Rises in Rates of Cesarean Section Births

Rises in Rates of Ces bean Section BirthsIn recent history, advancements in medical technology halt resulted in an adjoin in compass and cede preventatives. This has in turn, greatly plus cesarean delivery section rates. Birth was once a innate(p), ordinary event in a cleaning ladyhoods life, however this has been replaced by a maternal quality form where intervention is routine and interferes with the typical physiological brook procedure, putt women and their babies at fortune unnecessarily (Romano Lothian, 2008). Normal gestate is associated with the best ruttish and innate outcomes for women and their babies (New Zealand College of Midwives, 2009). However women have lost confidence in their witness ability to give present without the assistance of technological interventions. Where midwives previously fagged their measure moderateing and comforting cranching women they now spend their time managing technology (Romano Lothian, 2008). This essay go out discuss factors which promote or adversely contact the normal physiology of relationship and how we kitty promote the normal physiology of birth within a public maternity hospital conditionting. Environmental factors which whitethorn negatively or positively affect the normal physiology of fag pass on likewise be explored.Normal physiological birth follows a natural sequence. Regular annoyingful contractions of the uterus, stimulate and progress the cervix to efface and dilate along with foetal decent. This results in the self-produced vaginal delivery of the shaver and the placenta without complication to either mother or rape (Page McCandlish, 2006).It fundament be problematical to aid normal physiological birth within an milieu henpecked by a medical approach, where technology and medical expertise are highly valued. The midwife leaders submit to show bullocky leadership to support alone midwives. Midwives need to be vigorous improve and competent in the f acilitation of normal birth to append the rate of normal physiological birth (Midwives experience of facilitating normal birth in an obstetric-led unit a feminist perspective, 2009).M both of the factors that promote normal physiology are surroundingsal in nature. When women are in tire out they are extremely culture medium to touching observed, disrupted or disturbed, this disrupts the natural hormone responses and progress of take. Women largely find a solid environment preferable so that they detect comfortable to take off their clothing if they wish to do so. When women labour in a calm and quiet environment they feel a change in consciousness to a more primitive originator where birth instincts take over. Privacy and a home like environment overly help to serve normal birth (Sara Wickham Midwifery outdo workout, volume 5, 2008). Migrant women have reported that privacy is of particular greatness to them (Hennegan, Redshaw Miller, 2014). Women benefit from free dom of movement during labour (Thies-Lagergren, Hildingsson, Christensson Kvist, 2013) and if given the opportunity will instinctively choose a variety of movements to help them cope with labour including walking, swaying, standing, leaning and the hands and knees locate. Allowing freedom of movement benefits the mother in a emergence of ways including comfort, shortening labour, change magnitude uterine contractions and less need for pharmacologic pain comforter. It can also correct poor progress, misplacement and sometimes foetal heart rate anomalies (Romano Lothian, 2008). When women push ad libitum without cosmos coached they are less likely to require suturing from trauma and have less pelvic point dysfunction than women who are coached to push (Romano Lothian, 2008). The AWHONN (2013) recommends women should non push until they feel the urge to push and should do so spontaneously without direction. Womens experiences of have got during labour and birth are overwhelm ingly associated with their closeness in the decision making process (Christiaens, 2010). The process of writing a birth end also increases a chars feelings of control as it gives her the opportunity to think somewhat possible scenarios and plan her responses and survivals (Kuo, Hsu, Yang, Chang, Tsao Lin, 2010). Freedom to move around, scream out or make decisions about who enters the birthing space contri savees further to the perception of control (Ford, 2009). Women also feel more in control if they have access to information during labour (Tiedje Price, 2008). Health carry off issuers can help to facilitate a womans access to information by answering any questions she may have exclusivelyowing her to make informed choices. When women feel a sense of individualized security, derived from feeling respected, trusted and supported by the health care provider who is looking after them, they will experience less fear and an increased feeling of control (Meyer, 2012). Co ntinuous support for women in labour from a female with specialised training is thought to reduce anxiety and form hormones known to ca hire vasoconstriction and lower uterine blood flow, which may tiresome down progress and potentially harm the foetus. Continuous support is tell to increase the probability of a spontaneous vaginal birth, lower the utilize of analgesia, epidural, risk of caesarian section and instrumental delivery (Sosa, Crozier Robinson, 2012 Romano Lothian, 2008). These are all important factors in the facilitation and promotion of normal birth and positively affect the womans labour and birth environment. there are also many factors that adversely affect the normal physiology of birth, including induction of labour which increases a womens need for analgesia or epidural and puts her baby at an increased risk of needing neonatal resuscitation. Induction of labour also increases a womans risk of caesarean section, instrumental birth, shoulder dystocia, intr apartum fever, low birthweight babies and adit to neonatal intensive care (Tracey et al, 2007). Augmentation of labour can be a tempting option to speed up labour, however amniotomy and oxytocin brass are not without risk. Options such as changing identify and lecture to women about their emotions, which are low or not risk options, can be as effective and more pleasant for labouring women (Romano Lothian, 2008). Amniotomy can increase the risk of infection, may cause pressure injuries or ruptured eutherian mammal veins or arteries resulting in significant foetal blood loss. It is also associated with stack prolapse (Cohain, 2013). If amniotomy is carried out early in pregnancy it can set off a cascade of intervention and increase the risk of caesarean section. If labour is still not progressing oxytocin is usually administered and makes contractions stronger and more difficult to cope with as it is exogenous and does not cross the blood-brain barrier, so endorphins are not r eleased to decrease pain perception (Romano Lothian, 2008). Oxytocin administration also puts women at risk of hyperstimulation (Selin, Almstrom, Wallin Berg, 2009). Other interventions such as intravenous cannula and electronic foetal supervise are also apply in this intervention and there is an increase in other interventions such as epidurial which all have added risks. Amniotomy should single be used if progress is rightfully unnatural while oxytocin augmentation should only be used if labour is truly prolonged with sluggish uterine activity (Romano Lothian, 2008). Epidural analgesia relaxes the pelvic floor muscles making foetal decent and rotation difficult (Al-Metwalli, Mostafa Mousa, 2012). The absence of pain in labour can interfere with the natural oxytocin release. There is also a risk of hypotension so electronic foetal monitoring is used along with an intravenous cannula. Women who use this type of pain relief are less likely to have a vaginal birth and at a hi gher risk of instrumental delivery, prolonged labour and fever. Their babies are more likely to have infection (Romano Lothian, 2008). All of these interventions behave risks to mother and baby and adversely impact upon the normal physiological birth process.Some of the environmental factors that adversely affect the normal progress of labour include restriction of eating and drunkenness which began in the1940s when superior general anaesthetic was commonly used in obstetrics to reduce the chance of aspiration. General anaesthetic is now rare in obstetrics as is aspiration due to the use of airway protection. Women prefer to have the choice to eat and drink during labour and there is no benefit in restricting them to do so (Singata, Tranmer Gyte, 2013). When women are prevented from eating or drinking they are hydrated with iv liquids, this is also used to access a vein in case of an emergency. Although emergencies do happen there is no evidence to suggest iv access in low ris k labouring women improves outcomes. Women with Intravenous lines are not free to move around, may have increased stress levels, may result in fluid overload in both mother and foetus and does not adequately hydrate or provide nutrients. Continuous foetal monitoring has been gear up to reduce neonatal seizures when babies have been exposed to high doses of oxytocin but has not been linked to positive long term outcomes. It does however increase the risk of caesarean section and instrumental delivery without a irradiate benefit to the baby and reduces the mothers ability to mobilise (Alfirevic, Devane Gyte, 2013). These environmental factors have a negative affect on a womans normal progress in labour and should be avoided if possible.A midwife-led continuity of care model has been found to benefit women and their babies in a number of ways when compared with medical and shared models of care. Benefits include decreased use of epidural, less episiotomies and instrumental births an d less preterm birth or loss of baby prior to 24 weeks gestation. Women also had more chance of having a spontaneous vaginal delivery. As a result a midwife-led continuity of care model gives women the best chance of having a normal physiological birth (Sandall, Soltani, Gates, Shennan Devane, 2013).For a midwife to promote the normal physiological birth process and give effective and appropriate care, she needs to establish a race with women antenatally. It is important for the midwife to get to know each woman and her wishes and dreams for her imminent birth (New Zealand College of Midwives, 2009). This allows a partnership of trust and respect and helps to alleviate any fears or anxieties and share appropriate and correct information before the birth. When women chide about their fears with the midwife, she will be better informed and able to provide woman centred care (Pairman, Tracy, Thorogood Pincombe, 2010). Midwives need to use evidenced based practice staying within the ir scope of practice. Whenever a midwife interacts with a woman, she needs to support normal physiological birth and the natural cascade of normal labour. all interaction she has with a woman affects this cascade either positively or negatively (New Zealand College of Midwives, 2009). When women are in labour midwives need to consider the womans birth plan while maintaining a private warm room. It is also important to encourage her to find a comfortable position with appropriate comforts such as pillows and beanbags. Encouraging partners to support women by providing drinks, cool washers, and other physical support is an important midwifery use (Pairman, Tracy, Thorogood Pincombe, 2010). Midwives need to be unobtrusive and well prepared with safety equipment. When women are in the second stage of labour midwives need to encourage position changes to help decent where appropriate. Soothing hot compresses can be used on the perineum and vulva while the midwife gives clear and calm reassurance until the baby is natural and given to the mother for skin to skin contact. These factors will help midwives to facilitate the normal physiological birth process (Pairman, Tracy, Thorogood Pincombe, 2010). Midwives need to practice heathen safety by reflecting on their own cultural values and individuality in an effort to recognise the impact their own culture has on their practice. It is important for midwives to understand their position of power within the healthcare system (Page McCandlish, 2006).It is in most womens best interest to have a normal physiological labour and birth as it provides the best physical and emotional outcomes for both mothers and their babies. It is the midwifes role to ensure birth proceeds as normally as possible and interventions are only used when absolutely necessary. To achieve this, midwives need to understand the factors that promote and adversely affect the normal physiological birth process and any environmental factors that may negatively or positively impact on a womans labour and birth. There are a number of different models of care available to pregnant women, however it has been found that a midwife-led continuity of care model gives the best possible chance for a normal physiological birth and labour. Midwives need to create a calm, quiet, culturally safe, supportive environment where women feel safe and secure to use their natural birthing instincts and encourage position changes where appropriate. The environment needs to be well equipped with comforts such as pillows and beanbags and any safety equipment that may be needed. Although it can be difficult to facilitate a normal physiological labour and birth within a medically dominated environment, if midwives have strong leadership and are well educated to facilitate normal physiological birth they are more likely to increase the rates of normal birth.