title: Preventing primary cesarean births: midwifery care.
abstract: The incidence of cesarean birth in the United States is alarmingly high and cesareans are associated with added morbidities for women and newborns. Thus strategies to prevent cesarean particularly for low-risk, nulliparous women at term with a singleton fetus are needed. This article addresses evidence-based practices that may be used during intrapartum to avoid primary cesarean, including patience with progress in labor, intermittent auscultation, continuous labor support, upright positions, and free mobility. Second-stage labor practices, such delayed pushing and manual rotation of the fetus, are also reviewed. This package of midwifery-style care practices can potentially lower primary cesarean rates.
authors: *College of Nursing, University of New Mexico, Albuquerque, New Mexico †Health Sciences Clinical Professor, School of Nursing, University of California, San Francisco, California.
authors: Kim J
authors: KJ
authors: Cox
authors: Tekoa L
authors: TL
authors: King
mesh_terms: D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D036861:Delivery, Obstetric / Q000379:methods / Q000523:psychology; D004420:Dystocia / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D055318:Evidence-Based Nursing / Q000379:methods; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology / Q000523:psychology; D008880:Midwifery / Q000379:methods*; D009321:Natural Childbirth / Q000379:methods / Q000523:psychology; D009721:Nurse Midwives / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011247:Pregnancy; D040242:Risk Reduction Behavior