Caesarean section,also known as C-section or caesarean delivery,is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen,often performed because vaginal delivery would put the baby or mother at risk. Reasons for the operation include obstructed labor,twin pregnancy,high blood pressure in the mother,breech birth,shoulder presentation,and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section. A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed only when medically necessary.
Childbirth,also known as labour,parturition and delivery,is the completion of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019,there were about 140.11 million human births globally. In the developed countries,most deliveries occur in hospitals,while in the developing countries most are home births.
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum,ureter,or bladder. It can result in incontinence of urine or feces. Complications may include depression,infertility,and social isolation.
Health care,or healthcare,is the improvement of health via the prevention,diagnosis,treatment,amelioration or cure of disease,illness,injury,and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine,dentistry,pharmacy,midwifery,nursing,optometry,audiology,psychology,occupational therapy,physical therapy,athletic training,and other health professions all constitute health care. It includes work done in providing primary care,secondary care,and tertiary care,as well as in public health.
Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy,underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while they are pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death,as defined by the American College of Obstetricians and Gynecologists (ACOG),are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.
Natural childbirth is childbirth without routine medical interventions,particularly anesthesia. Natural childbirth arose in opposition to the techno-medical model of childbirth that has recently gained popularity in industrialized societies. Natural childbirth attempts to minimize medical intervention,particularly the use of anesthetic medications and surgical interventions such as episiotomies,forceps and ventouse deliveries and caesarean sections. Natural childbirth may occur during a physician or midwife attended hospital birth,a midwife attended homebirth,or an unassisted birth. The term "natural childbirth" was coined by obstetrician Grantly Dick-Read upon publication of his book Natural Childbirth in the 1930s,which was followed by the 1942 Childbirth Without Fear.
The Joint Commission is a United States-based nonprofit tax-exempt 501(c) organization that accredits more than 22,000 US health care organizations and programs. The international branch accredits medical services from around the world.
Obstetrical bleeding is bleeding in pregnancy that occurs before,during,or after childbirth. Bleeding before childbirth is that which occurs after 24 weeks of pregnancy. Bleeding may be vaginal or less commonly into the abdominal cavity. Bleeding which occurs before 24 weeks is known as early pregnancy bleeding.
Atul Atmaram Gawande is an American surgeon,writer,and public health researcher. He practices general and endocrine surgery at Brigham and Women's Hospital in Boston,Massachusetts. He is a professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and the Samuel O. Thier Professor of Surgery at Harvard Medical School. In public health,he is executive director of Ariadne Labs,a joint center for health systems innovation,and chairman of Lifebox,a nonprofit that works on reducing deaths in surgery globally. On June 20,2018,Gawande was named the CEO of healthcare venture Haven,owned by Amazon,Berkshire Hathaway,and JP Morgan Chase and stepped down as CEO in May 2020,remaining as executive chairman while the organization sought a new CEO.
Caesarean delivery on maternal request (CDMR) is a caesarean section birth requested by the pregnant woman without a medical reason.
In case of a previous caesarean section a subsequent pregnancy can be planned beforehand to be delivered by either of the following two main methods:
Peter J. Pronovost is Chief Quality and Transformation Officer at University Hospitals Cleveland Medical Center,the main affiliate of the Case Western Reserve University School of Medicine. At UH,Pronovost is responsible for improving value across the health system,helping people stay well,get well and manage their most acute medical conditions. He is the clinical lead for population health and the lead for high-reliability medicine,with direct responsibility for the UH employee accountable care organization. He is also responsible for telehealth and virtual health programs serving patient and provider communities.
Healthcare in the United States is largely provided by private sector healthcare facilities,and paid for by a combination of public programs,private insurance,and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare,and a significant proportion of its population lacks health insurance.
Maternal somatic support after brain death occurs when a brain dead patient is pregnant and their body is kept alive to deliver a fetus. It occurs very rarely internationally. Even among brain dead patients,in a U.S. study of 252 brain dead patients from 1990–96,only 5 (2.8%) cases involved pregnant women between 15 and 45 years of age.
Elliott S. Fisher is a health policy researcher and advocate for improving health system performance in the United States. He helped develop the concept of accountable care organizations and championed their adoption by Medicare. The development of the Affordable Care Act was influenced by his research on disparities in healthcare spending and utilization across the United States. He has strongly supported a rapid transition from fee-for-service to pay-for-performance models in the U.S. healthcare industry. He is a tenured faculty member at Dartmouth College,where he teaches in the Masters in Public Health program.
Maternal mortality refers to the death of a woman during her pregnancy or up to a year after her pregnancy has terminated;this metric only includes causes related to the pregnancy,and does not include accidental causes. Some sources will define maternal mortality as the death of a woman up to 42 days after the pregnancy has ended,instead of one year. In 1986,the CDC began tracking pregnancy-related deaths to gather information and determine what was causing these deaths by creating the Pregnancy-Related Mortality Surveillance System. According to a 2010-2011 report although the United States was spending more on healthcare than any other country in the world,more than two women died during childbirth every day,making maternal mortality in the United States the highest when compared to 49 other countries in the developed world.
Abuse during childbirth is generally defined as interactions or conditions deemed humiliating or undignified by local consensus and interactions or conditions experienced as or intended to be humiliating or undignifying. Bowser and Hill's 2010 landscape analysis defined seven categories of abusive or disrespectful care,including physical abuse,non-consented clinical care,non-confidential care,non-dignified care,discrimination,abandonment,and detention in health facilities.
Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients,with value defined as health outcomes per unit of costs. The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg,though implementation efforts on aspects of value-based care began long before then in the 1990s. With patient value as the overarching goal,VBHC emphasis systematic measurement of outcomes and costs,restructuring provider organizations,and transitioning toward bundled payments. Within this framework,cost reduction alone is not seen as proper strategy for healthcare systems:health outcomes have to improve to enhance value. Although value-based health care is seen as a priority in many health systems worldwide,a global assessment in 2016 found many countries are only beginning to align their health systems with VBHC-principles. Additionally,several studies report incoherent implementation efforts,and there seem to be various interpretations of VBHC,both within and across countries.
Ascension is one of the largest private healthcare systems in the United States,ranking second in the United States by number of hospitals as of 2019. It was founded as a nonprofit Catholic healthcare network in 1999. Ascension also runs a pharmacy system as well as delivery under AscensionRX.
Childbirth in China is influenced by traditional Chinese medicine,state control of reproductive health and birthing,and the adoption of modern biomedical practices. There are an estimated 16 million births annually in mainland China. In 2019,the fertility rate was 1.696 births per woman.
