The Role of the Legal System in the Cesarean Childbirth Controversy

1980 ◽  
Vol 1 (10) ◽  
pp. 1-8
Author(s):  
Judy Miller
Keyword(s):  
Birth Rate ◽  
Nursing Practice ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
The United States ◽  
Cesarean Birth ◽  
Threefold Increase ◽  
Cesarean Births ◽  
Patient Advocates

The threefold increase in the cesarean birth rate in the United States during the last ten years has caused much concern among the general public and some medical professionals. Nurses particularly have shared this concern as the scope of nursing practice has expanded and nurses increasingly see themselves as patient advocates. Obviously, not all cesarean births are unwarranted. The procedure may be indicated if there is maternal or fetal risk during labor, if attempted induction of labor fails, and/or if an emergency mandates immediate delivery which is not possible or suitable vaginally.A recent review of over 1,000 U.S. and foreign research articles cites three general reasons for the increasing cesarean birth rate: use of the operation for breech presentations and for repeat sections; the need for early intervention due to fetal distress as determined by the increasing use of fetal monitoring; and physicians' fear of malpractice suits. The first two reasons are matters of medical controversy.

What Do Women Want? Consent for the Use of Electronic Fetal Monitoring

2021 ◽  
Vol 11 (3) ◽  
pp. 145-153
Author(s):  
Sonya Dal Cin ◽  
Lisa Kane Low ◽  
Denise Lillvis ◽  
Megan Masten ◽  
Raymond De Vries
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Fetal Monitoring ◽  
Healthcare Setting ◽  
Professional Associations ◽  
The United States ◽  
Cesarean Birth ◽  
Electronic Fetal Monitoring ◽  
Risk Patients

BACKGROUNDGuidelines published by professional associations of midwives, obstetricians, and nurses in the United States recommend against using continuous cardiotocography (CTG) in low-risk patients. In the United States, CTG or electronic fetal/uterine monitoring (EFM) rather than auscultation with a fetoscope or Pinard horn is the norm. Interpretation of the fetal heart rate (FHR) and uterine activity (UA) tracings provided by continuous EFM may be associated with the decision for a cesarean birth. Typically, consent is not sought in the decision about type of monitoring. No studies were identified where women's attitudes about the need to consent to the type of fetal monitoring used during labor have been explored. Therefore, the purpose of this research was to examine women's attitudes about the use of EFM in a healthcare setting.METHODSWe asked a sample of women aged 18–50 years to respond to one of three monitoringscenarios. The scenarios were used to distinguish between attitudes about monitoring in general, monitoring the health of a mother in labor, and monitoring the health of the fetus during labor. Wemeasured their level of interest in being monitored and their opinions about whether healthcare providers should be required to obtain consent for the monitoring described in the scenario.RESULTSInterest in receiving monitoring (across all three scenarios) was moderate, with the highest level of interest in monitoring the fetus during labor and the least interest in monitoring a general health context. Across all scenarios, 82% of respondents believed that practitioners should obtain consent for monitoring, 14% were unsure, and 4% said there should not be a requirement for consent. While low (6%), the percentage responding that consent was not needed was highest in monitoring a fetus in labor.CONCLUSIONSWomen in our study expressed a strong preference for the opportunity to consent to the use of monitoring regardless of the healthcare scenario. There is findings suggest the need for further research exploring what women do and do not know about CTG and what their informed performance are a pressing need to rethink the role of a pressing need to rethink the role of shared decision-making and informed consent about the type of monitoring use during labor.

The role of calcium channel blockers in the treatment of women with preeclampsia

1996 ◽  
Vol 8 (1) ◽  
pp. 19-27 ◽  
Author(s):  
R Lewis ◽  
M Belfort ◽  
B Sibai
Keyword(s):  
Smooth Muscle ◽  
Gestational Hypertension ◽  
Fetal Distress ◽  
The United States ◽  
Chronic Hypertension ◽  
Channel Blockers ◽  
Appropriate Therapy ◽  
Mild Preeclampsia ◽  
Smooth Muscle Relaxant

Preeclampsia was originally known as a process whereby an unknown “toxin” was responsible for a variety of responses. While this toxin has yet to be determined, many theories have prevailed as to the appropriate therapy for this condition.Recently, antihypertensive therapy has become increasingly regarded as an important component of the medical management of women with preeclampsia. Initially, the ideal therapy for peripartum acute hypertensive emergencies was felt to be a smooth muscle relaxant and the most commonly prescribed agent was hydralazine. This drug was felt to be beneficial because of its action on vascular smooth muscle, decreasing vasospasm. Outside of the United States diazoxide was also used for this purpose, although this drug has been replaced because of the high incidence of fetal distress. Another agent that was frequently used was α-methyldopa which was initially considered to be the treatment of choice in the treatment of patieats with moderate and severe preeclampsia. Recently, α-methyldopa has been reserved for the outpatient management of gestational hypertension, especially in women with mild preeclampsia or chronic hypertension.

Predictors of intrapartum fetal distress: The role of electronic fetal monitoring

1979 ◽  
Vol 135 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Frederick P. Zuspan ◽  
E.J. Quilligan ◽  
Jay D. Iams ◽  
Herman P. van Geijn
Keyword(s):  
Fetal Monitoring ◽  
Fetal Distress ◽  
Electronic Fetal Monitoring

scholarly journals Nurses with Undiagnosed Hearing Loss: Implications for Practice

2014 ◽  
Vol 20 (1) ◽  
Author(s):  
Cara Spencer ◽  
Karen Pennington
Keyword(s):  
Hearing Loss ◽  
Communication Skills ◽  
United States Of America ◽  
Nursing Practice ◽  
Adult Population ◽  
The United States ◽  
Noise Levels ◽  
Practice Review ◽  
The Many

Hearing loss affects 36 million people in the United States of America, including 17% of the adult population. This suggests some nurses will have hearing losses that affect their communication skills and their ability to perform auscultation assessments, potentially compromising patient care and safety. In this article, the authors begin by reviewing the hearing process, describing various types of hearing loss, and discussing noise-induced hearing loss and noise levels in hospitals. Next, they consider the role of hearing in nursing practice, review resources for hearing-impaired nurses, identify the many costs associated with untreated hearing loss, and note nurses’ responsibility for maintaining their hearing health. The authors conclude that nurses need to be aware of their risk for hearing loss and have their hearing screened every five years.

scholarly journals The Role of the Nurse Disaster Preparedness Coordinator at a Large Suburban Teaching Hospital

2019 ◽  
Vol 34 (s1) ◽  
pp. s165-s166
Author(s):  
Beth Weeks
Keyword(s):  
Emergency Department ◽  
Emergency Management ◽  
Disaster Preparedness ◽  
Nursing Practice ◽  
The United States ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Hospital Emergency ◽  
Emergency Manager

Introduction:Mass casualty incidents, whether man-made or natural, are occurring with increasing frequency and severity. Hospitals and health systems across the United States are striving to be more rigorously prepared more such incidents. Following a mass shooting in 2012 and significant growth and expansion of our hospital and health system in the following years, a need was identified for more staff to support preparedness efforts.Aim:To discuss the roles and responsibilities of Nurse Disaster Preparedness Coordinator (NDPC), a dedicated position in the Emergency Department (ED).Methods:The role of Nurse Disaster Preparedness Coordinator was implemented in 2016, is a part-time position in the Emergency Department and reports to the ED Manager while working closely with the ED Director of Emergency Preparedness and the hospital Emergency Manager. The role addresses all areas of the emergency management continuum, from planning and mitigation to response and recovery.Results:The NDPC’s responsibilities fall into the categories of all-hazards preparedness, chemical, biological, radioactive, nuclear and explosive (CBRNE) response, and general nursing practice. All-hazards preparedness includes ED staff training, policy and procedure development, and liaising with hospital emergency manager to coordinate hospital-wide efforts. CBRNE response includes the training and maintenance of a patient decontamination team, a high-risk infectious disease team, and their equipment. General nursing practice addresses research, nursing indicators as they apply to disasters, promoting evidence-based practice, and community outreach.Discussion:A dedicated Nurse Disaster Preparedness Coordinator has allowed transition from intermittent larger exercises to a regular and frequent exercise schedule and better application of full-scale exercises. Overall, the creation of the role has strengthened hospital readiness for mass casualty incidents while alleviating the vast scope of emergency management responsibilities for a large suburban hospital.

scholarly journals The Regional Centralization of Electronic Fetal Heart Rate Monitoring and Its Impact on Neonatal Acidemia and the Cesarean Birth Rate

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Kaori Michikata ◽  
Hiroshi Sameshima ◽  
Hirotoshi Urabe ◽  
Syuichi Tokunaga ◽  
Yuki Kodama ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Birth Rate ◽  
Fetal Heart ◽  
Fetal Heart Rate Monitoring ◽  
Cesarean Birth ◽  
Cesarean Births ◽  
Before And After ◽  
The Impact ◽  
Before And After Study

Objective. The improvement of the accuracy of fetal heart rate (FHR) pattern interpretation to improve perinatal outcomes remains an elusive challenge. We examined the impact of an FHR centralization system on the incidence of neonatal acidemia and cesarean births.Methods. We performed a regional, population-based, before-and-after study of 9,139 deliveries over a 3-year period. The chi-squared test was used for the statistical analysis.Results. The before-and-after study showed no difference in the rates of acidemia, cesarean births, or perinatal death in the whole population. A subgroup analysis using the 4 hospitals in which an FHR centralization system was continuously connected (compliant group) and 3 hospitals in which the FHR centralization system was connected on demand (noncompliant group) showed that the incidence acidemia was significantly decreased (from 0.47% to 0.11%) without a corresponding increase in the cesarean birth rate due to nonreassuring FHR patterns in the compliant group. Although there was no difference in the incidence of nonreassuring FHR patterns in the noncompliant group, the total cesarean birth rate was significantly higher than that in the compliant group.Conclusion. The continuous FHR centralization system, in which specialists help to interpret results and decide clinical actions, was beneficial in reducing the incidence of neonatal acidemia (pH < 7.1) without increasing the cesarean birth rate due to nonreassuring FHR patterns.

The Role of Gender and Sensation Seeking in Film Choice

2008 ◽  
Vol 20 (3) ◽  
pp. 97-105 ◽  
Author(s):  
Smita C. Banerjee ◽  
Kathryn Greene ◽  
Marina Krcmar ◽  
Zhanna Bagdasarov ◽  
Dovile Ruginyte
Keyword(s):  
United States ◽  
Undergraduate Students ◽  
Sensation Seeking ◽  
Negative Mood ◽  
Positive Mood ◽  
The United States ◽  
High Arousal ◽  
Subject Design ◽  
Happy Mood

This study demonstrates the significance of individual difference factors, particularly gender and sensation seeking, in predicting media choice (examined through hypothetical descriptions of films that participants anticipated they would view). This study used a 2 (Positive mood/negative mood) × 2 (High arousal/low arousal) within-subject design with 544 undergraduate students recruited from a large northeastern university in the United States. Results showed that happy films and high arousal films were preferred over sad films and low-arousal films, respectively. In terms of gender differences, female viewers reported a greater preference than male viewers for happy-mood films. Also, male viewers reported a greater preference for high-arousal films compared to female viewers, and female viewers reported a greater preference for low-arousal films compared to male viewers. Finally, high sensation seekers reported a preference for high-arousal films. Implications for research design and importance of exploring media characteristics are discussed.

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