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Nursing 206 Essay

2146 words - 9 pages

Medically Elective Caesarean Deliveries; Risks vs. Benefits
Jason LeBeaú
College of Du Page County
Complex Medical Surgical/Leadership Nursing
17 October 2012

Medically Elective Caesarean Deliveries; Risks vs. Benefits
Women have been giving birth for millions of years. Before the advent of technology, women just instinctively knew when it was time to give birth and their bodies did the rest. They trusted that their bodies were meant for this purpose. Midwives and village elders would come to be with the laboring mother and to help her through the process. Vaginal birth was not only considered the normal way of birth, it was also the only way of birth. ...view middle of the document...

This paper will explore the reasons why women choose to have MECDs, the risks and benefits to the mother and to the baby and what nurses can do to help women make an informed and educated decision regarding the birth of their child.
Review of Literature
The rate of CDs in the United States has rose 53% from 1996 to 2007 and MECDs are a major contributor to this rise (Campbell, 2011, Miesnik & Reale, 2007). In the 1960’s, the CD rate was less than 5%. In 2007, that number jumped to 31.8%.
The benefits of a MECD for mothers are absence of labor pains, convenience and decreased pelvic floor trauma (Campbell, 2011). Benefits of CDs for the infant include-lowered rates of birth asphyxia, hypoxic ischemic encephalopathy and meconium aspiration. Reasons given as to why someone would choose a MECD include fear of childbirth, anxiety, physical complaints, and prior traumatic birth experience (Miesnik & Reale, 2007).
Risks to the mother, associated with CD include postpartum hemorrhage, fever, infection, pneumonia and thromboembolic events. Estimated blood loss in a vaginal birth with a healthy mother is 500 mL while the blood loss from a CD is 1000 mL. Surgical complications also included damage to the bowel, bladder, uterus and other abdominal structures (Miesnik & Reale 2007, Campbell, 2011). “Potential psychosocial results of any CD includes, increase in maternal perceptions of poor birth experience, delayed family bonding, possible difficulty initiating and maintaining breastfeeding and lengthy recovery time” (Campbell, 2011, p. 314). Also revealed is that there can be long term effects and those include adhesions and chronic pain from scar tissue. Primary CD is associated with a 40% increased risk of placental abruption in a second pregnancy and a 47% increased risk of placenta previa. Other increased rates include uterine rupture, ectopic pregnancy, unexplained stillbirth and increased rates of re-hospitalization following birth (Hewer, 2009, p.1765). Both the International Federation of Gynecology and Obstetrics and the American College of Nurse-Midwives have published statements stating that “primary elective cesarean for nonmedical reasons is not ethically justified” (Campbell, 2011, p. 314).
Along with risks to the mother come many risks to the baby due to a CD. According to Campbell (2011), a study done by MacDorman and Matthews (2009) compared the stillbirth rate between infants born vaginally and those born by MECD. They found that the infant mortality rate for the infants born by MECD was 2 to 3 times higher than for vaginal births. Other risk factors include respiratory difficulties, pre-term birth, delayed breastfeeding and possible laceration of the fetus during surgery (Miesnik & Reale, 2007, Bainbridge, 2008, Hewer, 2009).
Full term babies born by MECD were four times more likely to suffer from breathing issues than babies born by other methods. While the exact...

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