Choices for Inductive Labor in Nulliparous Women in Health Care Reforms - Essay Example

? Choices for Inductive Labor in Nulliparous Women in Health Care Reforms No: Topic: Choices for Inductive Labor in Nulliparous Women in Health Care Reforms Subtopics: 1. Literature Review 2. Factors Influencing the Choice for Inductive Labor in Nulliparous Women 3. Research Methodology 4. Population size 5. Discussion and Analysis 6. Conclusion 7. Recommendations Inductive Labor Inductive labor is a process where there is stimulation of the uterine contractions before the onset of spontaneous labor. Successful inductive labor leads to normal delivery (vaginal birth). This can happen when there is a concern on the mother’s or baby’s health. However, it is associated with various risks including; emergency cesarean delivery and various infections of delivery. Pregnant women who are aware of the risks and benefits of inductive labor can choose whether to have it or not. Thesis Admission of children to the neonatal unit is increased in relation to elective induction of labor at all the periods of gestation earlier than 41 weeks. If a woman has no pregnancy complications, then induction of labor will still be allowed and has no reduction in the spontaneous vertex deliveries. Annotated Bibliography American college of Obstetricians and Gynecologists (ACOG). Labor Induction and Unfavorable Cervix. Obstetrics and Gynecology. 2011. Chicago IL: ACOG The American college of Obstetricians and Gynecologists (ACOG) bring together several authors and medics who articulate issues of health, and this includes the favorable approaches to delivery for women of all ages and especially those with an unfavorable cervix. These authors address and recommend induction of labor as an option to any woman with this kind of condition and this may seem as a contradiction to other conventional beliefs concerning the consequences of induced labor. They confirm that there is no danger in induced labor as opposed to taking the chance of waiting long enough for hard labor to take its course. This article will assist in my research to provide medical and practical possibilities of induced labor to allow the proposal to give a good outcome to my thesis. Ehrenthal, Deborah B.; Jiang, Xiaozhang; Strobino, & Donna M. Labor Induction and the Risk of a Cesarean Delivery among Nulliparous Women at Term. (2010). Obstetrics & Gynecology. 116(1):35-42, July 2010. doi: 10.1097/AOG.0b013e3181e10c5c There are some institutions that employ induction of labor as a frequent practice. This study looks into such an institution as an assessment of their use and the outcomes of this practice. They try to find out the causes of morbidity and other maternal risks by correlating the variables such as induction and cesarean deliveries in the institution’s population. There study as compared to other articles reveals that induction during delivery will lead to cesarean delivery whether or not a woman has medical risks. This was done in all nulliparous women. This article brings in another factor to the study i.e. obesity. Just like the article above, they also make a recommendation of education both the patients and the care givers. This will reinforce my recommendations both for adopted strategies and for future research. Gershon D. Hernandez., Lisa M. Korst., Thomas M. Goodwin et al. Late Pregnancy Complications can affect risk estimates of elective induction of labor. The Journal of Maternal-Fetal and Neonatal Medicine, June 2011: 24(2) 787-794 These authors argue that when low risk parity women are subjected to induced labor in the early stages, it causes them to have prolonged and severe rapture of the membranes not mentioning the abnormal FHR that they will obviously go through. All the groups that were put on test here witnessed the same outcomes except for women in late inductive periods. It showed that induction at a gestation stage earlier than 39 weeks is more risky than any woman with a spontaneous or induced labor later than 39 weeks. This article therefore will highlight the benefits of late induction as opposed to early induction in women with low parity. My study needs to compare these two variables in order to draw proper conclusions. Glantz, J. Christopher. "Term labor induction compared with expectant management." Obstetrics & Gynecology 115.1 (2010): 70-76. Glantz was able to show that labor induction during the early stages was directly related to the increased chance of cesarean delivery. Most women at full term will get into the spontaneous labor at the index week as long as its full term. However, while multiparous women have successful deliveries compared to the nulliparous group, they are not excluded from the risk of cesarean delivery. Recommendations made by Glantz are such that inductions of labor should be done only with consent from informed women either made personally or from those very close to them as long they have the information. In this study I will get more reinforcement in the power of information and use of informed consent. Jonsson M, Cnattinguis S. and Wikstrom A-K. Elective Induction of Labor and the Risk of Cesarean Section in Low-risk parous women: A cohort Study, Acta Obstet Gynecol Scand. 2013; 92:198-203 This study is to be compared with the previous article above the proposed for women to adopt inductive labor when they encounter prolonged labor. This cohort, however, counteracts that notion and reveals that it is very risky for women with low risk parity to induce labor and goes further to show that those who have been known to have induced labor in the past have had increased incidences of emergency caesarean deliveries. When it comes to cases of those with no cervical ripening, the risk increases by a threefold threshold where the control used was cervical ripening. This will give a good argument for a comparative assessment of my thesis and will also provide data that will give an analysis of data for making conclusions to the study. For instance, it reveals that induced women were exposed to a 60% risk in experiencing prolonged labor and for those with no cervical ripening, the risk goes higher. Morhason-Bello, Imran O., Babatunde O. Adedokun, and Oladosu A. Ojengbede. "Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers." International breastfeeding journal 4.1 (2009): 16. Social induction of labor is mostly employed by institutions attended by those who are of a higher social status or class. The rich are said to be “lazy” or “tired of pregnancy”. This component will be very important to my study because it brings in a factor of economic empowerment in choices of inductive labor. It also brings in the issue of cost and access to these kinds of services. If one is allowed to choose to be induced are there additional costs to it. This is important to my report in assessment of the factors that influence maternal choices and to further make recommendations on which factors should be regulated for better practice. Ramasamy, Vidya & Thunga, Suchitra & Nayak, S R. Is elective induction safe? A prospective analysis. 2011. Journal of obstetrics and gynecology of India, 61. The study by this authors shows that there was no relationship between induction stage and the rate or risk of cesarean delivery in women with low parity. This is now a new perspective that will provide more variables to my study. What were the parameters used by their tested groups? There study found that there is prolonged labor that occurs significantly during the first and second stages within groups of women that have been induced. They emphasize the importance of ‘informed consent’ which to my study, will assist in the methodology of group selection and the will to participate in the study. Reisner DP, Wallin TK, Zingheim RW, et al. Reduction of elective inductions in a large community hospital. Am J Obstet Gynecol 2009;200:674.e1-674.e7. Induction according to these authors is a strategy proposed to improve health care in the design of the ultimate process to be used in reducing induction in nulliparous women. There medical approach is to begin with the care givers, by giving them education and all information necessary as concerns the dangers of inductive labor so as to let everyone be informed on the consequences of this process. This approach will assist my study in the approaches to use while proposing changes to health care reforms. Stock, S. J., Ferguson, E., Duffy, A., et al. Outcomes of elective induction of labor compared with expectant management: population based study. BMJ (Clinical research ed.), 344, e2838. 2012 In comparison to the other articles, this clinical research edition also reveals that it is safer or there is low risk if labor is induced at 37 weeks and more. There are less perinatal deaths and is more in tandem with those who go through spontaneous labor with normal vertex deliveries. However, one observation was that the same women would have more of their babies admitted for a longer period at the special care units. There is a recommendation for this index to be tested. It is also important to my study as some models are to be proposed for use in developing countries as this is what I will need to recommend at the end of my research. Tam, Teresa & Conte, Mary & Schuler, Hayley & Malang, Socorro & Roque, & Marya. Delivery outcomes in women undergoing elective labor induction at term. Archives of gynecology and obstetrics. 2012 It is based on a community hospital where only women who are a term are admitted. The women have been found to have low risk in induction too. The variables used by this study are the parity and the initial cervical ripening examinations. This will assist my study in looking at the kind of services available for women with low parity in community based hospitals. What are their chances of survival in case of maternal risks if induced? It has also helped me look at my study different and not to assume that all facilities are equipped adequately to handle nulliparous women. Work Cited American college of Obstetricians and Gynecologists (ACOG). (2011). Labor Induction and Unfavorable Cervix. Obstetrics and Gynecology. Chicago IL: ACOG Read More