While the American College of Obstetrician and Gynecologists (ACOG)'s recent update now recommends that postpartum care should be an ongoing process, rather than a single encounter and that all women have contact with their ob - gyns or
other obstetric care providers within the first three weeks postpartum is a start, we need MORE.
Obstetrician - gynecologists and
other obstetric care providers can discuss breastfeeding during pregnancy and can help women plan a successful start to breastfeeding.
• Obstetrician — gynecologists and
other obstetric care providers can discuss breastfeeding with you during pregnancy and can help you plan for a successful start to breastfeeding.
Obstetricians and
other obstetric care providers are trained to enhance adult learning by avoiding didactic lectures and facilitating peer - to - peer learning through robust participation of women and their support partners.
Each session begins with socializing opportunities, self - data collection, and a brief one - on - one interaction with the obstetrician — gynecologist or
other obstetric care provider for individual assessment and solicitation of patient concerns.
Recognizing the limitations of available data, the obstetrician or
other obstetric care provider and patient may choose to proceed with TOLAC in the presence of a documented prior low - vertical uterine incision.
When resources for emergency cesarean delivery are not available, ACOG recommends that obstetricians or
other obstetric care providers and patients considering TOLAC discuss the hospital's resources and availability of obstetric, pediatric, anesthesiology, and operating room staffs.
The decision to offer and pursue TOLAC in a setting in which the option of emergency cesarean delivery is limited should be carefully considered by patients and their obstetricians or
other obstetric care providers.
This timing places a responsibility on patients and obstetricians and
other obstetric care providers to begin relevant conversations early in the course of prenatal care.
Data comparing the rates of VBAC, as well as maternal and neonatal outcomes, after TOLAC to those after planned repeat cesarean delivery can help guide obstetricians or
other obstetric care providers and patients when deciding how to approach delivery in women with a prior cesarean delivery.
Obstetricians and
other obstetric care providers and insurance carriers should do all they can to facilitate transfer of care or comanagement in support of a desired TOLAC, and these procedures should be initiated early in the course of antenatal care.
Nonetheless, it remains appropriate for the obstetricians or
other obstetric care providers and patients to consider past birth weights and current estimated fetal weight when making decisions regarding TOLAC.
Good candidates for planned TOLAC are those women in whom the balance of risks (as low as possible) and chances of success (as high as possible) are acceptable to the patient and obstetrician or
other obstetric care provider.
Referral may be appropriate if, after discussion, obstetricians or
other obstetric care providers find themselves in disagreement with the choice the patient has made.
For example, if a patient who may not otherwise be a candidate for TOLAC presents in advanced labor, the patient and her obstetrician or
other obstetric care provider may judge it best to proceed with TOLAC.
• What resources are recommended for obstetricians or
other obstetric care providers and facilities offering a trial of labor after previous cesarean delivery?
Once labor has begun, a patient attempting TOLAC should be evaluated by an obstetrician or
other obstetric care provider.
All obstetrician — gynecologists and
other obstetric care providers should support women who have given birth to preterm infants to establish a full supply of milk by providing anticipatory guidance and working with hospital staff to facilitate early, frequent milk expression.
Obstetrician — gynecologists and
other obstetric care providers should support each woman's informed decision about whether to initiate or continue breastfeeding, recognizing that she is uniquely qualified to decide whether exclusive breastfeeding, mixed feeding, or formula feeding is optimal for her and her infant.
Obstetrician — gynecologist and
other obstetric care providers should engage the patient's partner and other family members in discussions about infant feeding and address any questions and concerns.
Obstetrician — gynecologists and
other obstetric care providers should be in the forefront of policy efforts to enable women to breastfeed, whether through individual patient education, change in hospital practices, community efforts, or supportive legislation.
All obstetrician — gynecologists and
other obstetric care providers should support women who have given birth to preterm and other vulnerable infants to establish a full supply of milk by providing anticipatory guidance, support, and education for women.
Obstetrician — gynecologists and
other obstetric care providers should work with hospital staff to facilitate early, frequent milk expression.
Because lactation is an integral part of reproductive physiology, all obstetrician — gynecologists and
other obstetric care providers should develop and maintain skills in anticipatory guidance, support for normal breastfeeding physiology, and management of common complications of lactation.
The offices of obstetrician — gynecologists and
other obstetric care providers should be a resource for breastfeeding assistance through the first year of life, and for those women who continue to breastfeed beyond the first year because many of the health benefits associated with breastfeeding increase with longer duration of breastfeeding.
The advice and encouragement of the obstetrician — gynecologist and
other obstetric care providers are critical in assisting women to make an informed infant feeding decision.
The offices of obstetrician — gynecologists and
other obstetric care providers should be a resource for breastfeeding women through the infant's first year of life, and for those who continue to breastfeed beyond the first year.
The offices of obstetrician — gynecologists and
other obstetric care providers should be a resource for breastfeeding women through the infant's first year of life, and for those who continue beyond the first year.
Because lactation is an integral part of reproductive physiology, all obstetrician — gynecologists and
other obstetric care providers should develop and maintain knowledge and skills in anticipatory guidance, physical assessment and support for normal breastfeeding physiology, and management of common complications of lactation.
Not exact matches
Most women in Ireland have
obstetric - led medicalised hospital
care as there are no
other choices available to them.
This has resulted in a «geographic lottery» in terms of women's choices and developments with some parts of the country offering midwifery led
care, birth pools, home birth services, open doula policies, anomaly scans, early transfer home, DOMINO
care and
other parts of the country offering nothing beyond an
obstetric led service.
For the purposes of this economic evaluation, the forms were initially used in a related study funded by the National Institute of Health Research (NIHR) research for patient benefit programme «assessing the impact of a new birth centre on choice and outcome of maternity
care in an inner city area,» which will be reported in full elsewhere, comparing the costs of
care in a free standing midwifery unit with
care in an
obstetric unit in the same trust.16 The data collected included details of staffing levels, treatments, surgeries, diagnostic imaging tests, scans, drugs, and
other resource inputs associated with each stage of the pathway through intrapartum and after birth
care.
Since the early 1990s, government policy on maternity
care in England has moved towards policies designed to give women with straightforward pregnancies a choice of settings for birth.1 2 In this context, freestanding midwifery units, midwifery units located in the same building or on the same site as an
obstetric unit (hereafter referred to as alongside midwifery units), and home birth services have increasingly become relevant to the configuration of maternity services under consideration in England.3 The relative benefits and risks of birth in these alternative settings have been widely debated in recent years.4 5 6 7 8 9 10 Lower rates of
obstetric interventions and
other positive maternal outcomes have been consistently found in planned births at home and in midwifery units, but clear conclusions regarding perinatal outcome have been lacking.
The midwife - led continuity model of
care includes: continuity of
care; monitoring the physical, psychological, spiritual and social well being of the woman and family throughout the childbearing cycle; providing the woman with individualised education, counselling and antenatal
care; attendance during labour, birth and the immediate postpartum period by a known midwife; ongoing support during the postnatal period; minimising unnecessary technological interventions; and identifying, referring and co-ordinating
care for women who require
obstetric or
other specialist attention.
The midwife - led continuity model of
care includes: continuity of
care; monitoring the physical, psychological, spiritual and social wellbeing of the woman and family throughout the childbearing cycle; providing the woman with individualised education, counselling and antenatal
care; continuous attendance during labour, birth and the immediate postpartum period; ongoing support during the postnatal period; minimising technological interventions; and identifying and referring women who require
obstetric or
other specialist attention.
In some models, midwives provide continuity of midwifery
care to all women from a defined geographical location, acting as lead professional for women whose pregnancy and birth is uncomplicated, and continuing to provide midwifery
care to women who experience medical and
obstetric complications in partnership with
other professionals.
In some countries (e.g. Canada and the Netherlands), the midwifery scope of practice is limited to the
care of women experiencing uncomplicated pregnancies, while in
other countries (e.g. United Kingdom, France, Australia and New Zealand), midwives provide
care to women who experience medical and
obstetric complications in collaboration with medical colleagues.