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Background: Attitudes drive practice, perhaps more than evidence. The objective of this study was to determine if the new generation of Canadian obstetricians has attitudes differing from those of their predecessors.
Methods: Employing a cross‐sectional, Internet, and paper‐based survey, we conducted an in‐depth study of obstetricians responding to the Canadian National Maternity Care Attitudes Survey....
Obstetric interventions, particularly induction of labor and cesarean section, are done more and more commonly, although there is a wide variation between hospitals and practitioners in specific rates. This degree of variation implies imprecision and uncertainty about diagnoses and indicated management. Although the net result of this variation has been a “more is better” approach leading to increasing...
The scientific literature was silent about a relationship of pelvic floor, urinary, and fecal incontinence and sexual issues with mode of birth until 1993, when Sultan et al's impressive rectal ultrasound studies were published. They showed that perirectal fibers were damaged in many vaginal births, but not as a result of a cesarean section. These findings helped to pioneer a new area of research,...
BackgroundTo date, most studies evaluating pain associated with cesarean birth have focused on delivery procedures or postoperative pain control methods rather than on the nature or severity of the pain experience of women, despite the increasing incidence and maternal requests for cesarean delivery. The objective in this study was to evaluate sensory, affective, and laterality aspects of pain after...
BackgroundOur objective was to examine the likelihood of primary cesarean delivery for women at low risk for the procedure in Massachusetts.
MethodsBirth certificate data for all births from 1996 to 2010 that were nulliparous, term, singleton, and vertex (NTSV; N = 427,393) were used to conduct logistic regression models to assess the likelihood of a cesarean delivery for each of the 31 ethnic groups...
BackgroundIn the United States, one‐third of pregnancies result in a cesarean delivery. In subsequent pregnancies, mothers must decide whether to pursue a vaginal birth after a cesarean (VBAC) or a repeat cesarean delivery. Pregnant women frequently turn to the Internet for support and information.
MethodsWe analyzed 300 posts from a popular online discussion board created for pregnant women who...
Background
To determine if maternal characteristics measurable upon admission to hospital predict cesarean among low‐risk spontaneously laboring nulliparous women.
Methods
We undertook a secondary analysis of data from a clinical trial of early labor support for nulliparous women carrying a singleton fetus in cephalic presentation at 37–41 weeks of gestation in British Columbia, Canada. Study participants...
Background
Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety,...
Background
Cesarean rates have increased significantly over the past decade. The reasons for this are both complex and context specific, and have significant consequences for health resources. The aim of this systematic review was to assess published, peer‐reviewed, and gray qualitative literature on the reasons behind cesarean delivery on maternal request (CDMR).
Methods
A systematic search of...
Background
Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades.
Methods
The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery...
Background
In‐hospital feeding practices have been shown negatively to affect breastfeeding exclusivity and duration. The purpose of this study was to report the prevalence and determinants of delayed breastfeeding, provision of traditional prelacteal foods, and use of infant formula in hospital.
Methods
Between June 2014 and March 2015, 700 women were recruited from three public and two private...
Background
The Twin Birth Study, a multicenter randomized controlled trial, found no differences in neonatal outcomes in women with twins randomized to planned cesarean or vaginal delivery. Nevertheless, women who present in spontaneous labor might expect a better outcome following a trial of vaginal delivery than undergoing cesarean delivery. In this secondary analysis, we aimed to compare neonatal...
Background
Rising cesarean rates call for studies on which subgroups of women contribute to the rising rates, both in countries with high and low rates. This study investigated the cesarean rates and contributing groups in Iceland using the Robson 10‐group classification system.
Methods
This study included all births in Iceland from 1997 to 2015, identified from the Icelandic Medical Birth Registry...
Background
The presence of midwives in a health system may affect perinatal outcomes but has been inadequately described in United States settings. Our objective was to compare labor processes and outcomes for low‐risk nulliparous women birthing in United States medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only).
Methods
We conducted...
Background
Sixty percent of United States births are to multiparous women. Hospital‐level policies and culture may influence intrapartum care and birth outcomes for this large population, yet have been poorly explored using a large, diverse sample. We sought to use national United States data to analyze the association between midwifery presence in maternity care teams and the birth processes and...
Background
The Unmet Obstetric Need (UON) indicator has been widely used to estimate unmet need for life‐saving surgery at birth; however, its assumptions have not been verified. The objective of this study was to test two UON assumptions: (a) Absolute maternal indications (AMIs) require surgery for survival and (b) 1%‐2% of deliveries develop AMIs, implying that rates of surgeries for AMIs below...
Background
The cesarean birth rate in the United States is 32%, and there is discussion about the cause of high surgical birth rates. Our purpose was to determine whether mode of birth is influenced by maternal, nurse, and system factors.
Methods
Secondary analysis of a data set of 163 women having postdates labor induction with oxytocin. Kaplan‐Meier survival curves were calculated to compare...
Background
Second‐trimester and early third‐trimester uterine rupture in a nonlaboring woman is a very rare and life‐threatening condition for both mothers and newborns. We aimed to present clinical characteristics, prenatal findings, and maternal and neonatal outcomes following second‐trimester and early third‐trimester spontaneous antepartum uterine rupture in our institute.
Method
The medical...
Background
Patients with a history of cesarean may benefit from shared decision‐making (SDM) interventions, such as patient decision aids, that provide individualized clinical information and help to clarify personal preferences. We sought to understand the factors that influence how care practitioners support choices for mode of birth and what individual and health system factors influence uptake...
Background
Both globally and in Australia, there has been a sharp rise in cesarean births (CB). Commonly, this rise has been attributed to the changing epidemiology of women giving birth. A significant body of knowledge exists on the risk factors associated with a greater need for cesarean. Yet, we have little information on the reasons recorded by clinicians as to why cesareans are provided. This...
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