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Cesarean Sections. Margaux Barlow, Jackie Engstrom, Rasika Kulkarni, Hillary O’Keefe. Why is this topic relevant???. Cesarean birth is the birth of the infant through an abdominal and uterine incision.

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cesarean sections

Cesarean Sections

Margaux Barlow, Jackie Engstrom, Rasika Kulkarni, Hillary O’Keefe

why is this topic relevant
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
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.
slide6

Figure 1. Cesarean Section Rate: OECD Countries Perspective 1971-1990Source: OECD Health Systems: Facts and Trends 1960-1991in provincial hospitals in this study.

sociological influence
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
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
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.”
pathophysiology
Pathophysiology
  • History
  • What is a cesarean?
    • Skin and uterine incision
cultural aspects
Cultural Aspects
  • Statistics
  • Research studies
    • Brazil
    • South Australia
impact on women s health
Impact on Women’s Health
  • Postpartum hemorrhage
  • Surgical & traumatic complications
  • Fever, Infection, Pneumonia & Thromboembolic events
  • Maternal mortality
  • Pelvic floor disorder
  • Loss of reproductive capabilities
impact on neonates
Impact on Neonates
  • Breastfeeding, bonding & attachment issues
  • Respiratory effects
  • Fetal injuries
reasons for couples choose c section
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
Nursing Implications
  • In addition to vaginal

delivery mothers:

  • Positioning
  • Anesthesia level checks
  • Urine checks

Bloody urine may indicated surgical

trauma to the bladder.

nursing interventions
Nursing Interventions
  • Wound care
  • Coughing & Deep Breathing
cesarean impacts on nursing
Cesarean Impacts on Nursing
  • Due to the increased risk of mothers return to the hospital after birth…
references
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.