title: Prevention of the first cesarean delivery.
abstract: Education of providers and patients on the importance of vaginal delivery, for the current pregnancy as well as future pregnancies, is essential to reverse the current trend of primary cesareans. When discussing cesarean with patients, counseling should include the effect on subsequent pregnancy risks including the possibility of uterine rupture and placentation abnormalities. In addition, counseling must include the concept that normal labor takes time. Re-education on the natural process of labor, the importance of allowing the time needed, and patience with the duration of pregnancy and process of labor is essential.
authors.affiliation: National Institute of Child Health and Human Development, National Institutes of Health, 31 Center Drive, Room 2A03, Bethesda, MD 20892, USA. Electronic address: spongc@mail.nih.gov.
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D037001:Directive Counseling / Q000379:methods*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D012307:Risk Factors; D019564:Unnecessary Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*
keywords: Cesarean; Maternal and fetal health; Prevention; Vaginal delivery