induction or augmentation of labor.

• Oxytocin, like any drug, has side effects that increase the chances of having a C/S delivery. Tachysystole, a increase in contractions of more than 5 in a 10 minutes time frame and the risk of uterine rupture are the most common side effects.

• Education the patient on allowing the natural hormones to take effect is encouraged.

• Providers and nurses should stay updated on the guidelines on use and not over saturate the uterus and causing unwanted results of a C/S.

Research Provider Preference

• There are factors one should consider when choosing a provider for the delivery of their child.

• Research the provider you may be considering, and pay close attention to the success of vaginal and c/s delivery rates. According to Weiss (2014), if the C/S delivery rate is less than 10%, this may be a person you would consider.

Research Provider Preference (cont’d)

• Inquire about the facilities that the provider will plan to do the delivery and if this will be convenient for you.

• Ask family and friends for referrals to provides they have used in the past.

• This is your body and your child, and knowing who will provider the best and safest care can make a difference in the choice you use in during your labor and delivery.

Conclusion

• Labor and delivery is a joyous and exciting occasion as new life is born into this world.

• Most parent(s) prefer to have the child born naturally and vaginally. But there are cases where others prefer to have the child born by cesarean section. The cesarean section may seem to be the way to go but it can present many problems in the afterwards for the mother and the baby.

Conclusion (cont’d)

• For the mother,– it can increase hospital stay, increase the risk of

infection to the wound site, – limit mobility if she lives in a two-story home and

is not allowed to climb the stairs, – unable to care for other children in the home

because of the C/S site – and the healing process.

Conclusion (cont’d)

• For the infant– multiple problems can start to include fetal distress – admission to the neonatal intensive care unit for an

extended period of time– tube feedings due to immaturity or grow problems– decreased bonding time with the parent

Conclusion (cont’d)

• It has been outlined of some methods that can be used to decrease the likelihood of having a cesarean section. Education, education, education is the primary goal, even for the patient that would prefer a repeat C/S, based on the reason for the first C/S.

• Not condoning a C/S, of course if the patient requires one, she should have it done without a doubt but it still caries some of the same risk for the mother and infant.

• If a C/S can be avoided it is highly encouraged to avoid one.

http://www.birthkeepermidwifery.com/p/vbac-vaginal-birth-after-cesarean.html

References:

• Gillman, J. (2011)., Elective cesarean section deliveries on the rise. Retrieved from

http://www.awhonn.org/awhonn/content.do?name=07_PressRoom%2F7B7_Sept16_Csections.htm

• Mayo Clinic (2012). Test and Procedures. C-Section. Retrieved from

http://www.mayoclinic.org/tests-procedures/c-section/basics/definition/PRC-20014571

• Weiss, R.E., (2014) 5 Reasons to avoid induction of labor. Retrieved from

http://pregnancy.about.com/od/induction/a/risksinduction.htm

• Weiss, R.E., (2014) 5 Ways to avoid a cesarean section. Retrieved from

http://pregnancy.about.com/od/laborbirth/a/avoidcesarean.htm