...“The RCOG (2001) National Sentinel Caesarean Section Audit reposted that the overall caesarean section rate was 21.5% (England and Wales) accounting for approximately 120,000 births per-year” (Marshall and Raynor, 2014). A caesarean section is an operation to deliver a baby through the lower part of the abdomen. An elective caesarean section means it’s a planned delivery in advance, before the onset of labour begins. An elective caesarean section has become a popular choice of birth, and the number of caesarean section births in the UK are on the rise “the caesarean rate has increased by 0.7 per cent to 26.2 per cent (166,081) in 2013-14. Elective caesareans has risen by (2.5 per cent)” (NCT, 2014). Elective caesareans are normally only offered to women with a medical reason; although any expectant mother can now request an elective caesarean section. Under new guidelines set out by ‘NICE’ every expectant mother will be entitled to a caesarean even if there is by no means a medical need of one (Mail Online, 2011). More so if the expecting mother is happy to accept all the risks to both herself and her unborn baby, a consultant cannot refuse her choice. Reasons to why an expectant mother would be offered an elective C-section would be for; obstetric history (previous caesarean sections, interval pelvic floor or anal sphincter repair). Currant pregnancy events, (significant fetal disease likely to lean to poor tolerance of labour, multiple pregnancies, placenta Previa)...
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...22 Ramamoorthy KG et al./Journal of Acupuncture and Herbs 1 (2015)22-31 Acupuncture for Prophylaxis of Intrathecal Morphine Induced Itch in Elective Caesarean Delivery: A Randomized Controlled Double Blind Study Karthik Ganesh Ramamoorthy FCARCSIa*, Mohammed Ibrahim MRCSb, Nasir Z. Ahmad FRCS, MMScc, Kevin Bailey FFARCSIb, Paul O’ Connor. FFARCSIb a. Department of Anaesthesia, Fortis Malar Hospital, Chennai, India b. Department of Anaesthesia, Letterkenny General Hospital, Letterkenny, Ireland c. Department of Surgery,Letterkenny General Hospital, Letterkenny, Ireland Received: August 3, 2015 Accepted: August 19, 2015 Abstract Objective: The objective of this prospective randomised double blinded placebo controlled trial was to assess the efficacy of acupuncture for prophylaxis of intrathecal morphine induced pruritis in patients undergoing Elective Caesarean delivery. Methods: After ethical approval and informed consent parturients scheduled for elective Caesarean section under spinal anaesthesia with intrathecal morphine, were randomised to receive acupuncture (Group 1) or sham acupuncture (Group 2). In Group 1 acupuncture was applied unilaterally at the Quchi acupoint for 30 minutes before initiation of spinal anaesthesia. In Group 2 sham acupuncture was applied at a non – acupoint 2 cm lateral to Quchi for 30 minute before initiation of spinal anaesthesia. The primary outcome was the incidence of pruritis and the secondary outcomes...
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...MIDW113 – Jodie Sparke S00163149_assess2 b). Postnatal case study – Gina is a 34 year old G2 P2 woman, day 2 post caesarean section. You enter her room to find her teary and upset; she tells you she had planned on having a natural birth in a midwifery led model of care. However, she experienced an emergency caesarean section after her baby showed signs of fetal distress. Describe and discuss the role and responsibilities of the midwife in providing pre and post-operative care to a woman in Gina’s position. You are expected to demonstrate, plan and evaluate safe, holistic, woman centred evidence-based midwifery care. This paper considers a postnatal case study of Gina, a day two post-operative, 34 year old Gravida 2 Para 2 woman. She experienced an Emergency Caesarean Section (ECS) resulting from fetal distress. This essay will investigate why birth can become an emergency and the evidence-based indications involved in decision making. It will explore the roles and responsibilities of a midwife in both the pre and post-operative support of a woman; based on a safe, woman centred and holistic approach to maternal care. It will discuss the emotional effects an ECS can have on a woman and her family as a crucial aspect in this case. An integral part of the preparation for birth is a birth plan. This allows the woman to detail how she would like her labour/birth to progress. It often includes the expectation of a natural vaginal birth. However, due to a variety of physiological...
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...Hospital in Baltimore Maryland July 2013. I would describe this as a landmark, “David vs Goliath” case involving medical negligence in the form of nonfeasance and malpractice. Reckless and willfulness disregard for safety is called criminal negligence and is often considered a form of gross negligence, a more serious tort (Pozgar, 2012). The question in my mind throughout the read was; “did the conduct of the provider and the hospital constitute criminal negligence”? The jury’s verdict and plaintiff’s award seemed to suggest yes. As a health professional, while I might agree with the Jury’s decision, I’m not so sure I agree with the size of the award. Did Johns Hopkins Hospital (the Hospital), negligently fail to perform a timely Caesarean section, causing Martinez to suffer from cerebral palsy, retardation, and other disorders. The following are the facts and details of this case as summarized from the source google scholar. On March 25, 2010, Rebecca Fielding (mother) began labor with her first child, Enzo Martinez. Ms. Fielding elected to have a natural birth at home, with the assistance of Evelyn Muhlhan, a registered nurse midwife (Midwife Muhlhan), and a doula. Fielding (who was 10 days overdue) was in labor for 14.5 hours...
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...Medically Elective Caesarean Deliveries; Risks vs. Benefits Jason LeBeaú College of Du Page County Complex Medical Surgical/Leadership Nursing NUR206 17 October 2012 Medically Elective Caesarean Deliveries; Risks vs. Benefits Introduction 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. Vaginal birth is no longer the only choice when it comes to delivering a baby. Cesarean deliveries (CDs) are now a lifesaving strategy. CD is a surgical procedure in which a doctor in an operating room makes an incision through the mother’s abdomen and down to the uterus. The baby is removed from the uterus and the uterus and abdomen are then closed with sutures. This takes place while the mother is awake and made numb from the waist down by either a spinal or epidural anesthetic. In emergency situations, a general anesthetic is used and the mother is put to sleep and is unconscious for the procedure. CDs were originally used to save the life of the mother, save the life of the baby or when a vaginal delivery wasn’t possible. Since the birth of CDs, they are now performed for...
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...(b) second is to explain the how the medicalization has negative effects on the health of people- i.e. ‘the medical establishment has become a major threat to health’ and providing a dossier of medicine’s adverse effects – the wrongs and harms it has done – through processes of clinical, social and cultural ‘iatrogenesis’ or doctor-induced conditions, and finally (c) third is to explain the impact of the dominance of professional medical power on the people’s lives especially including women. This paper is mostly based on the secondary sources such as books, articles, journals, papers, reports etc. Besides this some data has been collected from online sources. Key words: Medicalization, De-medicalization, Re-medicalization, Power, Caesarean section delivery. INTRODUCTION The concept of...
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...October 2012 As Diane’s new assistant just looking at the way they have the flow of the mother that is in labor is confusing. There are too many floors for the Labor and Delivery process which has the mother bouncing all over the hospital. If the pregnant mother is in distress she has to be moved to too many different floors. By moving the mother to all the different floors it could risk valuable time. I would suggest reorganizing one specific floor of the hospital for Labor and Delivery only. By having only one floor would help speed up the process for the delivering mothers. The way I would adjust the flow chart for women that are delivering via caesarean section would skip step one and go straight to step seven. I would do this because a mother that knows she’s having a caesarean section delivery would know the exact date of the delivery. She would have pre-registered prior and be ready for her operation when she walks into the hospital. Once the operation is complete with no complications, then step 6 would be next. After monitoring the mother and newborn then step 8 would be the next step. The mother would be extremely happy to be discharged with her new baby. If all mothers were electronically preregistered the flow chart would change. It would eliminate the need to register the day of the delivery and allow a smoother transition to the delivery room for the expectant mother. If everything works out smoothly there shouldn’t be any mother...
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...when you are a little boy. “Indian Camp” begins at the lake shore, Nick, uncle George and his father, which is a local doctor, are summoned to an Indian reservation to assist a woman whom had been in an agonising labor for two days. As they managed to come across the lake, Nick, uncle George and his father are led to the Indian reservation, where they find the woman recumbent in the shanty. Beside the woman, they find her husband, which has an injured foot as a result of working with an axe. However Nick’s father concentrates on the reason he has gotten to the Indian reservation, but on the given time, the complications of the childbirth is already enough, which leads to his decision of making a caesarean section. During the operation, the woman wrenches in agony and therefore all the men in the reservation help holding her. He delivers the baby boy safely. Furthermore Nick’s father asks him to attend when he is going to sew up the incision he has made, but Nick declines. Given that Nick’s curiosity had vanished long time ago. Nick’s father is self-satisfied and exalted, with his operation considering the remedies he had along with him. When Nick’s father turns towards the husband of the pregnant Indian woman to congratulate him, he discovers that the husband has slit his throat and the razor lies next to him. Nicks father then orders uncle George to get Nick out of the shanty,...
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...minutes. There was an adequate number of examining rooms and her 2-3 assistants depending on the workload were well instructed on the standing operating procedures. New patients were asked to arrive in the office early to get their initial paperwork completed. New patients were also told about the strict adherence to appointment times. 2. What procedures were followed to keep the appointment system flexible enough to accommodate the emergency cases, and yet be able to keep up with the other patients’ appointments? The doctor felt that most doctors used them having an emergency as an excuse not to stick to their appointment times and felt this would not work in her practice. If it was a true emergency, like broken arm or emergency Caesarean section she would drop everything else; however, if the interruption was brief, he would try to get back on schedule and give the patients the choice of waiting or rescheduling. Also, the doctor gives his assistants standing orders to keep a number of slots open throughout each day for patients with acute illnesses he also uses this time for the...
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...The funny thing about that night is I told them I wasn’t sure I was going to be in for work the next morning; (NAME) had laughed at that and said she would see me in the next day. I guess I proved them wrong. I walked out of (JOB) at 10pm after I had worked an eight hour shift at customer service, half of that trying to train a couple cashiers that would take my place during my leave. It was still 2 days before my due date and everyone at work was convinced I was going to be past my due date and would go into labor at work. Truthfully, there were running bets about who was going to drive me to the hospital so they too could get out of work. Needless to say, I spent way too much time at my job, but I love the girls I work with and didn’t want to leave them stuck for 8 weeks Christmas season, though I knew that it was inevitable. It was warm for mid-October though, I remember driving home with the window a quarter of the way down and singing to the radio. Without a doubt I was singing some country song and dreaming of getting my shoes off, sitting down, and having one of the only things that didn’t make me feel sick as a dog; a peanut butter and jelly sandwich. Twenty minutes and I would finally get to relax. At the house I was so uncomfortable, even in my favorite gray yoga pants and a tank top. I told my significant other, (NAME); I might go into labor that evening, though I had absolutely no proof or reasoning to this other than a feeling. No more than an hour later I started...
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...Absorbable Sutures versus Staples for Cesarean Sections Victoria Fath Kent State University Absorbable Sutures versus Staples for Cesarean Sections Introduction The Merriam-Webster Dictionary (n.d.) defines a Cesarean section as, "A surgical operation for giving birth in which a cut is made in the mother's body so that the baby can be removed through the opening." "Cesarean delivery is the most common major surgical procedure performed in the United States and elsewhere. Currently, approximately a third of pregnant women in the US and 15% worldwide deliver by cesarean, and this prevalence is on the rise" (Dana Figueroa et al., 2013, p. 33). Since Cesarean sections are incredibly common and are only increasing, the risks for complications, such as infections, increase with it. To try and decrease the risks as much as possible, this study aims to look at the differences between two types of closing material used in Cesarean sections; absorbent sutures and staples. Are absorbable sutures more effective and safer than staples for Cesarean sections? The purpose of this study is to compare absorbent sutures and staples for clients undergoing a Cesarean section and to see which material has a lesser risk for infection and wound complications, which is more cost effective for the hospital, and patient satisfaction. This paper will help shed light on this subject by compiling multiple research articles and journals to create a better understanding on which...
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...Increasing Rate of Cesarean Sections Humanity has been around for thousands of years and humans like most animals have existed due to the sexual reproduction of offspring. Women have been the mothers and birth givers since the beginning of time. They go through all the stressful acts of growth, hormones, and labor to give life to a beautiful innocent child that has been forming inside the womb for nine months. The child develops and matures through each trimester because the mother listens to her body, which is the most advanced technology that determines when to eat, nurture, and deciphers complications. The sexual reproduction process has always been the same for all women without change. However, the process and methods used during the delivery process have been studied, scrutinized, and practiced with the same goal in mind, a healthy mother and baby. Most methods of delivery have derived from midwife and doctor ideology being the foundation of the chosen method. During the medieval era, estimated infant death rate was near a staggering 30%. Death came in many guises for infants with most of those coming from bacteria and disease. During this era most births were performed by women because it was uncommon for a man to be involved in a womanly act. Therefore, the creation of a midwife was developed and they became the experts on birth. A popular delivery practice was to tie the woman down to prevent them from moving. To give and understanding on how new medicine...
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...1500 First reported successful Cesarean section (mother and child surviving). Jacob Nufer 1701 First successful ovariotomy. Robert Houstoun 1795 Pueperal sepsis first proposed to be due to infectious contagion as a result of observational, epidemiologic study in Aberdeen, Scotland. Alexander Gordon 1809 First ovarian cystectomy (Danville, Kentucky). Ephraim McDowell 1812 First recorded vaginal hysterectomy (performed accidentally and unplanned). Palletta 1813 First modern, documented total vaginal hysterectomy (though certainly not the first). C.J.M. Langenbeck 1825 First ever blood transfusion, performed for postpartum hemorrhage. James Blundell 1827 Fetal heart tone auscultated for the first time. John Creery Ferguson 1833 First detailed account of fetal heart tones made. Evory Kennedy 1843 First abdominal hysterectomy (the patient died). Charles Clay 1846 Ether first administered to a woman in labor. Crawford Williamson Long 1847 Puerperal fever shown to be caused by infectious contagion through interventional trial proving that it could be prevented. Ignaz Semmelweis 1847 Chloroform first used as an anesthetic, used during labor. James Young Simpson 1849 Vesicovaginal fistula successfully treated with surgery. J. Marion Sims June, 1853 First successful adbominal hysterectomy...
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...When a baby is born via Cesarean section, they do not get their mother’s natural vaginal microbiota that can help lead to a healthier life. This bacterium helps develop newborn’s own healthy microbiome that they need to function normally and fight infections. Babies born via C-section are at increased risk of obesity, asthma and autoimmune conditions, which are associated with changes in the microbiome. One solution to replace this bacterium is through a technique called vaginal seeding. Paraphrasing Julie Lamppa, who is a Certified Nursing Midwife working for Mayo Clinic— vaginal seeding is the practice of placing gauze inside the vagina of a woman who is having a C-section. After birth, the gauze is then used to wipe the baby’s mouth, face...
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...Preparation One of the first duties of a scrub nurse is to work with the rest of the team to make sure that everything needed for the surgical procedure is in the room and that a sterile environment has been established. The scrub nurse becomes a surgeon's go-to person when surgery begins. General Surgery The duties of a scrub nurse during surgery are to maintain a sterile environment for the surgeon as well as the patient on the operating table in order to decrease the chances of spreading infections. Instruments The scrub nurse must be able to identify every instrument used in the operating room in order to pass surgeons the appropriate tools needed during procedures. The nurses understanding of each tool's function helps make the surgery go smoothly and finish in a timely manner. Doctor's Comfort The duties of a scrub nurse include making sure surgeons can perform their task. They have to be keen observers, noticing if doctors need their foreheads wiped or if their goggles are getting foggy. Labor and Delivery In the specialized field of labor and delivery, the duties of a scrub nurse include helping the surgeon perform cesarean sections. OBSTETRICAL SURGICAL PROCEDURES CESAREAN SECTION Cesarean section is the delivery of the fetus by means of an abdominal incision and incision into the uterus. It is done when a vaginal delivery presents risks to the mother or fetus, and the obstetrician deems a cesarean the safer mode of delivery. Common...
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