Download PDF by Pray, Leslie A.: An update on Research issues in the assessment of birth

By Pray, Leslie A.

ISBN-10: 0309287405

ISBN-13: 9780309287401

"More than 30 years in the past, the Institute of drugs (IOM) and the nationwide learn Council (NRC) convened a committee to figure out methodologies and learn had to overview childbirth settings within the usa. The committee individuals suggested their findings and suggestions in a consensus record, study concerns within the overview of delivery Settings (IOM and NRC, 1982). An replace on study matters in the  Read more...

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Their inclusion criteria were healthy, low-risk women without any disease known to influence pregnancy; singleton; cephalic; BMI <32; smokes <10 cigarettes/day; no prior operation on the uterus; and 36 weeks, 1 day to 41 weeks, 6 days gestation. , BMI <18 or >29; smoking ≥20 cigarettes per day). Menard emphasized the need for consistent and evidence-based criteria of “low obstetric risk” so that valid comparisons across settings can be made and our understanding of birth settings advanced. Research Needed to Describe “Risk” In addition to developing uniform definitions of risk factors, several other research steps need to be taken in order to advance our understanding of risk.

Another participant who identified herself as being from the Netherlands agreed with Armstrong that the reasons for the increasing trend in hospital births are complex. They include demographic changes, that is, more older women entering pregnancy, as well as more primips; media portrayal of pregnancy as something to be feared; increased prenatal testing; and a diverse immigrant population, with varying cultural perceptions of pregnancy. She noted primary care in the Netherlands is midwife-led care, adding that the rate of home birth in the Netherlands is about 19 percent, with another 12 percent of women giving birth in a hospital but with their midwives and without attendance by obstetricians.

Overall mortality was fairly low (only 5 deaths out of 122,000 deliveries), with a death-tomorbidity ratio of 1 to 23. In Gregory’s opinion, available data and guidelines suggest that the 30-minute rule of “decision to incision” for emergency Cesarean delivery might not be good enough (Minkoff and Fridman, 2010). ” These include placenta previa/accreta, abruption, cord prolapse, and uterine rupture. She acknowledged, however, that, as Lagrew et al. (2006) pointed out, “most emergent Cesarean deliveries develop during labor in low-risk women and cannot be anticipated by prelabor factors” (p.

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An update on Research issues in the assessment of birth settings : workshop summary by Pray, Leslie A.


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