Search Results: MCHLine

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.

Contact: National Quality Forum, 1030 15th Street, N.W., Suite 800, Washington, DC 20005, Telephone: (202) 783-1300 Fax: (202) 783-3434 E-mail: [email protected] Web Site: http://www.qualityforum.org

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.

Contact: American College of Obstetricians and Gynecologists, 409 12th Street S.W., P.O. Box 96920, Washington, DC 20090-6920, Telephone: (202) 638-5577 Secondary Telephone: (202) 863-2518 E-mail: [email protected] Web Site: http://www.acog.org Available from the website.

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

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?

Contact: U.S. Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20857, Telephone: (301) 427-1104 Secondary Telephone: (301) 427-1364 Web Site: http://www.ahrq.gov Available from the website. Document Number: AHRQ Pub. No. 10-E001.

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

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.

Contact: National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, Telephone: (301) 496-4000 Secondary Telephone: (301) 402-9612 Fax: (301) 496-0017 E-mail: [email protected] Web Site: http://www.nih.gov Available from the website.

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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.

Contact: National Institutes of Health, Consensus Development Program, Office of Medical Applications of Research (OMAR), 6100 Executive Boulevard, Room 2B03, Bethesda, MD 20892, Telephone: (301) 496-1144 Fax: (301) 402-0420 Available from the website.

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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 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.

Contact: U.S. Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20857, Telephone: (301) 427-1104 Secondary Telephone: (301) 427-1364 Web Site: http://www.ahrq.gov Available from the website. Document Number: AHRQ Pub. No. 03-E017.

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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.

Contact: Public Citizen's Health Research Group, 1600 20th Street, N.W., Washington, DC 20009, Telephone: (202) 588-1000 Web Site: http://www.citizen.org/hrg/ Available in libraries.

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