scholarly journals Maternal Request Is not to Blame for an Increase in the Rate of Cesarean Section

Medicina ◽  
2013 ◽  
Vol 48 (12) ◽  
pp. 95
Author(s):  
Justina Kačerauskienė ◽  
Eglė Barčaitė ◽  
Arnoldas Bartusevičius ◽  
Dalia Railaitė ◽  
Rūta Nadišauskienė

Background and Objective. The aim of this study was to establish whether Lithuanian women would request an elective cesarean section in a low-risk pregnancy and to compare how the women’s opinion changed during the 5-year period. Material and Methods. A study was conducted at the Hospital of Lithuanian University of Health Sciences from November 1 to December 31, 2006, and from January 1 to February 28, 2011. A total of 204 and 239 women were enrolled in 2006 and 2011, respectively. Self-administered anonymous questionnaires collected information on women’s knowledge about the advantages of the different modes of delivery and their preferred type of birth in a low-risk pregnancy. Results. Overall, 82.4% of the participants in 2006 and 74.5% in 2011 thought that women should be able to choose the mode of delivery in a low-risk pregnancy. If they had had such an opportunity, 15.2% of women in 2006 and 14.9% in 2011 would have chosen cesarean section without any medical indication. The most frequently mentioned advantage of vaginal delivery was that it is natural, while safety for the newborn and the possibility of avoiding delivery pain were the mentioned advantages of cesarean section. Conclusions. Approximately 15% of Lithuanian women would request an elective cesarean section, and this percentage did not change during the 5-year period. While the national cesarean section rate is increasing with every year, it seems that “maternal request” cannot be blamed for this phenomenon. Despite all the available information about the different modes of delivery, women still lack professional and reliable knowledge about it.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Myriam de Loenzien ◽  
Quoc Nhu Hung Mac ◽  
Alexandre Dumont

Abstract Background Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns. Methods We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. Results Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women. Conclusions These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.


2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.


2019 ◽  
Vol 33 (22) ◽  
pp. 3867-3872 ◽  
Author(s):  
Ensiyeh Jenabi ◽  
Salman Khazaei ◽  
Saeid Bashirian ◽  
Soodabeh Aghababaei ◽  
Nasrin Matinnia

Author(s):  
Manasi Patnaik ◽  
Tejaswini M ◽  
Sudhanshu Kumar Rath ◽  
Shaik Afrah Naaz

Background: Fetal surveillance even in normal or low risk pregnancy is essential to ensure safe parturition with minimum intervention. Cardiotocography (CTG) and clinical estimation of amniotic fluid volume (AFV) measured as amniotic fluid index (AFI) are two tests that are easily available in the labor room and can be used to identify fetal well-being. Our study aimed to evaluate role of admission cardiotocography (CTG) and amniotic fluid index (AFI) on perinatal outcome in low risk pregnancy at term.Methods: The study was conducted as a prospective observational study. All low risk pregnant women at term admitted to the labor ward in early or established labour between September 2018 and August 2020 were included in the study. They underwent admission CTG and AFI assessment using ultrasonography. All parameters including CTG changes, mode of delivery, AFI, presence of meconium, APGAR score at 1 and 5 mins, need for admission in neonatal ICU and perinatal mortality were recorded. Quantitative data was compared using chi square test.Results: A total of 180 patients were included in the study. Majority of the women belonged to the age group of 30-35 years. Abnormal CTG showing fetal distress was seen in 105 (58.33%) cases. Non-reactive CTG was significantly associated with meconium stained liqour, requirement for LSCS, still birth, fetal distress, APGAR <7 at 1 and 5min and NICU admission (p<0.001). The association of low AFI with non-reactive CTG had statistically significant impact on perinatal outcomes like low birth weight, requirement for LSCS, fetal distress, APGAR <7 at 1 and 5 mins and NICU admissions.Conclusions: Admission CTG is a simple non-invasive test that can serve as a screening tool in low risk obstetric population to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. Thus, it may help in preventing fetal morbidity and mortality.


2009 ◽  
Vol 62 (3-4) ◽  
pp. 101-106 ◽  
Author(s):  
Zorica Grujic ◽  
Ana Sabo ◽  
Ilija Grujic ◽  
Vesna Kopitovic ◽  
Maja Papovic

Introduction. The aim of our study was to determine whether a single-dose preoperative administration of antibiotics was sufficient to prevent intra and postoperative infections in the parturients without a high risk of developing an infection, in whom the delivery was completed by cesarean section, as well as to answer whether the administered dose of antibiotics satisfied the requirements of therapeutic concentrations necessary to protect against infection in the period during the surgical procedure and during the first 6 postoperative hours. Material and methods. All investigated pregnant women were planned to have elective cesarean section as a mode of delivery. They were distributed in groups depending on the type (cephalexin, gentamycin and cephazolin) of antibiotic prophylaxis administered as a single dose. In all patients the clinical postoperative course was followed for possible infection. The concentrations of antibiotics were estimated immediately and 6h following the operation. The estimation of antibiotic concentrations was done by the method of liquid chromatography (for antibiotics belonging to the group of cephalosporins), i.e. RIA method for antibiotics from the group of aminoglycosides. Results and conclusion. The total number of infections in investigated groups was 5.18%. The measured mean concentrations of administered antibiotics following the operation and 6 h later were above MIC. This is a proof that the obtained antibiotic prophylaxis by a single dose administration of anbtibiotic is sufficient to prevent the invasion of pathogenic microorganisms from the skin.


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