Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. In addition, some women may seek to reduce medical interventions during labor and delivery. Satisfaction with one’s birth experience also is related to personal expectations, support from caregivers, quality of the patient–caregiver relationship, and the patient’s involvement in decision making. Therefore, obstetric care providers should be familiar with and consider using low-interventional approaches, when appropriate, for the during labor management of low-risk women in spontaneous labor... The current rates of cesarean delivery in the United States is alarming. The best way to deliver,for a woman who is pregnant with one baby (a singleton pregnancy),at term (nine months pregnant) and with the fetal head down (vertex presentation), is vaginally. And if you can deliver that first baby vaginally you most likely will have your subsequent deliveries vaginally. A pre-set,low-risk scoring system to predict obstetric outcome for the selection of women suitable for delivery in low-intervention units,such as a free standing birthing center, is used compared with vaginal deliveries, cesarean deliveries are associated with increased risks for the mother of medical or surgical complications, morbidity; or even death. Women with a prior cesarean delivery are at risk for severe complications such as uterine rupture, abnormal placement of the placenta, and unplanned hysterectomy in a subsequent pregnancy. Thus, the increase in cesarean delivery rates, from 20.7% in 1996 to 32% from 2009 to 2017, likely has contributed to overall increases in maternal morbidity and mortality documented during the past two decades. Reducing cesarean delivery rates, particularly for first-time mothers with low-risk pregnancies, is a stated goal for key professional organizations and federal agencies. In a 2014 consensus statement, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommended adoption of evidence-based practices for improving clinical care and changing practice culture to reduce cesarean delivery rates among first time nulliparous moms, with term, singleton, and vertex pregnancies. Selected practice guidelines have been packaged by the Council on Patient Safety in Women's Health Care into the Safe Reduction of Primary Cesarean Births patient safety bundle, which is now being implemented in several states with technical assistance from the Alliance for Innovation in Maternal Health and support from the Health Resources and Services Administration.
This is a national awareness campaign for women about their reproductive, pregnancy and birth experience. About 700 women die each year in the United States from complications during and after pregnancy Black and American Indian/Alaska Native women are about three times as likely to die from pregnancy-related causes than white women. At times the connection may not be easily made between a woman’s personal risk factors and reproductive/pregnancy and birth outcomes in the short and long term. This effort will mean addressing a target population of women and their support person(s). It will include a plan to promote more natural births employing new, innovative and traditional time-tested methods, with a goal for less adverse maternal and fetal outcomes.... Our aim is to deliver an urgent wake up call to women,American women, and hopefully slow down..., stop,the maternal mortality crises. Most importantly we are hoping that together we will be able to address current issues and enhance the reproductive, pregnancy and birth experience of women in their local communities. The foundation will support the mission of birthing centers including the ObGyne Birth Center For Natural Deliveries as a safe place for natural deliveries; and serve to disseminate education and resources to women especially those disproportionately affected and predisposed to a poor pregnancy and birth experience. In doing this we will reach and be able to advance health care for all women from pre-adolescents through women in the childbearing years to women well after the menopausal transition. We cannot do this alone. We plan to seek out women’s health advocates and health educators; to plan and implement awareness of our mission and education of our programs in their communities.
Dr Bola Sogade