Reducing Primary Cesareans

Abstract

Primary cesarean birth increases a woman's risk for hemorrhage, infection, pain, and cesarean births with subsequent pregnancies. A woman may experience difficulties with breastfeeding, bonding, and incorporating the newborn into the family structure. One urban, academic hospital in the Midwest participated in the American College of Nurse-Midwives Healthy Birth Initiative: Reducing Primary Cesarean Births Project. The project purpose was to reduce the rate of cesarean births in nulliparous, term, singleton, and vertex pregnancies. Strategies employed included use of intermittent auscultation, upright labor positioning, early labor lounge, one-to-one labor support, and team huddles. The baseline nulliparous, term, singleton, vertex cesarean rate in 2015 was 29.3%. In 2016, after 1 year of implementation of the project, the hospital decreased nulliparous, term, singleton, vertex cesarean rate to 26.1%—a reduction of 10%. In 2017, the rate was decreased to 25.3%—a reduction by 3.7%.

Benefícios da verticalização do parto

“…A verticalização do parto reduz significativamente a duração média do primeiro período do trabalho de parto (em 2 horas a menos) e está associada à não necessidade de analgesia epidural, assim como a uma menor probabilidade de parto por cesariana (Gams et al, 2019). No entanto, quando é administrada analgesia por via epidural, a adoção de posições verticais, pode ser largamente desvantajosa em relação à adoção de posições supinas (Brocklehurst, 2017).…”

Improving Nurse Management of the Second Stage of Labor

“…The effort to reduce CS rates is essential because there are significant maternal morbidities associated with cesarean birth surgeries that increase with each subsequent pregnancy (Gams et al, 2019;. Short term effects include infection, blood loss, and venous thrombosis.…”

Pregnant Women's Perceptions Regarding Nursing Care at the Time of Childbirth: A Qualitative Study in South Punjab Pakistan

“…The Ministry of Health's endorsement of specialized training for nurse midwives aligns with these principles, recognizing their crucial role in adopting best practices for childbirth care. This approach aims to reduce unnecessary interventions and cesarean sections, highlighting the significance of nurse midwives in coordinating childbirth care (7,21). This comprehensive overview underscores the intricate relationship between nursing care quality and patient satisfaction, emphasizing the need for healthcare systems to adapt continually to meet evolving patient needs.…”