➡ It is uncertain whether there are any differences in maternal or perinatal mortality
between caesarean sections performed by non-physician clinicians and by doctors.
It is uncertain whether there are any differences in maternal or perinatal mortality
between caesarean sections performed by non-physician clinicians and by doctors (very low - certainty evidence)(Wilson 2011).
Not exact matches
Some moms are in pain after a
caesarean delivery while others feel sore because of a tear in the perineum (the area
between the back passage and vagina).
In Scotland, where wide variations in surgical deliveries have been found
between units, four evidence based recommendations have been prioritised: clinicians and women should regard trial of labour as the norm after a previous
caesarean; offering external cephalic version to women at term if their baby is breech; monitoring and regularly reviewing
caesarean data with support for staff; and one to one midwifery care for all women in labour.20 The National Childbirth Trust — a UK parents organisation — is concerned about medicalisation and erosion of midwifery skills and confidence.
Higher distances
between the call room (where the staff hangs out when they're not treating patients) and the delivery rooms also predicted higher
caesarean rates.
This includes that the mother must have no significant pre-existing disease, no significant disease arising during pregnancy, a singleton pregnancy (no twins or higher order multiples), the baby must be head - down, labor must start
between 37 and 41 weeks of pregnancy, the mother must have had no more than 1 previous
caesarean section, and labor must begin spontaneously.
Whether the key outcomes of
caesarean section differ
between non-physician clinicians and medical doctors was explored in one review that included six studies conducted in low - income countries.
On the whole, there was no evidence of a difference
between the caseload and team subgroups for any of the outcomes included in the subgroup analysis, which included
caesarean section, instrumental vaginal birth, spontaneous vaginal birth, intact perineum, preterm birth < 37 weeks and all fetal loss before and after 24 weeks plus neonatal death.
The authors are currently analysing additional data from women interviewed
between November 2016 to January 2017, which, when combined with data from all the other women, shows that anxiety is associated with chronic post
Caesarean pain in a statistically significant way.
INTERPRETATION: Planned
caesarean section is better than planned vaginal birth for the term fetus in the breech presentation; serious maternal complications are similar
between the groups.
The WHO reiterates the view of its health experts, who have said since 1985 that the «ideal rate» for
caesarean sections is
between 10 % and 15 % of births.
«The anti natal clinic and maternity unit is well used and his team deliver
between 350 - 600 births a year but any
Caesarean sections have to be taken to a larger hospital.