Running Head: CRITIQUE OF EVIDENCE 1
CRITIQUE OF EVIDENCE 4
Critique of Evidence
Institutional Affiliation
Student’s name
Critique of Evidence
This paper will provide an additional critique of the evidence provided in the literature review. Three articles were reviewed based on their content and how it relates to the PICOT question which is "For expectant mothers, how does cesarean delivery compare to normal child delivery result in excessive blood loss after birth?” All the articles chosen are not older than 5 years.
The first article that will be critiqued is the article by Tommy titled “C-section - benefits, and risks. (2018, April 24). Tommy's. https://www.tommys.org/pregnancy-information/labour-birth/caesarean-section/c-section -benefits-and-risks.” The research design of the study is through a survey. The author uses personal stories from people who have undergone C-section and uses these stories to generate data. The threat to the external/internal validity of this research is that the stories might be biased in a way. There is also a threat of the respondent misleading the researcher due to misunderstanding of the questions asked. There were no legal or ethical issues identified in this article. The results from this article are useful for women to know what to expect before and after undergoing a c-section delivery. This is important for evidence-based practice because it will enable women to make informed decisions about the type of delivery to have.
The second article that will be critiqued is the article by Escobar which was published in 2017, September 15. The title of the article is “Why C-section rates are so high.” The research design of the study is a mixture of both primary and secondary sources. The author makes use of personal stories from mothers who have undergone C-section during the delivery as well as using other published material on the topic. The threats to the internal and external validity of this research are that the stories provided by the sample might not be representative of the whole population. The likely legal and ethical issues within the article include the fact that the author reveals the identity of one of the respondents and this could lead to privacy and confidentiality issues. The main thing that can inform evidence-based practice is that women should be aware of the problems surrounding c-sections and only undergo this kind of delivery when it is completely necessary.
The third article to be critiqued is one by the “World Health Organization” published in 2015, April 10. The title of the article is “WHO statement on cesarean section rates.” The research design of the article is a mixed-method design. Different research methods have been used to draw conclusions in the article. The WHO conducted various studies to identify causes of the rising rates of c-s ...
UChicago CMSC 23320 - The Best Commit Messages of 2024
Running Head CRITIQUE OF EVIDENCE .docx
1. Running Head: CRITIQUE OF EVIDENCE
1
CRITIQUE OF EVIDENCE
4
Critique of Evidence
Institutional Affiliation
Student’s name
Critique of Evidence
This paper will provide an additional critique of the evidence
provided in the literature review. Three articles were reviewed
based on their content and how it relates to the PICOT question
which is "For expectant mothers, how does cesarean delivery
compare to normal child delivery result in excessive blood loss
after birth?” All the articles chosen are not older than 5 years.
The first article that will be critiqued is the article by Tommy
titled “C-section - benefits, and risks. (2018, April 24).
Tommy's. https://www.tommys.org/pregnancy-
information/labour-birth/caesarean-section/c-section -benefits-
and-risks.” The research design of the study is through a survey.
2. The author uses personal stories from people who have
undergone C-section and uses these stories to generate data. The
threat to the external/internal validity of this research is that the
stories might be biased in a way. There is also a threat of the
respondent misleading the researcher due to misunderstanding
of the questions asked. There were no legal or ethical issues
identified in this article. The results from this article are useful
for women to know what to expect before and after undergoing
a c-section delivery. This is important for evidence-based
practice because it will enable women to make informed
decisions about the type of delivery to have.
The second article that will be critiqued is the article by
Escobar which was published in 2017, September 15. The title
of the article is “Why C-section rates are so high.” The research
design of the study is a mixture of both primary and secondary
sources. The author makes use of personal stories from mothers
who have undergone C-section during the delivery as well as
using other published material on the topic. The threats to the
internal and external validity of this research are that the stories
provided by the sample might not be representative of the whole
population. The likely legal and ethical issues within the article
include the fact that the author reveals the identity of one of the
respondents and this could lead to privacy and confidentiality
issues. The main thing that can inform evidence-based practice
is that women should be aware of the problems surrounding c-
sections and only undergo this kind of delivery when it is
completely necessary.
The third article to be critiqued is one by the “World Health
Organization” published in 2015, April 10. The title of the
article is “WHO statement on cesarean section rates.” The
research design of the article is a mixed-method design.
Different research methods have been used to draw conclusions
in the article. The WHO conducted various studies to identify
causes of the rising rates of c-section deliveries and they
reinforced these studies with secondary sources on the same
topic. Data were analyzed and the recommendations provided.
3. These recommendations are important in evidence-based
practice and can be used to inform major changes. One of the
recommendations from this article is for hospitals to use the
Robson classification system to help in controlling the rate of
C-section deliveries (WHO, 2015). No legal or ethical issues
were identified in this article.
Conclusion
In conclusion, the three articles provide sufficient evidence
showing that c-section rates have been on the rise in the United
States. The World Health Organization recommends that the
Robson classification should be used in hospitals to control the
rate of C-section deliveries and prioritize those that are
necessary.
REFERENCES
C-section - benefits and risks. (2018, April 24). Tommy's.
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section -benefits-and-risks
Escobar, N. (2017, September 15). Why C-section rates are so
high. TheBump.com - Pregnancy, Parenting, and Baby
Information. https://www.thebump.com/a/c-section-rate-
problems.
WHO. (2015, April 10). WHO statement on cesarean section
rates. WHO | World Health
Organization.
https://www.who.int/reproductivehealth/topics/maternal_perinat
al/faq-cs-section/en/
Running Ahead: KEEPING UP E-COMMERCE GROWTH
Running Ahead: KEEPING UP E-COMMERCE GROWTH
4. Kathy A. Greggs
Liberty University
06/03/2020
Keeping Up E-Commerce Growth
Amazon is arguably the largest E-commerce company in the
world, and in recent times the company has seen enormous
growth, e-commerce growth. Meaning that the market is
expanding and if the company will not adapt to the expansion, it
might fail. What does this mean, it needs to adapt to the
environment. Therefore, the general problem to be addressed is
keeping up with the e-commerce growth. On the other hand, the
specific problem to be addressed is how to keep up the
operating segment (online stores) which makes up more than
5. half of Amazon’s Revenue. There are a few points that needs to
be focused upon, the shifting business mix of the company,
whereby a significant and relevant growth indicator and the
general health of business has been illustrated by the pace of the
gross profit growth. According to Anthony Diclemnte (2017),
“gross profit model buoys his 12-month price target on the e-
commerce giant to $1,965 from $1,800.” But another important
and intricate aspect to understand is the growth challenge that
international rather than domestic, mainly because the company
has been handling the domestic market efficiently holding
almost a half of the retail market.
Based on the Financial Reports of the retail Giant, the
Fluctuations of the foreign exchange played an important role.
This is because it cost the company almost $1.3 billion to hit
the “international revenues.” Ignoring the impact of the
movement of the foreign exchange, amazon would have
continued to grow more slowly. This pattern of growth has been
the norm of the day for some time, and it is what will affect the
company if it is not taken care of, but it is a challenge that
affects the company, a sit invests in the business and captures
margins at cost of growth while losing money at the same time.
The company has positive operating margins in every quarter,
and the reverse is similar for the international segment of the
company. Meaning that the international growth segment comes
at a cost that might affect the other markets of the company.
Therefore it is important to acknowledge that the business is
small internationally and in addition to that it has a slow growth
curve, combining these two aspects; lower profits and slower
growth creates a concern.
One of the key strategies of the company has been getting closer
and closer to the customer, t creates more competitive features.
Currently the business has differentiated its services based on
different geographical areas, many new features and exclusive
services are only in specific geographical areas, and even within
the home market the United States. Some of these services
depend on coming up with accompanying infrastructure,
6. specifically in the fulfillment and distribution centers of the
company. Whereby the main purpose for such initiatives is
mainly accomplished by partners (who contribute over half of
its revenue) like the retailers (Amazon Locker and/or the Postal
Service that help to accomplish same day deliveries or delivery
on Sundays. Whereby these services cannot be established
outside the country easily, and specifically in new countries
whereby they may lack such structures and the partners might
completely not be there, whereby it puts the fulfillment of the
company on a tight spot.
In the United States, there are more than sixty distribution and
fulfillment centers that have approximately 50 million of square
feet of space, which is way bigger than any centers in foreign
countries with Amazon operations. In the sense that Germany
and China have less than 10 million of square feet respectively.
This creates an imbalance as the ecommerce market in the three
countries is almost on the same magnitude. Which becomes a
problem, because before the company mainly focused
differentiation that was solely created by low prices and its
massive online selection, but the differentiation ta the moment
focuses on customer personal fulfillment, and it can only be
feasible in the local market, which enables the kind of
innovation that has been discussed before. On the other hand the
company cannot just decide to invest in the international
market, which has been established actually costs the company
instead of making profits meaning that additional investments
will make losses for the company. This is because the company
lacks market share and lack scale in the foreign countries,
which creates a vicious circle that prevents Amazon form being
able to create the same services that are in the local market and
extend the services to the international market.
Therefore, what does this mean, the revenue of the company
comes majorly form a few countries. The country details are not
provided but the North American Region that consists of United
States, Canada, U.K., Japan, German and Mexico, but
dominated by the U.S. Market, make up almost 95% of the
7. revenue that the company receives annually (Dawson, 2015).
Therefore I is possible that these countries that company is
looking forward to achieve the scale and density that it has
achieved in the U.S. market in the other markets. This can only
be fulfilled through focusing on building the density and scale
rather than spreading thinly all over the international market.
Looking at the company currently, the investment is mainly and
particularly focused on the Chinese market and to some extent
in the Indian market (Wu & Park, 2019). Whereby these regions
are a challenge because of the presence of the local competitors
in these regions and the tough regulations put in place in these
markets. This makes it almost impossible to succeed in these
markets. The investments being made in these regions are
essentially all the cash and profits established in these regions
and the in addition to the current expansion plans, which
showing any signs of paying off. Therefore, the company thinly
spreads itself, meaning that the more it continues with this
technique of thinly spreading it is the likely that it will not
succeed in any market of the international countries outside the
U.S. making their current strategy counterproductive.
Works Cited
Amazon's International Growth Challenge by Jan Dawson, May
8. 11, 2015. Retrieved from
https://www.vox.com/2015/5/11/11562518/amazons-
international-growth-challenge
AMAZON.COM, INC Report by Anthony DiClemente & Lee
Horowitz, December 5, 2017. Retrieved from
https://www.academia.edu/36436755/Initiating_Coverage_Initia
te_on_AMZN_with_Outperform_Rating_and_1_350_Target_Pri
ce_Fearing_the_Mammoth_Disruptor
Wu, J., & Park, S. H. (2019). The role of international
institutional complexity on emerging market multinational
companies’ innovation. Global Strategy Journal, 9(2), 333-353.
2
Running Ahead: KEEPING UP E-COMMERCE GROWTH
Running head: KEEPING UP E-COMMERCE GROWTH.
Kathy A. Greggs
Liberty University
05/23/2020
9. Keeping Up E-Commerce Growth
Amazon is arguably the largest E-commerce company in the
world, and in recent times the company has seen enormous
growth, e-commerce growth. Meaning that the market is
expanding and if the company will not adapt to the expansion, it
might fail. What does this mean, it needs to adapt to the
environment. Therefore, the general problem to be addressed is
keeping up with e-commerce growth. On the other hand, the
specific problem to be addressed is how to keep up the
operating segment (online stores) which makes up more than
half of Amazon's Revenue. There are a few points that need to
be focused upon, the shifting business mix of the company,
whereby a significant and relevant growth indicator and the
general health of business has been illustrated by the pace of the
gross profit growth. According to Anthony Diclemnte (2017),
"gross profit model buoys his 12-month price target on the e-
commerce giant to $1,965 from $1,800.” But another important
and intricate aspect to understand is the growth challenge that
international rather than domestic, mainly because the company
has been handling the domestic market efficiently holding
almost half of the retail market.
Based on the Financial Reports of the retail Giant, the
Fluctuations of the foreign exchange played an important role.
This is because it cost the company almost $1.3 billion to hit
the “international revenues.” Ignoring the impact of the
movement of the foreign exchange, amazon would have
10. continued to grow more slowly. This pattern of growth has been
the norm of the day for some time, and it is what will affect the
company if it is not taken care of, but it is a challenge that
affects the company, a sit invests in the business and captures
margins at cost of growth while losing money at the same time.
The company has positive operating margins in every quarter,
and the reverse is similar for the international segment of the
company. Meaning that the international growth segment comes
at a cost that might affect the other markets of the company.
Therefore, it is important to acknowledge that the business is
small internationally and in addition to that it has a slow growth
curve, combining these two aspects; lower profits and slower
growth create a concern.
One of the key strategies of the company has been getting closer
and closer to the customer, it creates more competitive features.
Currently, the business has differentiated its services based on
different geographical areas, many new features, and exclusive
services are only in specific geographical areas, and even within
the home market in the United States. Some of these services
depend on coming up with accompanying infrastructure,
specifically in the fulfillment and distribution centers of the
company. Whereby the main purpose of such initiatives is
mainly accomplished by partners (who contribute over half of
its revenue) like the retailers (Amazon Locker and/or the Postal
Service that help to accomplish same-day deliveries or delivery
on Sundays. Whereby these services cannot be established
outside the country easily, and specifically in new countries
whereby they may lack such structures and the partners might
completely not be there, whereby it puts the fulfillment of the
company on a tight spot.
In the United States, there are more than sixty distribution and
fulfillment centers that have approximately 50 million square
feet of space, which is way bigger than any centers in foreign
countries with Amazon operations. In the sense that Germany
11. and China have less than 10 million square feet respectively.
This creates an imbalance as the e-commerce market in the three
countries is almost on the same magnitude. Which becomes a
problem, because before the company mainly focused
differentiation that was solely created by low prices and its
massive online selection, but the differentiation at the moment
focuses on customer personal fulfillment, and it can only be
feasible in the local market, which enables the kind of
innovation that has been discussed before. On the other hand,
the company cannot just decide to invest in the international
market, which has been established costs the company instead
of making profits meaning that additional investments will make
losses for the company. This is because the company lacks
market shares and lack scale in the foreign countries, which
creates a vicious circle that prevents Amazon form being able to
create the same services that are in the local market and extend
the services to the international market.
Therefore, what does this mean, the revenue of the company
comes majorly from a few countries. The country details are not
provided but the North American Region that consists of the
United States, Canada, the U.K., Japan, German, and Mexico,
but dominated by the U.S. Market, make up almost 95% of the
revenue that the company receives annually (Dawson, 2015).
Therefore, it is possible that these countries that company is
looking forward to achieving the scale and density that it has
achieved in the U.S. market in the other markets. This can only
be fulfilled by focusing on building the density and scale rather
than spreading thinly all over the international market. Looking
at the company currently, the investment is mainly and
particularly focused on the Chinese market and to some extent
in the Indian market (Wu & Park, 2019). Whereby these regions
are a challenge because of the presence of the local competitors
in these regions and the tough regulations put in place in these
markets. This makes it almost impossible to succeed in these
markets. The investments being made in these regions are
essential all the cash and profits established in these regions
12. and in addition to the current expansion plans, which showing
any signs of paying off. Therefore, the company thinly spreads
itself, meaning that the more it continues with this technique of
thinly spreading it is the likelihood that it will not succeed in
any market of the international countries outside the U.S.
making its current strategy counterproductive.
Research Questions.
How has technology impacted e-commerce?
What percentage of company performance has been affected by
e-commerce?
To what extent has e-commerce affected job security?
How has e-commerce affected the expenditure of organizations?
Problem Statement.
E-commerce came to its existence due to technology.
Before that, most of the companies relied on traditional ways of
conducting commerce and businesses. However, after the
evolution of technology, there has been continued innovation of
new advancements in technology. Therefore, these new
advancements of technology are being invented today.
Therefore, this has continued to impact the whole idea of e-
commerce. The new technologies however affect e-commerce
positively. Therefore, it has promoted the efficiency of the
business. This is because companies can do their work faster
and in an easier way.
Before the evolution of e-commerce, companies and businesses
performed poorly due to low productivity. E-commerce involves
conducting business electronically. Therefore, this has
improved how companies conduct business. Therefore, it has
improved its productivity and hence overall performance is
improved. This is because e-commerce is because of technology
which makes work easier and faster. Moreover, the work is
accurate hence improving the quality of productivity in a
company. Nevertheless, ever the evolution of e-commerce has
negatively impacted the job security of many employees. This is
13. because most of the organizations prefer doing their operations
electronically. As a result, the need for labor force has been
decreasing from time to time. Therefore, most of the employees
have lost their jobs. However, companies nowadays have a few
numbers of employees. However, these employees are required
to had skills in the field of technologies. They should be
computer literate for them to qualify for the job position.
Therefore, employees who are computer illiterate lose their
jobs.
Since the companies are conducting their business
operations electronically with few employees, this has been
cost-effective so far. This is because it has helped companies
utilizing e-commerce to reduce the cost of paying salaries to a
large number of employees. As a result, the money has been
reallocated to various departments. Some of these departments
include the marketing department. This has increased the
marketing strategies within the organization's marketing
department to increase its customers. With an increased
customer base, companies have been in a position to increase
their sales and revenues. Consequently, the company has been
able to maximize its profits. The marketing department can as
well market its products through social media platforms. This
has saved the company the cost of paying salesmen to conduct
marketing strategies.
Quantitative Study.
A quantitative study can be defined as a research design
that involves measuring variables using numerical models,
analyzing the measurements using statistical procedures, and
then evaluating the relationship that exists between the involved
variables. Therefore, a quantitative study has data collection
methods that will be explained in detail below. This study
method also has ways of analyzing data collected including a
target population.
Data Collection.
Data collection can, therefore, be defined as the procedure
14. of gathering the info and data as well as gauging it based on
involved variables of interest. Data collection is usually done
through systematic and well-known methods and procedures
that allow researchers to get answers to their research questions.
Nevertheless, data collection allows researchers to do a
hypothesis. After the hypothesis has been done, researchers will
then be able to evaluate the outcomes of the entire research
study. Moreover, data collection is important to researchers
because it helps them acquire some form of quality evidence
that leads to the analysis and interpretation of rich data.
Through this, researchers will be able to come up with reliable
and viable conclusions of the entire research answers to the
research questions (Flick, 2017). Therefore, the systematic
process of data collection starts with outlining the type of data
required for the research. The researcher will then be expected
to select a sample from the target population through a process
known as sampling. Once that is done, the researcher will then
utilize various data collection instruments that apply to the
entire process (Paradis et al. 2016).
A quantitative study can be divided into four categories. They
include descriptive, experimental, correlation, and quasi-
experimental research designs. However, the research will use a
descriptive research design. This is because descriptive research
involves data collection that leads to testing the hypothesis. It
also collects data that help answer research designs outlined
above. It will also cover most of the areas of study. This helps
improve the reliability and validity of the data collected.
Nevertheless, a descriptive research design allows researchers
to conduct problem-structuring models. These models will then
help the research team have a clear understanding. Most of the
researchers use this category of quantitative study because it
reports on things as they are, without any addition or
subtraction. This is uncommon to the other research design
categories. The research team will employ a descriptive
research design that will be useful in outlining the features of
the involved variables such as technology, job security, overall
15. performance, and the cost involved and its relationship with e-
commerce. The design is suitable for obtaining data about the
current trends of the occurrence, which is e-commerce
(Dewaele, 2018). The following section will outline the data
collection techniques employed in the research.
Data Collection Methods.
There are various ways of collecting data. The common methods
of collecting data in the quantitative study include
questionnaires, interviews, tracking, experiments, observations,
and surveys. However, the research will use questionnaires and
observations to collect data. The reason behind this selection is
that it is easier and cost-effective unlike the other methods of
data collection. However, these methods have various
challenges especially from the participation side of the
respondents. This is because most people perceive it as a waste
of time since it is one-on-one. However, for the researchers, this
is considered reliable information.
Surveys.
The surveys primarily embrace the use of questionnaires. These
methods of data collection save a lot of time since the research
team will gather information directly from the participants
concerning the subject matter, e-commerce. That is in the case
of surveys and interviews. Most of the surveys utilize
questionnaires to collect data (Brannen, 2017). The
questionnaires will be, therefore, used during surveys. The
questions in the questionnaires are mostly close-ended. Hence
respondents will not have to waste their time explaining
themselves. The survey questionnaires can either be web-based
or paper-based. The web-based will involve surveying a target
area of study that is far from reach. Therefore, respondents will
be given questionnaires to fill them out online. As for the
paper-based, the survey will be conducted manually where the
research team issues out questionnaires to the target population
in person.
Experiments.
16. This is where the researchers conduct experiments that involve
variables of the research. The experiments aim to evaluate the
relationship that could exist between the variables of interest
(Kazdin, 2016). For example, the research team could do an
experiment on the technology variable and manipulate it with
the job security variable and then see if there is any change.
This method of data collection is very important in the
qualitative study as it helps in understanding the relationship
between the involved variables. Therefore, they are reliable and
give valid findings. However, they are quite expensive but
worth it.
Interviews.
This is the most common method used by researchers trying to
tell what society thinks about their research topic, such as e-
commerce. The research team conducts interviews that are often
structured to avoid wastage of time. Therefore, structured
interviews encompass a group of questions formulated by the
research team. These questions had already been done and a
pilot test carried out on them. Therefore, the questions meet the
needs of the research, that is it focuses on answering the
research questions. Structured interviews are the opposite of
open-ended interviews whereby the participants are expected to
elaborate their answers in detail (Dikko, 2016). Therefore, when
coming up with open-ended interview questions, researchers do
not subject the questions to pilot tests. Therefore, with open-
ended interviews, the research team pick up on some few ideas
and risk leaving out the most important ideas related to their
study. Therefore, structured interviews are appropriate in any
case since all the information will be gathered because the
responses are precise and on point. The research team will
therefor use structured interviews will involve asking questions
face to face to the respondents.
Literature Sources.
The literature resources could involve gathering information
from textbooks, magazines, and newspapers. The literature
17. resources will be very useful to the team since the resources
help clarify any doubts. Therefore, literature sources are usually
perceived as secondary data collection method (Walliman,
2017). The literature resources are also most common in most
researches since they are less expensive and less time-
consuming. Overall, the questions asked in all the data
collection methods will involve the research questions.
Hypothesis.
In any quantitative research, there must be a corresponding
hypothesis relating to the research questions. However, there
are two main types of hypotheses in a quantitative study. The
main purpose of the hypothesis in research is to bring clarity.
Therefore, there is a null and alternate hypothesis. The null
hypothesis establishes the fact that there is no relationship
between the involved variables. The alternate hypothesis, on the
other hand, clarifies that there is a relationship between the
variables. The research, therefore, had alternate hypotheses
alone. One is that technology has a positive impact on e-
commerce. The second hypothesis is that e-commerce has risked
the job security of many employees and will continue risking is
as long as it exists. E-commerce has helped companies cut down
on their expenditure. Lastly, e-commerce has improved the
overall performance of a company. Therefore, e-commerce is a
good thing since the positive side outweighs the negative side.
Works Cited
AMAZON.COM, INC Report by Anthony DiClemente & Lee
Horowitz, December 5, 2017. Retrieved from
https://www.academia.edu/36436755/Initiating_Coverage_Initia
te_on_AMZN_with_Outperform_Rating_and_1_350_Target_Pri
ce_Fearing_the_Mammoth_Disruptor
Amazon's International Growth Challenge by Jan Dawson, May
11, 2015. Retrieved from
https://www.vox.com/2015/5/11/11562518/amazons-
international-growth-challenge
Brannen, J. (Ed.). (2017). Mixing methods: Qualitative and
quantitative research. Routledge.
18. Dikko, M. (2016). Establishing Construct Validity and
Reliability: Pilot Testing of a Qualitative Interview for
Research in Takaful (Islamic Insurance). Qualitative
Report, 21(3).
Flick, U. (Ed.). (2017). The Sage handbook of qualitative data
collection. Sage.
Kazdin, A. E. (2016). Single-case experimental research
designs.
Paradis, E., O'Brien, B., Nimmon, L., Bandiera, G., &
Martimianakis, M. A. T. (2016). Design: the selection of data
collection methods. Journal of graduate medical education, 8(2),
263.
Walliman, N. (2017). Research methods: The basics. Routledge.
Wu, J., & Park, S. H. (2019). The role of international
institutional complexity on emerging market multinational
companies’ innovation. Global Strategy Journal, 9(2), 333-353.
10
Running Head: LITERATURE REVIEW
1
“Literature Review”
20. Review of the Literature from the Three Articles
Article 1: The first article is one by Tommy published in 2018.
The article is titled
“C-section - benefits, and risks." The concepts explored in the
study are the “benefits and risks of
C-Section deliveries”. Some of the advantages of C-Section
include reducing the risk of pain
during the delivery process, vaginal injuries, “loss of bladder
control”, “pelvic organ prolapse”,
and excessive bleeding. The possible risks of having a C-
Section include womb infections, heart
attack, birth complications, and problems with future
pregnancies. The process can also
negatively affect the baby. The method used in the study was a
review of secondary sources such
as journals, books, and peer-reviewed articles.
Article 2: The second article is one by Escobar published in
2017. The title of the article
is “Why C-section rates are so high.” The concepts explored in
the study are possible factors that
lead to a high rate of C-Section deliveries. The main cause for
the high rate of C-Section
deliveries according to the article is unnecessary C-section
deliveries for women who are at low
21. LITERATURE REVIEW 3
risk of complications. The method used in the study was a
review of secondary sources such as
books, magazines, and journals. According to Escobar, C-
section accounts for about 33% of all
the births that happen in America. This percentage is relatively
high.
Article 3: The third article is one by the World Health
Organization published in 2015.
The title of the article is "WHO statement on cesarean section
rates." The concepts explored in
the study are the position of WHO on the increased cesarean
section rates. According to WHO,
the natural method of delivery should be through the vaginal
canal unless the situation dictates
otherwise. In its statement, the WHO proposed the use of "The
Robson classification” as a way
to monitor and compare the rates of Caesarean sections. The
proposed system can compare and
analyze the rates of c-sections in different facilities and in
different countries and regions. The
22. aim to curb the unnecessary performance of c-sections during
delivery. The needs of the patient
should always be put first. Medical practitioners should not
focus on the profits gained from
performing the c-section procedure. The best interest of the
patient should be their main concern.
Conclusion
The debate on how cesarean section deliveries compare to
normal child deliveries
continues to raise a lot of questions on the benefits and risks of
both and which method is the
most recommended. The cesarean section procedures should
only be done where necessary
because of the risks they pose to the mother and her baby.
Women should also educate
themselves about labor and delivery prior to delivery.
LITERATURE REVIEW 4
REFERENCES
C-section - benefits and risks. (2018, April 24). Tommy's.
23. https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section
-benefits-and-risks
Escobar, N. (2017, September 15). Why C-section rates are so
high. TheBump.com - Pregnancy,
Parenting, and Baby Information.
https://www.thebump.com/a/c-section-rate-problems.
WHO. (2015, April 10). WHO statement on cesarean section
rates. WHO | World Health
Organization.
https://www.who.int/reproductivehealth/topics/maternal_perinat
al/faq-cs-section/en/
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section-benefits-and-risks
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section-benefits-and-risks
https://www.thebump.com/a/c-section-rate-problems
https://www.who.int/reproductivehealth/topics/maternal_perinat
al/faq-cs-section/en/
Running Head: PICOT QUESTION
1
24. Evidence Practice Problem Paper
Running Head: PICOT QUESTION
2
For expectant mothers, how does cesarean delivery compared to
normal child delivery
result in excessive blood loss after birth?
For expectant women who go through surgery to deliver, there
are certain risks that are
associated with this kind of delivery. Child delivery is meant to
be through a vaginal opening on
natural cases, but there are cases that a woman has to undergo
surgery to get the child out of her
womb (WHO, 2015). In America alone, it has been found that at
least one child in three, if born
through C-Section Natalie, 20180, the truth behind America's C-
section rate (Escobar, 2017).
This is a very high percentage implying that at least 33% of
25. births in America are through
C-Section.
It is important to understand which scenarios result in delivery
through C-section. This is
necessary because it helps expectant mothers to predict the
likelihood of a normal child delivery
or the likelihood of a C-section delivery. Given that 1 of three
children is born through C-section,
what risk follows to the mothers after this kind of delivery, in
this case, excessive blood loss
after this surgery. From my PICOT question, expectant mothers
are the population, cesarean
delivery is the interest, normal delivery is the comparison
interest, excessive blood loss is the
outcome and after birth is the time frame of the question ("C-
section - benefits and risks," 2018).
For the PICOT question, it involves assessing complications
that are expected to arise after
C-section to ensure that a mother is not discharged from
maternity before ascertaining that her
wound is not bleeding and will not bleed after she has been
delivered.
To gain insight into the articles which I used to develop my
question, I used different
26. terms of my internet search. One of these terms was a cesarean
section where I obtained the
Running Head: PICOT QUESTION
3
article to understand what it is. Secondly, I did an internet
search for risks of C-section, and I
realized blood loss is one of them. Thirdly, I did an internet
search for the percentage of women
who deliver through this type of process.
As a summary, I learned that during C-section, the wound left
could bleed, and there are
cases when this bleeding is very extreme.
27. Running Head: PICOT QUESTION
4
REFERENCES
C-section - benefits and risks. (2018, April 24). Tommy's.
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-sectio
n-benefits-and-risks
Escobar, N. (2017, September 15). Why C-section rates are so
high. TheBump.com -
Pregnancy,
Parenting and Baby Information. https://www.thebump.com/a/c-
section-rate-problems
WHO. (2015, April 10). WHO statement on caesarean section
rates. WHO | World Health
Organization.
https://www.who.int/reproductivehealth/topics/maternal_perinat
al/faq-cs-section/en/
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section-benefits-and-risks
https://www.tommys.org/pregnancy-information/labour-
birth/caesarean-section/c-section-benefits-and-risks