Birth
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The percentage of United States births delivered by cesarean section continues to increase, even for women considered to be at low risk for the procedure. The purpose of this study was to use an "intention-to-treat" methodology, as recommended by a National Institutes of Health conference, to examine neonatal mortality risk by method of delivery for low-risk women. ⋯ The finding that cesarean deliveries with no labor complications or procedures remained at a 69 percent higher risk of neonatal mortality than planned vaginal deliveries is important, given the rapid increase in the number of primary cesarean deliveries without a reported medical indication.
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The influence of women's birth preferences on the rising cesarean section rates is uncertain and possibly changing. This review of publications relating to women's request for cesarean delivery explores assumptions related to the social, cultural, and political-economic contexts of maternity care and decision making. ⋯ The psychosocial context of obstetric care reveals a power imbalance in favor of physicians. Research into decision making about cesarean section that does not account for the way care is offered, observe interactions between women and practitioners, and analyze the context of care should be interpreted with caution.
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Randomized Controlled Trial
Maternal axillar and breast temperature after giving birth: effects of delivery ward practices and relation to infant temperature.
Little is known about the development and control of skin temperature in human mothers after birth. The purpose of this study was to explore the effects of delivery ward practices and early suckling on maternal axillar and breast temperatures during the first 2 hours postpartum and to relate them to the infant's foot and axillar temperatures. ⋯ Maternal temperature rose after birth, and the rise was higher in multiparas than in primiparas. Skin-to-skin contact and early suckling increased temperature variation. Maternal temperature was related to infant foot and axillar temperatures.
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Randomized Controlled Trial Controlled Clinical Trial
Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior.
Previous reports have shown that skin-to-skin care immediately after vaginal birth is the optimal form of care for full-term, healthy infants. Even in cases when the mother is awake and using spinal analgesia, early skin-to-skin contact between her and her newborn directly after cesarean birth might be limited for practical and medical safety reasons. The aim of the present study was to compare the effects of skin-to-skin contact on crying and prefeeding behavior in healthy, full-term infants born by elective cesarean birth and cared for skin-to-skin with their fathers versus conventional care in a cot during the first 2 hours after birth. ⋯ The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby.