Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement

Main, Elliott K.; Moore, Dan H.; Farrell, B. A.; Schimmel, Leon D.; Altman, Robert J.; Abrahams, Carol; Bliss, Mary; Polivy, Laurie; Sterling, Jacci

doi:10.1016/j.ajog.2006.03.013

Cited by 114 publications

(101 citation statements)

References 23 publications

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“…Early trials completed in the 1980s reported that intrapartum oxytocin used early in labor reduced the risk of CB [14,15] but more recently studies have shown a strong association with uterine hyperstimulation and an increased risk of emergency cesarean [11,16] . Main and colleagues [17] found that early use of oxytocin reduced the use of CB, although other studies have shown a significant association with increased surgical birth [11,18] .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, moderate variation in CB rates across health systems have been reported for nulliparious women at term with singleton vertex presentations. This is attributed to differences in the use of clinical interventions among organizations, not to differences in patient populations or risk factors [17,23] . Similarly, those studies found that clinical factors such as admission to hospital in early labor may increase the risk of CB.…”

Section: Introductionmentioning

confidence: 99%

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Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

Regan

McElroy

Chung

et al. 2014

JNEP

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The purpose of this study was to examine the relationship between the type and timing of commonly used intrapartum clinical factors and their relationship to birth outcomes. The factors included in the analysis were type of provider (midwife or obstetrician), place of birth (home or hospital), cervical dilation on admission, and commonly used labor interventions, namely use of continuous electronic fetal monitoring, epidural anesthesia and oxytocin on the type of birth (cesarean or vaginal birth). The research question guiding the analysis was: what factors increase the likelihood of cesarean birth (CB)? The findings reported here are parts of a larger mixed methods study that used three data collection methods: a projective test, a focus group, and a semi-structured postpartum interview. The study took place in an urban area in the mid-Atlantic United States and the sample was comprised of 49 low-risk primigravid women recruited between 28-36 weeks gestation. The analysis reported here only used data from the postpartum interview. During the interview, each woman reported the events of their labor and birth that were then mapped along a timeline. The findings show that admission to hospital early in labor played a key role in increasing the number of interventions used and was associated with increased risk of CB. The small, homogenous sample limited the ability to conduct more comprehensive statistical analysis and to generalize to more diverse groups, however, the proportional differences are highly suggestive and warrant further investigation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

Regan

McElroy

Chung

et al. 2014

JNEP

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“…Suspecting a large baby is not an indication for induction (Chauhan et al, 2005;Irion & Boulvain, 2003). Induction of labor is a major contributor to the overall increase in cesarean section rates (Main et al, 2006).…”

Section: Care Practice #1: Labor Begins On Its Ownmentioning

confidence: 99%

Position Paper: Promoting, Supporting, and Protecting Normal Birth

2007

jpe

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This updated position paper contrasts medical management of labor and birth with the normal physiology of birth and describes the care practices that support and facilitate the normal process. Lamaze International urges care providers to adopt these care practices as the standard of care, unless evidence-based medical reasons dictate otherwise. The roles of Lamaze-certified childbirth educators and the Lamaze Institute for Normal Birth in protecting, preserving, and promoting normal birth are described.

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“…Do women know that their risk of episiotomy may be as much as 7 times higher if they go to a private obstetrician's practice rather than a public clinic (Howden, Weber, & Meyn, 2004)? Do low-risk, first-time mothers know that the hospitals where women are most likely to be induced or admitted early in labor have c-section rates 3 times higher than other hospitals that restrict those practices (Main et al, 2006)? (And how do they know which hospitals those are, anyway?)…”

Section: Nicus: If We Build It They Will Come?mentioning

confidence: 99%

First, Do No Harm: How Routine Interventions, Common Restrictions, and the Organization of Our Health-Care System Affect the Health of Mothers and Newborns

Romano¹

2009

j perinat educ

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In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses a new study that demonstrates the ''First, do no harm'' principle in a different way. New research on the potentially harmful effects of intravenous lines demonstrates that refraining from routine interventions in labor protects the safety of women and babies. A new systematic review of movement and position changes in labor shows that eliminating unfounded restrictions also protects maternal and infant health and well-being. Finally, a study of patterns of use of neonatal intensive care units reveals how the organization of the maternity care system itself can affect the health outcomes of its beneficiaries.

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Is there a useful cesarean birth measure? Assessment of the nulliparous term singleton vertex cesarean birth rate as a tool for obstetric quality improvement

Cited by 114 publications

References 23 publications

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

Position Paper: Promoting, Supporting, and Protecting Normal Birth

First, Do No Harm: How Routine Interventions, Common Restrictions, and the Organization of Our Health-Care System Affect the Health of Mothers and Newborns

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