Msn 6008 Research

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MSN 6008 Research and Technology for Advance Nursing Practice U02a1 Research Problem Topic and Question Submitted by: Adrienne Jenkins 01/22/2012 Cesarean delivery has become the most common major surgical procedure in many parts of the world. The national rate of cesarean delivery in the United States has increased more than 50% since 1996 to 31.8% in 2007. This upward trajectory appears likely to continue in the near future (Jhang et al., 2010). The consistently high cesarean section rate has been attributed in part to maternal request. Evidence suggests that nonemergent elective cesarean delivery may have several negative outcomes for women and their newborns. There are several reasons for the increase in cesarean deliveries: delayed childbearing, increasing maternal body mass, multiple gestations pregnancies due to in vitro fertilization, low use of vaginal birth after previous cesarean (VBAC), repeated cesareans, satisfaction with a favorable birthing experience, and possible physician liabilities due to complications with vaginal deliveries. A negative birth experience has been linked to an increased risk of postpartum depression and therefore efforts to improve maternal satisfaction may also lead to improved clinical outcomes (Blomquist, 2011). Women who preferred a cesarean section were more anxious, were generally poorly informed of the risks factors, and/or overestimated the safety of the procedure (Gamble, 2001). Those who preferred cesarean delivery during the second trimester, who were older, and who had health problems before or during pregnancy were more likely to have cesarean deliveries. Identifying women who have a preference for cesarean delivery during the second trimester may increase the opportunity for intervention and thus reduce the rate of cesarean delivery (Chu 2010). What are the implications for nonemergent elective

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