Reproductive and Surgical Integrity

While Rosenthal (2006) suggests that there have been instances where women have made uninformed choices in prenatal procedures, patients due for delivery are by surgical ethics in obstetric practice required to make informed choices on the obstetrical procedures and medication that are to be used on them. Although there are risks associated with vaginal after birth cesarean (VBAC), several studies show that about 3 to 4 out of 5 women who have experienced caesarian delivery can successfully give birth through vaginal delivery.

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  1. Apart from the advantage of having the gratification of achieving vaginal birth, it is safe for the patient to undergo a vaginal birth. The health risks are however increased for patients who have been exposed to cesarean for a number of times. Additionally, the ultrasound results show that the baby is on vertex position, which is the safest position for normal delivery. Her risk of experiencing the rupture of the uterine scar is very low since her previous cesarean resulted to a low transverse incision.
  2. I would advise her to keep checking on her sugar levels test. I would recommend that cesarean delivery be done if she has a fetal weight of at least 5,000 grams if she does not suffer diabetes and at least 4,500 grams in case she has diabetes.
  3. There is always a risk of the baby changing its position prior to birth. This may occur if the patient turns out to have excess amniotic fluid and consequently, the baby may assume a breech position. The risk to the patient includes having a second cesarean delivery. Under this condition, vaginal after birth cesarean (VBAC) is still possible on attempt by a doctor to push the baby using his hands into vertex position. This should be done before the bursting of the amniotic membrane.

 

References

Torres, J. M., & De Vries, R. G. (2009). Birthing Ethics: What Mothers, Families, Childbirth Educators, Nurses, and Physicians Should Know About the Ethics of Childbirth. The Journal of Perinatal Education18(1), 12–24. http://doi.org/10.1624/105812409X396192

Rosenthal MS. (2006). Socioethical issues in hospital birth: Troubling tales from a Canadian sample. Sociological Perspectives, 49(3): 369–390