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

	Mother	Baby
Safety	Decrease the risk of morbidity Reduced the number of c-sections in multigravida women Safe against high risk of uterine rupture in a second or repeated C- section case Pregnancy complications are greatly reduced in future Returning to normalcy quickly	There is a risk of injury in VBAC depending upon the fetal position and its passage during child birth
Cost	low expensive when compared to c-section	The condition of baby are usually healthy and the cost of expense is low in VBAC than C-section
Pain	Pain during labour Minimal pain after delivery in VBAC whereas in "-section the intensity of pain can be more after delivery due to incision and needs appropriate analgesics to control pain	The chance of injury to baby is possible during VBAC
Long term effects	Scar after C-section	has good immunity against infections in VBAC because of the fetus passing through mothers birth canal comes across good bacteria which can fight intestinal infections effectively The level of blood glucose can be high in the initial hours of birth due to the stress of mother during VBAC
Effects on breast feeding	Early breastfeeding is initiated in VBAC than C-section Has a good flow of milk due to the hormonal changes during the labour	baby fed at the earliest in VBAC Delat on breastfeeding initiation in C-section
Parenting	Early bond	Bonding of the baby depends on the frequency and early breastfeeding