National Institutes of Health Consensus Development Conference Statement on Vaginal Birth After Cesarean PDF Download
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Author: Department of Human Services
Publisher: CreateSpace
ISBN: 9781499520194
Category :
Languages : en
Pages : 48
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Book Description
Vaginal birth after cesarean (VBAC) describes vaginal delivery by a woman who has had a previous cesarean delivery. For most of the 20th century, once a woman had undergone a cesarean delivery, clinicians believed that her future pregnancies required cesarean delivery. Studies from the 1960s suggested that this practice may not always be necessary. In 1980, a National Institutes of Health (NIH) Consensus Development Conference Panel questioned the necessity of routine repeat cesarean deliveries and outlined situations in which VBAC could be considered. The option for a woman with a previous cesarean delivery to have a trial of labor was offered and exercised more often in the 1980s through 1996. Since 1996, however, the number of VBACs has declined, contributing to the overall increase in cesarean delivery (Figure 1). Although we recognize that primary cesarean deliveries are the driving force behind the total cesarean delivery rates, the focus of this report is on trial of labor and repeat cesarean deliveries. A number of medical and nonmedical factors have contributed to this decline in the VBAC rate since the mid-1990s, although many of these factors are not well understood. A significant medical factor that is frequently cited as a reason to avoid trial of labor is concern about the possibility of uterine rupture-because an unsuccessful trial of labor, in which a woman undergoes a repeat cesarean delivery instead of a vaginal delivery, has a a higher rate of complications compared to VBAC or elective repeat cesarean delivery. Nonmedical factors include, among other things, restrictions on access to a trial of labor and the effect of the current medical-legal climate on relevant practice patterns. To advance understanding of these important issues, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Medical Applications of Research of NIH convened a Consensus Development Conference on March 8-10, 2010. The conference was grounded in the view that a thorough evaluation of the relevant research would help pregnant women and their maternity care providers when making decisions about the mode of delivery after a previous cesarean delivery. Improved understanding of the clinical risks and benefits and how they interact with nonmedical factors also may have important implications for informed decisionmaking and health services planning. The following key questions were addressed by the Consensus Development Conference: 1. What are the rates and patterns of utilization of trial of labor after prior cesarean delivery, vaginal birth after cesarean delivery, and repeat cesarean delivery in the United States? 2. Among women who attempt a trial of labor after prior cesarean delivery, what is the vaginal delivery rate and the factors that influence it? 3. What are the short-and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms? 4. What are the short- and long-term benefits and harms to the baby of maternal attempt at trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms? 5. What are the nonmedical factors that influence the patterns and utilization of trial of labor after prior cesarean delivery? 6. What are the critical gaps in the evidence for decisionmaking, and what are the priority investigations needed to address these gaps?
Author: Department of Human Services
Publisher: CreateSpace
ISBN: 9781499520194
Category :
Languages : en
Pages : 48
Get Book Here
Book Description
Vaginal birth after cesarean (VBAC) describes vaginal delivery by a woman who has had a previous cesarean delivery. For most of the 20th century, once a woman had undergone a cesarean delivery, clinicians believed that her future pregnancies required cesarean delivery. Studies from the 1960s suggested that this practice may not always be necessary. In 1980, a National Institutes of Health (NIH) Consensus Development Conference Panel questioned the necessity of routine repeat cesarean deliveries and outlined situations in which VBAC could be considered. The option for a woman with a previous cesarean delivery to have a trial of labor was offered and exercised more often in the 1980s through 1996. Since 1996, however, the number of VBACs has declined, contributing to the overall increase in cesarean delivery (Figure 1). Although we recognize that primary cesarean deliveries are the driving force behind the total cesarean delivery rates, the focus of this report is on trial of labor and repeat cesarean deliveries. A number of medical and nonmedical factors have contributed to this decline in the VBAC rate since the mid-1990s, although many of these factors are not well understood. A significant medical factor that is frequently cited as a reason to avoid trial of labor is concern about the possibility of uterine rupture-because an unsuccessful trial of labor, in which a woman undergoes a repeat cesarean delivery instead of a vaginal delivery, has a a higher rate of complications compared to VBAC or elective repeat cesarean delivery. Nonmedical factors include, among other things, restrictions on access to a trial of labor and the effect of the current medical-legal climate on relevant practice patterns. To advance understanding of these important issues, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of Medical Applications of Research of NIH convened a Consensus Development Conference on March 8-10, 2010. The conference was grounded in the view that a thorough evaluation of the relevant research would help pregnant women and their maternity care providers when making decisions about the mode of delivery after a previous cesarean delivery. Improved understanding of the clinical risks and benefits and how they interact with nonmedical factors also may have important implications for informed decisionmaking and health services planning. The following key questions were addressed by the Consensus Development Conference: 1. What are the rates and patterns of utilization of trial of labor after prior cesarean delivery, vaginal birth after cesarean delivery, and repeat cesarean delivery in the United States? 2. Among women who attempt a trial of labor after prior cesarean delivery, what is the vaginal delivery rate and the factors that influence it? 3. What are the short-and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms? 4. What are the short- and long-term benefits and harms to the baby of maternal attempt at trial of labor after prior cesarean versus elective repeat cesarean delivery, and what factors influence benefits and harms? 5. What are the nonmedical factors that influence the patterns and utilization of trial of labor after prior cesarean delivery? 6. What are the critical gaps in the evidence for decisionmaking, and what are the priority investigations needed to address these gaps?
Author: Penny Simkin
Publisher: Da Capo Lifelong Books
ISBN: 0738285021
Category : Health & Fitness
Languages : en
Pages : 999
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Book Description
Feel informed and empowered with this thoroughly updated, full-color pregnancy guide, which recognizes that “one size fits all” doesn’t apply to maternity care. Pregnancy, Childbirth, and the Newborn provides the comprehensive guidance you need to make informed decisions about having a safe and satisfying pregnancy, birth, and postpartum period–decisions that reflect your preferences, priorities, and values. This sixth edition includes: -CDC guidelines regarding COVID-19 -Updated dietary guides and breastfeeding and surrogacy information -Birth plans including doulas and caesarians when necessary -Tips on how to reduce stress -And so much more Pregnancy, Childbirth, and the Newborn is inclusive, reflecting today's various family configurations such as single-parent families, blended families formed by second marriages, families with gay and lesbian parents, and families formed by open adoption or surrogacy. This pregnancy guide speaks to today's parents-to-be like no other.
Author: Hélène Vadeboncoeur
Publisher: Fresh Heart Publishing
ISBN: 1906619204
Category : Health & Fitness
Languages : en
Pages : 335
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Book Description
Book discusses VBAC (vaginal birth after caesarean).
Author: Mark B. Landon
Publisher: Elsevier Health Sciences
ISBN: 0323613403
Category : Medical
Languages : en
Pages : 1548
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Book Description
Highly readable, well-illustrated, and easy to understand, Gabbe's Obstetrics: Normal and Problem Pregnancies is an ideal day-to-day reference or study tool for residents and clinicians. This 8th Edition of this bestselling text offers fast access to evidence-based, comprehensive information, now fully revised with substantial content updates, new and improved illustrations, and a new, international editorial team that continues the tradition of excellence established by Dr. Steven Gabbe. - Puts the latest knowledge in this complex specialty at your fingertips, allowing you to quickly access the information you need to treat patients, participate knowledgably on rounds, and perform well on exams. - Contains at-a-glance features such as key points boxes, bolded text, chapter summaries and conclusions, key abbreviations boxes, and quick-reference tables, management and treatment algorithms, and bulleted lists throughout. - Features detailed illustrations from cover to cover—many new and improved—including more than 100 ultrasound images that provide an important resource for normal and abnormal fetal anatomy. - Covers key topics such as prevention of maternal mortality, diabetes in pregnancy, obesity in pregnancy, vaginal birth after cesarean section, and antepartum fetal evaluation. - Provides access to 11 videos that enhance learning in areas such as cesarean delivery and operative vaginal delivery. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices
Author: Geraldine M. Collins-Bride
Publisher: Jones & Bartlett Learning
ISBN: 1284123022
Category : Medical
Languages : en
Pages : 768
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Book Description
Clinical Guidelines for Advanced Practice Nursing: An Interdisciplinary Approach, Third Edition is an accessible and practical reference designed to help nurses and students with daily clinical decision making. Written in collaboration with certified nurse midwives, clinical nurse specialists, nurse practitioners, nutritionists, pharmacists, and physicians, it fosters a team approach to health care. Divided into four areas—Pediatrics, Gynecology, Obstetrics, and, Adult General Medicine—and following a lifespan approach, it utilizes the S-O-A-P (Subjective-Objective-Assessment-Plan) format. Additionally, the authors explore complex chronic disease management, health promotion across the lifespan, and professional and legal issues such as reimbursement, billing, and the legal scope of practice. The Third Edition has a keen focus on gerontology to accommodate the AGNP specialty and to better assist the student or clinician in caring for the aging population. The authors follow the across the life span approach and focus on common complete disorders. Certain chapters have been revised and new chapters have been added which include:Health Maintenance for Older Adults; Frailty; Common Gerontology Syndromes; Cancer Survivorship; Lipid Disorders; Acne (pediatrics section). Please note that the 2016 CDC Guidelines for prescribing opioids for chronic pain in the United States were not yet available at the time the authors were updating the Third Edition. See the Instructor Resources tab to read a note from the authors about their recommendations for resources around these guidelines.
Author: Gabriella Piscopo
Publisher: Taylor & Francis
ISBN: 1000823288
Category : Business & Economics
Languages : en
Pages : 89
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Book Description
Management, Organization and Childbirth: Towards a New Model for the Birth Path explores the complex topic of the birth path with a multidisciplinary magnifying glass on the paradigms, languages, and tools critical to the organization, management, and clinical science. The work consists of five chapters. The first chapter provides a multidimensional analysis of childbirth. The second chapter presents an organizational analysis that moves in unison with different models of health. The third chapter studies the birth path in organizational and cynical terms by describing it in its core processes. The fourth chapter proposes a study conducted in the Italian context, which identifies some useful determinants for redesigning the birth path. The fifth chapter formulates a proposal for redesigning the birth path based on a new health paradigm. The proposed model offers useful insights for multiple categories of readers. To students of medicine and higher education tracks in healthcare management, it can offer opportunities to raise awareness not only regarding multi-professional practice but also regarding confrontation with complementary disciplines. To practitioners and policy makers, it can provide useful stimuli to promote rational and informed decisions around the childbirth. To researchers studying the health context within different disciplinary domains, the model can offer unexplored research spaces within the new business complex system.
Author: Bruce L. Flamm
Publisher: Springer Science & Business Media
ISBN: 1461224829
Category : Science
Languages : en
Pages : 316
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Book Description
Cesarean section rates Percentage Indication Low High Failure to progress 2. 0 4. 0 Repeat cesarean section 2. 0 6. 0 Breech and abnormal lie 1. 3 3. 5 Fetal distress 1. 5 3. 0 Third-trimester bleeding 1. 0 1. 0 Totals 7. 8 17. 5 l From Quilligan, by permission of Contemporary Obstetrics and Gynecology. vaginal delivery, I have yet to meet a physician who would do something they believed would harm their patient even if they were paid ten times as much for a section. On the other hand, there are fears and misconceptions. I have heard many doctors say "I have never been sued for a section I did, but I have been sued for the section I did not do. " The fear of not having performed a section in my opinion is real, although difficult to prove, and until the public can be educated that cesarean section delivery cannot eradicate fetal death and damage, this fear will remain and will be responsible for some unnecessary cesarean sections. Bruce Flamm and I hope this book will correct misconceptions that have been responsible for many unnecessary cesarean sections. I am still frequently asked the same old question: What is an ideal cesarean section rate? I still give an answer similar to the 1983 answer, perhaps somewhat modified.
Author: Barbara A. Anderson, DrPH, CNM, FACNM, FAAN
Publisher: Springer Publishing Company
ISBN: 082614084X
Category : Medical
Languages : en
Pages : 218
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Book Description
Describes how nursing professionals can mitigate the maternal health crisis through advocacy and improved practice. This graduate-level nursing text and professional clinical reference is the first to comprehensively address the escalating crisis in U.S. maternal health—our country experiences the highest maternal mortality among developed nations—and provides strategies and roadmaps for improved outcomes. It challenges the current approach to ameliorating the maternal crisis, which embeds maternal care into “child health” and ”women’s health,” and characterizes maternal health as a distinct, contemporary epidemiological crisis in America. At its heart, the book calls for the application of nursing knowledge and skill in advocating for and changing practices. The text examines the social determinants responsible for the crisis, including structural and systemic economic and political forces, declining accessibility to maternal care, and lack of a national effort to improve maternal health. With a strong public focus, the book engages readers through narratives and interactive critical thinking exercises in analyzing the problem and related structural and systemic barriers. It offers guidelines for advocacy and improved practice while fostering creative thinking by which readers can imagine their own solutions. Specific issues addressed include the current status of health care delivery, the public health safety net, practice-policy initiatives, specific sociocultural factors contributing to enhanced risk, myths and impugning attitudes about childbearing women, the life-long impact of maternal health neglect, and the contribution of nursing to advocacy, prevention, and improved practice. Key Features: Synthesizes key data on the maternal health crisis in America focusing on nursing leadership and contributions Underscores the need for a collaborative public health nursing perspective in addressing the maternal health crisis Examines social determinants responsible for the crisis Presents exercises and narratives for advocacy and improved practice Spotlights maternal health as a specific entity Includes learning objectives, expert opinions, key questions to guide critical thinking, brief summary, and references in each chapter
Author: Laura E. Levine
Publisher: SAGE Publications
ISBN: 1483324451
Category : Psychology
Languages : en
Pages : 1562
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Book Description
This exciting chronological introduction to child development employs the lauded active learning approach of Laura E. Levine and Joyce Munsch’s successful topical text, inviting students to forge a personal connection to the latest topics shaping the field, including neuroscience, diversity, culture, play, and media. Using innovative pedagogy, Child Development From Infancy to Adolescence: An Active Learning Approach reveals a wide range of real-world applications for research and theory, creating an engaging learning experience that equips students with tools they can use long after the class ends.
Author: Vincenzo Berghella
Publisher: Jaypee Brothers Medical Publishers
ISBN: 9352701607
Category : Medical
Languages : en
Pages : 330
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Book Description
This book is a guide to labour and delivery management for trainees in obstetrics and gynaecology, and midwives. Divided into three sections, the text begins with detailed discussion on labour, from preparation before labour and delivery, through the different stages of labour, to postpartum care. The next section covers caesarean delivery, and the third, ‘special labour’ which explains labour complications, twins, prelabour rupture of membranes, and more. The book is authored by recognised experts from the USA and Italy, and is based on evidence from randomised controlled trials (RCTs). Clinical photographs, diagrams and tables further enhance learning. Key points Guide to labour and delivery management for trainees in obstetrics and gynaecology, and midwives Text based on evidence from randomised controlled trials (RCTs) Recognised author team from USA and Italy Includes clinical photographs, diagrams and tables
