The Role of Nurses in Reducing the Caesarean Section Birth Rate At 31. 1% of all births in 2006, the rate of childbirth by Caesarian section in the United States rose to its highest, far from the standards set by the World Health Organization. The same institution stated that when a country’s C-section rate exceeds 15%, the risks of this procedure now far outweigh its life-saving purposes (Ponte 2007). This phenomenon, especially of elective C-section, sparked great concern and fueled the undertaking of many efforts to lower this rate to a more acceptable level.
The rise in C-sections is being attributed to: 1. a clinical environment where medical doctors wish to avoid the trend of lawsuits filed against them, 2. uninformed decision making on the part of the mothers with regards to the benefits and risks of both methods, 3. private/individual interests of medical health providers and healthcare industries in the added costs and needs associated with C-sections and 4. the prevailing culture of reliance on technology over more natural methods (Ponte 2007, Childbirth.org 2008).
The immediate and long term health of both mother and baby should gain primacy in decisions regarding childbirth method so that the promotion of safer, cost-effective, non-surgical and more natural methods and the further enhancement of these methods through scientific study will help decrease the C-section rate. The nursing profession should be a part of this endeavor in a number of ways through the following: 1.
Information dissemination: the decision on whether to undergo a C-section or not in circumstances where informed consent or refusal can take place should constitute an objective presentation of the risks and benefits of both C-section and vaginal methods (Sakala and Mayberry 2005). Unfortunately, many women, especially first time mothers resort to information from the internet and television, which may not be based on scientific evidence or may be biased. A set of credible information on both methods which dispel existing misconceptions should be drafted and made available to pregnant women through various forms of media.
Stress should be given on the dangers of C-section as a form of major surgery. The advantages of vaginal birth including the nature of pregnancy and birth itself should be included because this information is more often left out. Efforts have been made in 2005 by the Maternity Center Association, now Childbirth Connection, in this respect, as an advocate of evidenced-based medical practice. They have utilized creative and aggressive means of dissemination through publishing books for easy reading on the subject, made information also available in the internet and others. The same effort should be supported and/or replicated by nurses.
2. Education: Nurses should actively initiate and participate in education efforts aimed at increasing their awareness on evidence-based practice as best practice and as a guarantee to the rights of mothers and babies to quality health care. This principle should be the basis in discussing why vaginal birth method should be promoted and supported in the absence of compelling scientific studies against it. Education activities should also be extended outside hospital settings and reach out to women in general or pregnant mothers in communities, schools and other possible venues. 3.
Labor support with regards to vaginal birth: resorting to C-section even when the mother is healthy and pregnancy is uncomplicated may be due to fears with regards to the mother’s capacity to give birth vaginally or to endure natural birth pains. Hence, increasing and sustaining the confidence of pregnant women in this regard can be performed by nurses in a number of ways. The use of various forms of complementary therapy, such as aromatherapy, music therapy and massage, for birth pain relief during labor has been practiced in some hospitals already (Zwelling, Johnson and Allen 2006).
Ensuring that the mother has the freedom to move around and providing minimal intervention are also proven guarantees of a normal delivery and are part of the practice of Lamaze (Yale 2005). 4. Research: current practices regarding the delivery of maternal health care should be subjected to regular evaluation in terms of safety and quality by scientifically measuring actual outcomes in patients in order to ensure that current practices are evidence based (Kitson 2000, Melnyk 2005).
Nurses should also undertake or support research efforts with regards to the promotion of natural childbirth and improving its practice as well as documenting C-section practice in order to add to the dearth of scientific evidence for evaluation is also plausible (Fawcett et al 2005). Research would then serve as bases in the making of hospital policies and as guidelines for actual nursing practice.
List of References Caesarean Section: Why does the national U. S. caesarean section rate keep going up? (2008). Accessed February 20,2008 at http://www. childbirthconnection. org/article. asp? ck=10456 Fawcett, J.et al (2005). Adaptation to caesarian birth: Implementation of an international multisite study. Nursing Science Quarterly, 18( 3): 204-210 Kitson, A. (2000). Towards evidence-based quality improvement: perspectives from nursing practice.
International Journal for Quality in Health Care , 12: 459-464 Melnyk, B. M. et al (2005). Nurses’ perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews on Evidence-Based Nursing , 1(3), 185-193 Ponte, W. (2007). Caesarean birth in a culture of fear. Accessed February 20,2008 at http://www.childbirthconnection. org/article. asp? ck=10456 Sakala, C. and Mayberry L. (2005).
Vaginal or caesarean birth? Using a translational research model to promote informed health care decision making. Accessed February 20,2008 at http://www. childbirthconnection. org/article. asp? ck=10456 Yale, S. (2006). Doula support and attitudes of intrapartum nurses: A qualitative study from the patient’s perspective. The Journal of Perinatal Education, 15(1):11-18 Zwelling, E. , Johnson, K and Allen, J. (2006). How to implement complementary therapies for laboring women. MCN: The American Journal of Maternal/Child Nursing , 31(6): 364- 370.