Search Results: MCHLine

Annotation: This patient safety bundle was revised in 2023 to incorporate respectful care concepts, revise existing elements, include new elements related to evidence-informed practices, and update data collection plans. The bundle provides actionable steps to support labor and care processes that can be adapted to a variety of facilities and resource levels to improve quality of care and safely reduce cesarean births. Implementation details and resources, a data collection plan, an evidence-informed "change package," and learning modules are included on the website. Some materials are available in English, Spanish, and French.

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• Printable Patient Safety Bundle

Keywords: Cesarean section, Childbirth, Data collection, Measures, Obstetrical care, Prevention, Protocols, Quality improvement, Resources for professionals, Safety, Vaginal birth

Annotation: This toolkit to support vaginal birth and reduce primary cesarean sections includes evidence-based tools and resources to support pregnant patients who transfer to the hospital from a community birth center and to effectively integrate midwifery care and doula support into the hospital setting. The toolkit serves as a “how to” guide to help educate and motivate maternity clinicians to apply best practices to support vaginal birth. Included are strategies to (1) improve the culture of care, awareness, and education for cesarean reduction; (2) support intended Vaginal Birth; (3) manage labor abnormalities and safely reduce cesarean births; and (4) use data to drive reduction in cesareans. Twenty appendices include checklists, guidelines, partograms, performance measures, and assessment tools for healthcare providers.

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• Summary

Keywords: Birthing Centers, California , Cesarean section, Childbirth, Doulas, Hospitals Quality assurance, Labor, Midwives, Model programs, Pregnant women, Prevention, Vaginal birth

Annotation: This website provides tools for optimizing the outcomes of labor safely and reducing the risk of primary cesarean delivery among lost-risk women. The site describes the American College of Nurse-Midwives' Healthy Birth Initiative: Reducing Primary Cesareans Project; presents statistics on primary cesarean sections; and links to additional resources and tools to help reduce non-medically indicated cesarean sections, share decision-making with patients, promote and support physiologic birth; and improve the quality of maternity care. Clinical guidelines for the care of women during each stage of labor are also provided.

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Keywords: Cesarean sections, Childbirth, Guidelines, Midwifery, Prevention, Safety, Social support, Vaginal birth

Annotation: These consensus guidelines provide information for clinicians on the safe prevention of primary cesarean delivery. Developed jointly by the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), the document includes background information on cesarean delivery; discusses the importance of balancing risks and benefits of vaginal and cesarean sections; describes indications for primary cesarean delivery, presents, clinical management questions and answers; and provides inks to more than 100 reference citations. C-section trenda data is also included.

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Keywords: Cesarean section, Childbirth, Guidelines , Prevention, Safety, Vaginal birth

Annotation: This booklet for pregnant women presents questions and answers on cesarean section (c-section). Questions include Which is safer, vaginal birth or c-section? What are the possible benefits and harms of vaginal birth and c-section? What is it like to have a c-section? If my doctor or midwife suggests a c-section, how should I decide if it is right for me? Is it possible to safely prevent a c-section? and What happens if I need a c-section?

Keywords: Cesarean section, Childbirth, Informed consent, Patient rights, Pregnant women, Research, Safety, Vaginal birth

Annotation: This scientific review summarizes current evidence on the health consequences of cesarean delivery, focusing on the adverse consequences of cesarean delivery as well as adverse outcomes that may be intrinsic to labor or vaginal birth. Included are answers to ten questions related to the physical effects in women and babies that may occur more frequently with cesarian versus vaginal delivery; complications that are unique to cesarean and vaginal deliveries; and risks to women and children that may be associated with method delivery. A detailed list of the review findings, the methods used to locate and present the best evidence, and the implications for the future are also presented.

• Full Report

Keywords: Cesarian section, Comparative analysis, Outcome evaluation, Research reviews, Vaginal birth

Annotation: This report focuses on efforts of the National Priorities Partnership (NPP) to improve maternity care for mothers and infants. Specifically, NPP sought to reduce the percentage of infants electively delivered prior to 80 weeks' gestation to 5 percent or less and to reduce Cesarean births among low-risk women to 15 percent or less. Topics include goals and strategies (including measurement in hospitals to increase transparency and create a culture for improvement, systems improvement, and consumer engagement), considerations for moving forward (including vaginal birth after Cesarean, prenatal care and breastfeeding, and definitions and standardization), and the path forward.

Keywords: Breastfeeding, Cesarean section, Childbirth, Health systems, Infant health, Pregnant women, Prenatal care, Reproductive health, Vaginal birth after Cesarean, Women's health

Annotation: This patient education brochure describes the choices women have when planning how to give birth after a previous cesarean delivery. It describes the reasons why women might consider a trial of labor after a cesarean delivery (called TOLAC) and, if successful, a vaginal birth after cesarean delivery (VBAC). The brochure explains the reasons why women may want to think about TOLAC, the potential risks involved, and the factors that have been shown to increase or decrease the chances of successful TOLAC and VBAC. Included are illustrations of the various types of cesarean incisions and a glossary of terms. The brochure is also available in Spanish.

Keywords: Consumer education materials, Labor, Pregnant women, Risk factors, Spanish language materials, Vaginal birth after cesarean

Annotation: This report is part of a series that examine the rates at which 13 elective procedures are delivered in different communities across the state of California. The report examines the geographic variation in elective childbirth procedures, including elective induction, cesarian sections (C-sections), and vaginal birth after cesarian (VBAC). Each procedure is defined, and the risks and benefits are addressed. Comparative statistics on the rate and type of elective procedures performed in each of the state's hospital service areas (HSAs) is presented in table format. The data is from the period 2005-2009 and is based on the patients’ place of residence.

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Keywords: California, Cesarian section, Childbirth, Geographic regions, Induced labor, Infant health, Reproductive health, State surveys, Vaginal birth after Cesarian section, Women's health

Annotation: This systematic review was conducted to inform the 2010 National Institutes of Health Consensus Development Conference on emerging issues relating to vaginal birth after cesarean (VBAC). The report reviews two background questions: (1) what are the rates and patterns of utilization of trial labor after prior cesarean, VBAC, and repeat cesarean deliveries in the United States? and (2) what are the nonmedical factors that influence the patterns and utilization of trial labor after prior cesarean? The report also addresses four key questions: (1) Among women who attempt trial of labor after prior cesarean, what is the vaginal delivery rate, and what are the factors that influence it? (2) What are the short- and long-term benefits and harms to the mother of attempting trial of labor after prior cesarean vs. elective repeat cesarean, and what factors influence benefits and harms? (3) What are the short- and long-term benefits and harms to the infant of maternal attempt at trial of labor after prior cesarean vs. elective repeat cesarean, and what factors influence benefits and harms? And (4) what are the critical gaps in the evidence for decision-making, and what are the priority investigations needed to address these gaps?

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Keywords: Cesarean section, Childbirth, Pregnancy, Repeat cesarean birth, Research, Vaginal birth after cesarean

Annotation: This report compares out-of-pocket maternity care costs under 12 consumer-driven health plans (CDHPs) from the group and individual markets to the costs under a traditional health insurance plan. The report discusses the costs of maternity care, the features of private health insurance affecting maternity coverage, and the issues raised by the development of CDHPs. The report, which includes an executive summary, contains the following sections: (1) how does health insurance cover pregnancy?, (2) what are CDHPs?, (3) what does a typical pregnancy cost?, (4) how does maternity coverage under CDHPs compare to traditional insurance?, and (5) CDHP information resources to support consumer decision-making. A conclusion and endnotes are included. Statistical information is presented in tables throughout the report as well as in several appendix tables.

Keywords: Cesarean section, Costs, Health insurance, Labor complications, Pregnancy, Pregnancy complications, Prenatal care, Preterm birth, Vaginal birth

Annotation: This fact sheet provides information on the cost of maternity and infant care in the United States. Information is provided about the cost of vaginal and Cesarean section deliveries and for preterm and full-term infants. Figures and tables throughout the fact sheet show the distribution of average expenditures by type of service, average expenditure for maternity care by source of payment and by geographic region, and health care costs paid for by employers in the first year of life.

Keywords: Cesarean section, Costs, Geographic factors, Health care, Health insurance, Preterm birth, Vaginal birth

Annotation: This document comprises advance materials for the NIH State-of-the-Science Conference: Cesarean Delivery on Maternal Request, held on March 27-29, 2006, in Bethesda, MD. It includes a conference agenda; lists of panel members, speakers, and planning committee members; and abstracts of proposed presentations, which are divided into the following categories: (1) trends and incidence of cesarean delivery over time and (2) short- and long-term benefits and harms to the mother and the baby.

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Keywords: Cesarean section, Infant health, Pregnancy outcome, Repeat Cesarean birth, Reproductive health, Trends, Vaginal birth, Vaginal birth after Cesarean, Women's health

Annotation: This statement reflects the panel's assessment of medical knowledge available at the conference held on March 27-29, 2006, in Bethesda, MD by the National Institute of Child Health and Human Development (NICHD) and the Office of Medical Applications of Research (OMAR). Topics include trends and incidence of cesarean delivery over time, short- and long-term benefits and harms to the mother and the baby, what factors influence benefits and harms, and what future research directions need to be considered. Rosters of panel members and the planning committee are included.

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Keywords: Cesarean section, Conferences, Infant health, Pregnancy outcome, Repeat Cesarean birth, Reproductive health, Trends, Vaginal birth, Vaginal birth after Cesarean, Women's health

Annotation: This report addresses evidence from trials of routine vs. restricted use of episiotomy related to the influence of episiotomy on measures of pelvic floor relaxation, continence, and sexual function and satisfaction. The goal of this synthesis is to inform health professionals, professional organizations, advocates, and individual women about the current state of the evidence about the routine use of episiotomy. The report, which includes an abstract, also includes study methods, results, a discussion, references and included studies, and a list of excluded studies. Statistical information is presented in figures and tables throughout the report. Four appendices (which are available electronically but are not part of the print document) include exact search strings, sample abstraction forms and quality rating forms, evidence tables, and acknowledgments.

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• Summary

Keywords: Childbirth, Literature reviews, Research, Sexual health, Vaginal birth, Women's health

Annotation: This report provides a framework for comparing the harms and benefits of delivery options for women with prior cesarean delivery. The information is designed to help consumers, health professionals, payers, and policymakers in decisionmaking about repeat cesarean or trial of labor.

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Keywords: Cesarean section, Childbirth, Pregnancy, Repeat cesarean birth, Vaginal birth after cesarean

Annotation: This report analyzes the cesarean section rate in the United States for the period 1989-1990. It includes discussions of cesarean safety for both the mother and child, the clinical reasons given for performing cesareans, the nonmedical factors linked to cesarean operations, and the development of clinical guidelines for both cesarean sections and vaginal births after cesarean sections. Charts list cesarean rates for 48 states plus the District of Columbia as well as the number of cesarean operations performed at 2,657 U.S. hospitals during that time period. Sets of questions for consumers to use with obstetricians and hospital administrators are included along with a model for maternity information legislation.

Keywords: Cesarean section, Childbirth, Cost containment, Dystocia, Fetal distress, Guidelines, Legislation, Malpractice insurance, Maternal health, Mortality, Newborn infants, Repeat cesarean birth, Vaginal birth after cesarean