Abstract

Mothers and their unborn are a vulnerable population. Despite overwhelming advances in health care and technology, the United States' indicators of maternal and infant mortality are dismal. To lay the foundation for a research trajectory ultimately aimed at improving the experiences and outcomes of pregnancy, two research projects were undertaken to investigate the impact of practice patterns for elective delivery on the current obstetrical paradigm. A qualitative clinical case study explored antepartum recommendations for cesarean section following the implied diagnoses of inevitable labor dystocia secondary to maternal physical stature in two healthy women. The women's perspectives on their experiences of leaving the traditional medical model of obstetrical care, along with their actual antepartum and intrapartum medical record data should spur conversation between all perinatal health care stakeholders. To obtain a broad view of the current obstetrical milieu, a large secondary data analysis was conducted on two years of birth certificate data from 2008-2009 in one large southwestern United States county with high delivery rates. The study was designed specifically to explore the impact of obstetrical practice patterns across hospitals on the phenomenon of early term birth at 37-38 weeks gestation. Early term infants have consistently been reported as incurring higher rates of neonatal morbidity and mortality compared to their full term counterparts. Differences in rates of early term births across hospitals resulting from elective deliveries revealed the need for continuing education of health care providers, nurses and the child-bearing population.

Date of publication

Spring 4-30-2012

Document Type

Dissertation

Language

english

Persistent identifier

http://hdl.handle.net/10950/72

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