Evidence-Based Recommendations for Nursing Education for Prevention of Primary Cesarean Sections: A Best Practice Approach

Abstract

The purpose of this thesis was to develop a best practice pocket guide to prevent primary cesarean sections. Cesarean section accounts for one-third of deliveries in the United States (Branch & Silver， 2012). Cesarean section rates have skyrocketed from 20.7% in 1996 to 32.8% in 2012 (Osterman & Martin, 2014). The major driver for the increased rates is the rise in primary cesarean sections, which accounts for 60% of the increase (Osterman & Martin, 2012). Compared to vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity (Chapman & Durham, 2010). Although in certain cases cesarean delivery is best for the mother and the fetus, in low-risk pregnancies, cesarean section may pose greater risks compared to vaginal delivery, especially in relation to future pregnancies (Caughey, Cahill, Guise, & Rouse, 2014; Berghella, 2014). The most effective method to reduce overall morbidity is the prevention of the first cesarean (Caughey et al., 2014). Implementing an evidence-based pocket guide for nurses and certified childbirth educators will provide them with best practice recommendations in order to prevent primary cesarean sections. The pocket guide can also be utilized by providers in educating mothers regarding cesarean sections, to aid them in making informed decisions.