Should since last birth), postdate pregnancy, maternal

    Should
be made conduct an individual assessment 
in women with factors that increase the risk of uterine rupture. Factors
that are likely to increase the risk of uterine rupture include a short
interval (less than 12 months since last birth), postdate pregnancy, maternal
age 40 or more  obesity,  pre-labor Bishop score and macrosomia .A
recent retrospective study included  3176
patients  assessed the safety of women
undergoing VBAC with a short  interval.
The study concluded that a short 
interval (less than 12 months) is not a risk factor for  complications such as uterine rupture and
maternal death, but it is for preterm birth. There is a need for more data
before making sure of the safety of this approach. There is uncertainty in how
to integrate this knowledge into prenatal counseling, and  the presence of these risk factors does not
contraindicate trial VBAC. However, you can consider such factors during the
decision-making process, especially when considering induction or augmentation
of VBAC labor (Kessous
& Sheiner, 2013).

 

Implication for Nursing and Health Policy
in Jordan

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     Cesarean
rates in Jordan are still increasing . The proportion of Cesarean  may be unnecessary or undesirable. Maternal
mortality  after CS is 10 times greater
than vaginal birth in developing countries . this is of concern and requires immediate action by
hospital administrators ,health care professionals  and policymakers. At the national level,
maternity services policy  to encourage
evidence -based practice, and to devote the rights of women,  and require adequate systems to ensure
quality, including a review of the use of obstetric procedures. At the level of
health and institutional service providers, focus on improving the quality of
the provision of information and emotional care provided to laboring women will
increase VBAC.

 

     Providing
continuing professional development to inform practitioners of women’s rights,
and teach women how to make decisions about mode of delivery ,as well as the
involvement of women in decision-making, will facilitate respectful care.
Informing women about mode of birth and birth procedures may help them to
better understand and participate in the decision-making process. These factors
significantly increase in the uptake of VBAC births. It can help women to learn
about the safety, success rates, risks ,potential and benefits of VBAC births.
can help women take a more informed decision. should be provided decision-aids
and information programs during pregnancy for all pregnant women in prenatal
institution ,they do not affect the rate of VBAC but they decrease women?s decisional conflict and increase their knowledge about possible modes
of birth. Hospitals should have guidelines to promote access to VBAC and
actively monitor and improve quality of care for women who choose labor after
cesarean. Development of national evidence- based policies and quality
assurance systems would help to decrease the rate of unnecessary cesareans, and
give pay more attention to respect for women’s preferences during labor and
birth.

 

Conclusion and Recommendation

 

     Every year 1.5 million women
have cesarean birth, and this population is still increasin. This paper conclud
that VBAC is a reasonable and safe choice for the majority of women with
privousr cesarean. Furthermorer, there is evidence of serious harms relating to
repated  cesareans. Women who have had a
privous cesarean face many obstacles when choosing birth mode . There are many
factors that affect the availability of a VBAC birth which makes it difficult
for mothers to access the facility and / or provider that will provide this
service. The lack of sufficient access to facilities providing VBAC birth
affect  a mother’s autonomy to choose how
she wants to birth. Promoting education for mothers about making decision can
help increase the uptake of a VBAC birth and help to restore a mothers’
autonomy through the use of decisional aid .

 

     Women making decisions about
mode of birth after a previous cesarean birth can benefit from access to
decisional-aids by reducing their anxiety and 
decisional conflict and by increasing their knowledge about the
potential risks and benefits. These factors can greatly increase the uptake of
VBAC births. It can help women to 
identify safety, success rates, risks and potential benefits of VBAC
births and can help women make a more informed decision.

 

     Women with a privos
cesarean  need to be provide information
on both modes of birth available . Women have a right to choose and a right to
know the benefits and  risks  of both modes of birth so that they can make
an informed- decision. The doctor and the women need to work together in the
informed decision process and doctor bias needs to be removed. Overall, the
improvement of informed consent process by reducing bias and increasing patient
education can help to increase  the
uptake of VBAC births

 

 

 

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