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Ten Ways to Avoid an Unnecessary Cesarean

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Ten Ways to Avoid an Unnecessary Cesarean

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  • I am mindful that we have a very different maternity set up here in New Zealand. Our c-section rate is climbing, but we have some research about to be published that shows that our midwifery stats are good - one-on-one midwifery is making a difference to outcomes. I'll let you know when that research comes out.
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Ten Ways to Avoid an Unnecessary Cesarean

  1. 1. 10 Ways to Avoid an Unnecessary Cesarean <ul><ul><li>Chukwuma I. Onyeije, M.D. </li></ul></ul><ul><ul><li>http://maternalfetalmedicineblog.com </li></ul></ul><ul><ul><li>http://onyeije.net/present </li></ul></ul>
  2. 2. Is there such a thing as an unnecessary cesarean delivery?
  3. 3. Cesarean Rates Have Been Increasing in the U.S. 6 Percent 6 Percent 6 Percent 23 Percent 30 Percent 17 Percent
  4. 4. Reasons for the Increased Rate of Cesarean Delivery <ul><li>Fear of malpractice claims and lawsuits </li></ul><ul><li>Incentives for physicians to practice in a manner that efficient </li></ul><ul><li>Casual attitudes about surgery </li></ul><ul><li>Refusal to offer or provide information about VBAC </li></ul>
  5. 5. <ul><li>Subtopic Goes Here </li></ul>Your chance of having a Cesarean depends on where you live...
  6. 6. Fewer VBACs means More Cesareans
  7. 7. There are many factors related to the chance of cesarean Cesarean Section Rate Induction of labor Time of day Vitamin D deficiency (?)‏ Physician's Cesarean Section Rate Mother's Age Type of Practice Nature of previous Pregnancies Availability of VBAC
  8. 8. The Public Citizen Health Research Group has estimated that half of the nearly one million cesareans performed every year are medically unnecessary.
  9. 9. Many Cesarean Deliveries Are Necessary <ul><li>Elective deliveries </li></ul><ul><li>Cesarean deliveries due to medical emergencies </li></ul><ul><li>Cesarean deliveries where vaginal birth is not possible </li></ul>
  10. 10. 5 Ways to Avoid an Unnecessary Cesarean Before Labor Adapted from: Robin Elise Weiss, LCCE http://pregnancy.about.com/od/laborbirth/a/avoidcesarean.htm
  11. 11. #1 Educate Yourself About Labor, Delivery and Childbirth
  12. 12. <ul><li>#2 </li></ul><ul><li>Select your care provider wisely. </li></ul>
  13. 13. #3 Avoid induction of labor (if possible)
  14. 14. #4 Use labor interventions wisely
  15. 15. #5 Bring support for labor
  16. 16. 5 Questions to Ask to Avoid an Unnecessary Cesarean During Labor Adapted from: ---- at CNN.com http://edition.cnn.com/2009/HEALTH/12/17/birth.plan.tips/
  17. 17. #6 &quot;Doctor, is this an emergency, or do we have time to talk?&quot;
  18. 18. #7 &quot;Doctor, what would happen if we waited an hour or two?&quot;
  19. 19. #8 &quot;Doctor, are you sure the baby is too big for me to deliver?&quot;
  20. 20. #9 &quot;Doctor, is there something else I can try before having a C-section?&quot;
  21. 21. #10. &quot;Doctor, can we talk more about the baby's heart rate?&quot;
  22. 22. Conclusion <ul><li>Physicians want what is best for any pregnant woman and her baby. </li></ul><ul><li>Unfortunately, some factors in modern obstetrics have the effect of placing the desires of patients are at odds with their doctors. </li></ul>
  23. 23. Conclusion <ul><li>As a patient, the way to avoid an unnecessary cesarean is to keep the lines of communication open with your provider </li></ul>
  24. 24. More Information: http://edition.cnn.com/2009/HEALTH/12/17/birth.plan.tips/ http://www.childbirthconnection.org/article.asp?ck=10456 http://bit.ly/51eBe7 (Academic Thoughts on VBAC by @hilseb) http://bit.ly/4L9w1q (Ten thoughts on VBAC by Nicholas Fogelson)

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