Question

Compare and contrast VBAC and repeat cesarean section for the following: safety for both mother and baby, cost, pain; long-term effects, effects on breastfeeding, and parenting.

Part 1 - PRENATAL CASE STUDIES Client Profile Esparanza is a 25-year-old, G2P1001, MHF at 36 wga. She had a previous ce sarean section with an epidural in Mexico six years ago for a breech presentation at 88 weeks gestational age. The baby weighed six pounds. She is five feet two inches tall, and her PPW was 100 pounds. She would like a vaginal birth after cesarean sec- tion (VBAC) with this pregnancy, however she saw six doctors before she found one who would even consider doing a VBAC. Case Study Esparanza seems anxious at today's prenatal visit. She tells the nurse that the baby feels like his head is up under her ribs and she fears another cesarean section for breech. The following data is obtained at this visit: Wt 125 lb FHT 140s URQ Fundal height (FH) 35 cm Fetal movement +(FM) Urine chemstrip testing: all negative No HA, vision changes No CVAT No edema

Answer 1

First delivery is a caesarean section so now should prefer caesarean section. Vaginal delivery may create risk because breech presentation. Not safe for both mother and foetus.

Safety

• Uterine contractions causes exaggerate abdominal wall which create tension result in tear because of previous surgical incision
• Following results slowing of cervical dilation
• Foetus experience asphyxia