Instructor Cynthia Walton
4 November 2014
The Cesarean Epidemic
and How Birthing Education Can Help
Pregnancy is a very personal and emotionally charged experience for most women and with it comes ups, downs, and a slew of uncertainties. For many new moms the unknown or lack of experience of what is happening, what will happen and the fear of what could happen, is all too much. Due to these warranted emotions and trepidations, women now more than ever are turning to non-medically indicated, elective procedures in order to have a sense of control over the process or because they were assured by their physician that all will be okay. In the last twenty years the induction rate in America has more than double (Hamilton Martin & Ventura 4) Along with the rate of induction, the use of Cesarean section surgery has risen by more than 50 percent, which is often attributed to the use of medical induction. (Zahng et al 326) These procedures pose many threats to both mother and infant and research from all over the country shows that the rising rates of these interventions has not improved maternal or neonatal mortality. (Power et al. 167) Birthing education should be mandatory for all expectant mother's to help prevent, or at least put into perspective the risks associated with elected, non medically deemed necessary, interventional procedures such as induction of labor and cesarean sections during the birthing process. The implementation of this practice may help to relieve the rising numbers of said procedures.
Induction of labor is a process by which medications, or other methods, are administered to a pregnant woman to help bring on or “induce” contractions in the uterus before a spontaneous vaginal delivery occurs. Historically, induction has been used to coax a baby who has exceeded it's welcome in the womb, but there are many other legitimate, medical, reasons to induce as well. According to Dr. Russell S. Kirby, medically deemed acceptable reasons for inducing a mother constitute maternal medical problems, including pregnancy induced hypertension, and diabetes, fetal jeopardy and distress as well as premature rupture of vaginal membranes. Dr. Kirby also states that medically deemed inappropriate reasons to induce a labor entail prior cesarean section with a classical incision, active genital herpes, placenta previa, a condition in which the placenta is lying too low in the uterus and blocks passageway for the baby, prolapsed umbilical cord and situations in which the baby is in “transverse lie.” (Kirby148) Transverse lie refers to the child lying in such a way that the leading portion of the baby down the birthing canal is an arm, shoulder or even torso. These ailments are all considered inappropriate because they are, in most cases, easily avoidable and pose no severe threats to mother or baby.
While inducing labor has it's known benefits, the dangers of inducing labor are also well documented and non arguable. According to professor of nursing as well as registered nurse Renee T. Ridley along with registered nurses Claudia D. Akinsipe, and Laura E. Villalobos, maternal complications linked to voluntary induction include sepsis, hemorrhaging caused by oxytocic agents, failed induction, hyper stimulation of the uterus that causes elongated contractions and can raise fetal heart rates as well as create uterine tearing. (5) Most importantly, as reported by Dr. Steven Clark, labor induction can trigger abnormal contractions in the uterus and cause difficulty in child birth. These challenges can create labor arrest and significantly increase the risk of cesarean surgery. (Clark et al. 156) In regards to the fetus/newborn, it has also been found by Akinsipe, Villalobos and Ridley, that inducing labor, especially too early, can cause the baby to be born with insufficient pulmonary function, sepsis, cord prolapse which is when the umbilical cord precedes the baby down the birthing...
Cited: Akinsipe, Claudia D, Villalobos, Laura E, Ridley, Renee T. "A Systematic Review Of Implementing An Elective Labor Induction Policy." Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG 41.1 (2012): 5-16. MEDLINE. Web. 23 Oct. 2014.
“Cesarean Birth.” ACOG.org 006 Web. Retrieved 5 Nov. 2014 from: http://www.acog.org/Patients/FAQs/Cesarean-Birth-C-Section
Clark, Steven L, et al
“Definition of full term.” ACOG.org. 579 (2013) Web. Retrieved 23 Oct. 2014 from: http://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric- Practice/co579.pdf?dmc=1&ts=20141024T1719261811
Goldenburg, L Robert., et al
Hamilton, Brady E., Martin, Joyce A., Ventura, Stephanie J."Births: Preliminary Data For 2011. National Vital Statistics Reports. 61.5." Centers For Disease Control And Prevention (2012): ERIC. Web. 23 Oct. 2014.
Kirby, Russell S. "Trends In Labor Induction In The United States: Is It True That What Goes Up Must Come Down?." Birth: Issues In Perinatal Care 31.2 (2004): 148-151. Academic Search Premier. Web. 10 Oct. 2014.
Lothian, Judith A. "Childbirth Education At The Crossroads." Journal Of Perinatal Education 17.2 (2008): 45-49. Alt HealthWatch. Web. 7 Nov. 2014.
Power, Michael L., et al. "Attitudes And Practices Regarding Late Preterm Birth Among American Obstetrician-Gynecologists." Journal Of Women 's Health (15409996) 22.2 (2013): 167-172. Academic Search Premier. Web. 11 Oct. 2014.
“What is Cesarean Birth?” ACOG.org. American College of Obstetricians and Gynecologists. (2011) Web. 10. Oct. 2014.
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