cesarean delivery on maternal request

Elective Cesarean Delivery on Maternal Request ... The articles in this book are drawn from a variety of sources and aim at preparing the younger generation for a deeper, more enlightened view of marriage, conception, pregnancy, and childbirth. Globally, how to control the rate of CDMR in China is still an important issue. The majority (58.4%) of respondents report performing between 51 and 150 deliveries per year, and for the majority (66.0%) between 10% and 25% of those are cesarean deliveries. The mean number of years since residency was 13.67 (SD 9.73 years) with a median of 12 years and a range of 1 year to 40 years. Some women might have had multiple motivations to choose a cesarean delivery at the same time. The successful experience of other parturient women’s vaginal delivery increased their confidence in delivery, whereas a failure of a trial of labor in other women possibly made them fear vaginal delivery and choose cesarean delivery. In addition, when exploring the motivation of pregnant women in late pregnancy to consider cesarean delivery, we found that “afraid of vaginal labor pains, think cesarean delivery is less painful” was the most important factor. Most of the current knowledge is based on indirect analyses that compare elective cesarean deliveries without labor (ie, cesarean delivery without a specified indication) instead of cesarean delivery on maternal request, to the combination of vaginal, unplanned cesarean, and emergency cesarean deliveries (instead of planned vaginal deliveries). Variation in primary cesarean delivery rates by individual physicians within a single hospital laborist model. Cesarean delivery on maternal request. About half of respondents believe women have the right to cesarean delivery on maternal request, and a similar percentage acknowledge having performed at least one cesarean delivery on maternal request. Montan S. Increased risk in the elderly parturient. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). In the group of cesarean delivery on maternal request, the rate of neonatal asphyxia ( B) 3 - 5 is 0.06%, while the rate in the group of planned vaginal delivery is … Reducing the rate of cesarean delivery on maternal request ... This monograph explores the mechanisms and timing of possible etiologic events that contribute to fetal and neonatal neurologic injury. the report presents evidence that most cases of cerebral palsy are a result of multifactorial and ... This research was carried out in Chongqing, China, and participants in four hospitals, two of which were in economically wealthy regions and two of which were in economically poor regions, were recruited. Compared with those who undergo vaginal delivery, women who have a cesarean delivery are more prone to febrile diseases [1] and small bowel obstruction [2], and they have a higher risk of severe acute maternal morbidity (SAMM) [3], postpartum depression [4], and postpartum death [5]. 2017;12(11):e0186304. B) Placenta previa. About one fifth of respondents were neutral as to whether a woman has the right to request an unindicated cesarean delivery, and a similar number were neutral as to whether they would do one. The NIH Conference Statement concludes that there is only moderate support for only a handful of risks and benefits of cesarean delivery on maternal request as compared with vaginal delivery: maternal hemorrhage (favors planned cesarean section), maternal length of stay (favors planned vaginal delivery), and neonatal respiratory morbidity (favors planned vaginal delivery). One respondent noted that “patients have named celebrities.” Another respondent stated, “I think the media’s portrayal of “Hollywood personalities” having planned caesarean births has made it a glamorous option...much to the detriment to our patients.” This represents a validation of the procedure that is irrelevant to the issues that bear on the decision to undergo a cesarean delivery. As can be seen in Table 2, there were nine potential benefits that the three groups of respondents (those who would not do a cesarean delivery on maternal request, those who were neutral or unsure as to whether they would do one, and those who would perform a cesarean delivery on maternal request) differed on. This statistic is consistent with the national overall cesarean delivery rate provided in the report on the development of China’s maternal and child health in 2019 [25], which is still at a high level compared to the global average [21]. ?����.&W���uvJ��5���b.�Þ�]���S�����}4W��ʴCgױi-6�lY]�k��t�3��^v��" ��,�g�3xE^�7�M�%y ���Ӑ�$��%y �d����z�땬`:x8x:x8��xGށ�ȩ�b]��S��b� Risk and Choice in Maternity Care: An International Perspective Composite non-clinical interventions for a safe cesarean ... The increasing rate of cesarean delivery at a national level and the increase in cesarean delivery without indication prompts us to explore further the reasons behind the recent trends in cesarean delivery and elective cesarean delivery. 2019;19(1):22. Clinicians were more likely to discuss risks to the mother than risks to the neonate, and were more likely to discuss risks from cesarean delivery than from vaginal deliveries.

Cesarean Delivery on Maternal Request: Obstetrician ... 2013;41(1):5–15. Robson SJ, Tan WS, Adeyemi A, Dear KBG. Cesarean delivery on maternal request (CDMR), patient choice cesarean, or cesarean on demand all refer to elective caesarean section (CS) for singleton term pregnancy carried out on maternal request in the absence of maternal or fetal indications . Detection and Prevention of Adverse Drug Events: Information ... According to WHO recommendations, a cesarean delivery rate > 10–15% is associated with additional risks and higher healthcare costs without further advantages for mother and newborn . 2014;289(4):781–5. Cesarean delivery on maternal request. Although cesarean delivery on maternal request accounts for a small proportion of all U.S. deliveries, a data-driven campaign guiding the recommendations of clinicians and the decisions of women and their families is critical. With the intervention of the Chinese government in terms of the health institution reformation and other aspects, the rate of cesarean delivery has shown a downward trend in recent years [23, 24]. Am J Obstet Gynecol 2005;192:1872–6. [37]. Then, the variables with P < 0.1 in univariate analysis and/or with significance from a professional perspective were included in the multivariate logistic stepwise regression model to obtain the factors influencing CDMR. Smith … Patient Information. 0000019068 00000 n After nearly four years, Birthrights are delighted to share that Oxford University Hospitals NHS Foundation Trust (OUH) will offer Cesarean delivery on maternal request 0000003970 00000 n Visit our ABOG MOC II collection. The demographic characteristics and prenatal examination information of the included pregnant women were then obtained. Cesarean delivery on maternal request Among those that do exist, their publication dates are relatively old. 11. Although obstetricians endorsed the right that women have to request a cesarean delivery, and many had done a cesarean delivery on maternal request, their discomfort with the procedure was evident. BMC Psychiatry. In recent years, China has taken some measures, such as health education, painless delivery and the introduction of corresponding policies to reduce the rate of cesarean delivery [42]. A total of 1538 pregnant women from four medical institutions were recruited for this study.

In 2007, the American College of Obstetricians and Gynecologists (ACOG) defined CDMR as a primary cesarean delivery on maternal request in the absence of any medical or obstetric indication [13]. Those who would not perform a cesarean delivery on maternal request were less likely to endorse improved sense of maternal well-being, and reduced risk of perineal damage, pelvic organ prolapse, long-term incontinence, hypoxic insult, lacerations, complications from labor, cerebral palsy, and neurodevelopmental delay. U.S. National Library of Medicine, National Institutes of Health. Wang E, Hesketh T. Large reductions in cesarean delivery rates in China: a qualitative study on delivery decision-making in the era of the two-child policy. 2010;89(1):49–53. Efforts must be made to assure availability of pain Supported by the Office of Medical Applications of Research, National Institutes of Health, and Grant R60 MC 05674 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. Eide KT, Morken NH, Baeroe K. Maternal reasons for requesting planned cesarean section in Norway: a qualitative study. National Institutes of Health. Defined as a cesarean delivery on maternal request for a singleton pregnancy at term in the absence of medical or obstetric indications, CDMRs are estimated to make up 4% to 18% of all cesareans today. 0000003832 00000 n Respondents cited more risks than benefits of cesarean delivery on maternal request, and nearly all discuss these risks with patients who are considering one. Chinese Medical Electronic Audio and Video Publishing House.

BJOG 2002;109:618–23. The History of Cesarean Section Of comparative developed countries, only Brazil and Italy have higher c-section rates; c-sections occur in only 19 percent of births in France, seventeen percent of births in Japan, and sixteen percent of births in Finland. Charges for obstetric liability insurance and discontinuation of obstetric practice in New York. 2018;15(10):e1002672. Obstet Gynecol. 8. Two recent studies found that two thirds of obstetricians surveyed are willing to perform cesarean delivery on maternal request,4,12 and there is evidence that more than one half would be willing to perform a cesarean delivery on maternal request,11 but little is known about obstetrician–gynecologists’ practical experiences surrounding elective cesarean delivery. March 27–29, 2006. Additionally, the overall CDMR rate was 8.42 % (108/1283). The ethical obligations of an obstetrician to a patient who requests a cesarean delivery without maternal or fetal indication differ depending on whether the request is made before or during labor. Bagheri A, Alavi NM, Abbaszadeh F. Iranian obstetricians’ views about the factors that influence pregnant women’s choice of delivery method: A qualitative study. 0000020059 00000 n NIH VideoCast - Cesarean Delivery on Maternal Request (Day 3) may email you for journal alerts and information, but is committed In data processing, some continuous variables (age, family care score, social support score, pregnancy stress score, anxiety score and depression score) were converted into categorical variables. Aref-Adib M, Vlachodimitropoulou E, Khasriya R, Lamb BW, Selo-Ojeme D. UK O&G trainees’ attitudes to caesarean delivery for maternal request. It is possible, for example, that some respondents misremembered the number of deliveries conducted in the past year. It should be noted that the response to this survey is the highest ACOG has obtained in 11 years of survey research, and suggests a high level of interest in the topic. Obstet Gynecol. Cesarean delivery on maternal request - PubMed RBD analyzed the data and wrote the paper. A follow-up survey was conducted in early pregnancy (< 15 weeks), middle pregnancy (15 weeks-27 weeks and 6 days) and late pregnancy (28 weeks–before delivery). Cotzias CS, Paterson-Brown S, Fisk NM. Acta obstetricia et gynecologica Scandinavica. This study mainly used the follow-up data of the late pregnancy period closest to the delivery time as the basic situation of the pregnant women before delivery. PubMed Google Scholar. Obstetric Interventions is aimed at obstetricians, obstetric trainees, and midwives. This book provides an evidence-based insight into the choices that obstetricians and midwives face every day at all stages of the birthing process. From the 1Department of Research, the American College of Obstetricians and Gynecologists, Washington, DC; 2Department of Research, the American College of Obstetricians and Gynecologists and Department of Psychology, American University, Washington, DC; 3Division of Practice Activities, the American College of Obstetricians and Gynecologists, Washington, DC; 4Pregnancy and Perinatology Branch and 5Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland; and 6Washington, DC. There are some risks and benefits to this decision for both mother and baby. There was no relationship between patient education and patient income and the number of risks and benefits endorsed. A review of literature on the views of stakeholders. 1. We also found that a doctor recommendation was an important motivation for pregnant women to consider cesarean delivery. Article  Surgery and patient choice. It should be noted that all responses were self-report and thus implicitly rely on physicians’ recall. Generally these were redundant with a risk already on the list, and for a few respondents it was reduced liability.

Cesarean Delivery on Maternal Request Nearly three fifths (58.4%) of respondents reported noticing an increase in maternal requests for unindicated cesarean delivery over the past year. 2016;123(5):667–70. 2007;22(5):1264–72. There was no gender difference in attitudes toward doing a cesarean delivery on maternal request in the context of a history of previous delivery complications. A large majority (85.6%) of respondents rated themselves as very or extremely qualified to discuss the risks and benefits of elective cesarean delivery with patients.

0000043829 00000 n Cesarean Delivery on Maternal Request xref Moreover, infants born via cesarean section might be subjected to subtle physiological modulation due to hormonal, physiological, bacterial and medical interventions [3]; they are more susceptible to respiratory and immune system diseases [6,7,8,9]; and they may even sustain a lasting impact on their growth and development [10, 11]. In addition, the doctors’ advice, lack of confidence in vaginal delivery and a belief that cesarean delivery was safer for children were the main motivations for women to choose a cesarean delivery (Table 3). As a group, the respondents were much more willing to do cesarean delivery on maternal request in the context of a history of 3rd or 4th degree laceration with her first delivery, with only about 11% likely to refuse to do one. Professional liability issues and practice patterns of obstetric providers in Washington State. 0000121397 00000 n China’s maternal and child health cause development report (2019) (1). 0000124186 00000 n

While acting as a stand-alone text on obstetric care, this volume also forms part of a three-volume set - all authored by leading authorities - on the entirety of obstetric and gynecologic practice. 7.2. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. elective CD indicated by maternal request without premature rupture of membranes) were selected from the available population based on abovementioned delivery mode and cesarean indications, as well as Enceph-Rev Psychiatr Clin Biol Ther. Anesthesia for Cesarean Section Common Child Health Outcomes: A Prospective Cesarean ... It also contributes to reproductive risks for women who Statistical analysis was performed by SAS 9.4 software (SAS Institute, Cary, NC, USA). Department of Statistical Research and Development of Chongqing Health Information Center. The groups were similar on all of the other demographic or practice variables except for the number of deliveries performed. Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term. Zung WWK. You may be trying to access this site from a secured browser on the server. 0000168112 00000 n Neonatal Encephalopathy and Cerebral Palsy: Defining the ... 3 . It has also been shown in a study in Brazil that doctors’ opinions have major impacts on the decisions of pregnant women, especially those made about the delivery mode [56]. Ninety-eight (17.1%) of the respondents reported a change. 10. The majority of respondents (92.2%) report that their department or practice has no policy regarding maternal request cesarean deliveries. Luo XL, Zhang WY. The Collaborative Ambulatory Research Network was established to facilitate assessment of clinical practice patterns and aid in the development of educational materials. A case-control study of caesarean delivery on maternal request: who and why?

J Womens Health. Introduction The proportion of women electing for cesarean delivery has increased in both developed and developing countries. Google Scholar. The rate of cesarean delivery on maternal request (CDMR) however remains uncertain and recent data on CDMR are lacking.

The most frequently endorsed risk was intraoperative risks to the mother such as bleeding and damage to internal organs (93.7%). Depression was measured by the Self-rating Depression Scale (SDS), which calculated a depression severity index (actual total score/highest possible score for all entries) [38]. Birth-Iss Perinat C. 2009;36(3):208–12. A research report in the United States showed that nearly half of obstetricians believe that pregnant women have the right to choose cesarean delivery [43], and Chinese obstetricians have the same belief [36]. Alternatively, the opinions of the clinicians in our study could have been influenced by the increased media exposure of cesarean delivery on maternal request. By continuing to use this website you are giving consent to cookies being used. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. Smilkstein G, Ashworth C, Dan M. Validity and reliability of the family APGAR as a test of family function. Of the 591 respondents, only 46 (27 Collaborative Ambulatory Research Network and 19 non–Collaborative Ambulatory Research Network) practice a specialty other than obstetrics and gynecology. 0000152525 00000 n Short-term and long-term effects of caesarean section on the health of women and children. Ethics in Obstetrics and Gynecology makes an original and timely contribution to the bioethics literature. Group differences in responses on continuous measures were assessed using independent sample t tests, and categorical data were assessed using the χ2 test.

The database was established using EpiData 3.1 software (EpiData Associations, Odense, Denmark), and real-time double entry and logical verification of the data were carried out. 2021:1-7. https://doi.org/10.1080/14767058.2021.1887124. The impetus for this study originated in the Office of Medical Applications of Research at the National Institutes of Health to assess current beliefs and practices before the State-of-the-Science Conference on cesarean delivery on maternal request. 2021;4(3):e212235.

Due to the lack of enough scientific evidence, it’s difficult to thoroughly evaluate the overall risks and benefits of CDMR. Predicting the success of vaginal birth after caesarean delivery: a retrospective cohort study in China. 7. The non–Collaborative Ambulatory Research Network group was also more likely to have patients with a college education, while the Collaborative Ambulatory Research Network group was more likely to have patients with high school or less education, or an advanced degree (P<.001). 1965;12(1):63. Only a small number (3.4%) view themselves as primary care providers; the majority (53.6%) report that they are both specialists and primary care providers. Cesarean delivery on maternal request and its influencing factors in Chongqing, China. This study was funded by the National Natural Science Foundation of China (71,573,027). This book defines the principles and practice of the care in labour developed by The National Maternity Hospital, Dublin, Ireland. Akintayo AA, Ade-Ojo IP, Olagbuji BN, Akin-Akintayo OO, Ogundare OR, Olofinbiyi BA. Guidelines for Perinatal Care Based on respondents’ estimates, one half (49.4%) serve a middle class patient population with estimated yearly income between $25,000 and $59,999. Anesthesia and the Fetus integrates into one volume the multidisciplinary components of: fetal development fetal pharmacology assessments of fetal and neonatal outcome anesthesia and analgesia during pregnancy anesthesia and analgesia ... Furthermore, the management and counselling concerning short and long-term maternal and neonatal outcomes have become a main topic for obstetricians [ 4 ]. Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. The majority of respondents who do patient counseling in the context of a patient request for a nonmedically indicated cesarean delivery reported discussing all of the risks presented on the questionnaire: short-term risks to the mother, short-term risks to the neonate, short-term risks to the mother from attempting vaginal delivery, short-term risks to the neonate from attempting a vaginal delivery, long-term risks to the mother from a cesarean delivery, and long-term risks to the mother from a vaginal delivery (Table 3).

Mylonas I, Friese K. Indications for and Risks of Elective Cesarean Section. RESULTS: About half of respondents believe women have the right to cesarean delivery on maternal request, and a similar percentage acknowledge having performed at least one cesarean delivery on maternal request. 0000013615 00000 n Presents papers from the workshop 'Patient Safety through Intelligent Procedures in medication' focusing on: identification of ADE and medication errors in hospital settings; the role of human and organizational factors on ADE and ... A majority of those who had noted an increase and who gave an explanation attributed the increase to various sources of information, including the popular media, the internet, and child birth education (52.7%). Google Scholar. Cesarean The global cesarean delivery rate was 21.1 % in 2015, almost twofold of that in 2000 [21]. Clinicians who do not believe women have a right to an elective cesarean delivery were also less likely to have performed one in the past year than clinicians who do subscribe to this belief (P<.001). NIH VideoCasting. Cesarean Delivery: A Comprehensive Illustrated Practical Guide Liao ZJ, Zhou YB, Li HT, Wang C, Chen DJ, Liu JM. 0000007236 00000 n Length of stay18. Cadernos de saude publica. With regard to factors that affect the outcome of cesarean delivery on maternal request, males and females differed on two of the items. Non–Collaborative Ambulatory Research Network respondents were more likely to perform fewer than 51 or more than 200 deliveries per year than the Collaborative Ambulatory Research Network group (P<.05). C-section: Cesarean delivery — also known as a C-section — is a surgical procedure used to deliver a baby through incisions in the mother's abdomen and uterus. Estimating the Rate of Cesarean Section by Maternal Request: Anonymous Survey of Obstetricians in Australia. Therefore, we suggest that obstetric medical staff should enhance their understanding of professional knowledge, adhere to the indications for cesarean delivery, and give pregnant women a full opportunity to undergo a trial of labor. The list of risks and benefits were based on those examined in the NIH State-of-the-Science Conference.2 Overall, respondents endorsed more risks than benefits (mean number of risks 7.28, SD 2.69); mean number of benefits 4.47, SD 2.92; P<.001). The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Maternity Services and Policy in an International Context: ... Females were more negative toward cesarean delivery on maternal request and were somewhat less likely to perform them, which is consistent with other studies.5 In contrast, we found only one small effect of clinician age and none of the education and income characteristics of the respondents’ practices. Additionally, a series of health policies were developed by the Chinese central and local … In this study, the cesarean delivery rate in Chongqing, China, was 36.01 %. This book includes the origin of the eponym and describes many myths from ancient Greek, Roman, Persian and medieval cultures. 0000152981 00000 n

Chigbu CO, Ezeome IV, Iloabachie GC. Therefore, the high cesarean delivery rate may be due to other factors. Pregnant women (N = 327) who had no definite willingness to undergo cesarean delivery or who were willing to have a cesarean delivery were asked about their motivations to have a cesarean delivery, whereas those who were willing to have a vaginal delivery were asked about their motivations to have a vaginal delivery (data not shown). 2006;108(3, Part 1):541–8.

Jakobsson H, Abrahamsson T, Jenmalm M, Harris K, Quince C, Jernberg C, et al. American College of Obstetricians and Gynecologists, ACOG has released its latest recommendations on Cesarean Delivery on maternal request. Jeffrey Ecker, MD. Clinicians were asked to select which of 14 risks and 14 benefits to mother and neonate they believed were associated with cesarean delivery on maternal request.

2017;295(5):1151–6. This book still remains the standard reference work on medical disorders in obstetric practice in the UK and UK-influenced areas such as the former Commonwealth. cesarean ;] Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms. _����FB�Ҥ�r�?��> �I��䐋���㫺�"��3>���v�ۇ~r��8��ܩ]��p�������-J�����6?�K3fy Cesarean Delivery on Maternal Request. School of Public Health and Management, Chongqing Medical University, #1 Yixue Rd, 400016, Chongqing, China, Ruibin Deng, Xian Tang, Jiaxiu Liu, Yuwen Gao & Xiaoni Zhong, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, 400016, Chongqing, China, You can also search for this author in Cite this article. Hum Reprod. A total score of all entries was calculated, with a score < 35 for a low level of social support, 35–45 for a medium level, and > 45 for a high level. Five of the 14 benefits were endorsed by more than one half of the respondents. Betran AP, Torloni MR, Zhang JJ, Gulmezoglu AM, Section WHOWGoC. 0000004462 00000 n Among those who perform more than 50 deliveries per year, cesarean delivery accounts for between 10% and 25% of deliveries for more than 65% of respondents. 0000012843 00000 n