How does delivery method

influence maternal and

newborn complications?
NURS 3749 Nursing Research
Kayla Sterling, Caitlin Hanley, Summer Neely, and
Sabrina Nichols
Dr. Valerie O’Dell
Introduction - Research Question
Meaning
● Analysis of how delivery method, vaginal or cesarean,
influences the outcomes of mothers and newborns.

● Outcomes are defined as a result.

○ A risk or a benefit of each delivery method.

● Each delivery method comes with its own risks and benefits.
Introduction - Outcomes explored
Including but not limited to:

○ Surgical site infections

○ Maternal psychological response
○ Perineum preservation
○ Feeling of control
○ Trauma
○ Immediate ability for the infant to thrive
○ Long-term diseases
○ Breastfeeding, etc.
Maternal Risks - Cesarean Delivery
● Surgical Site Infections (SSI)
○ “Post Cesarean infection is a major
contributor to maternal death…”
○ SSI can prolong hospitalization,
increase health care costs, and
other socioeconomic implications.
○ It can be frustrating for the mother
during the recovery period to be
battling an infection and care for a
newborn. Result - physical and
emotional stressors.
Maternal Risks - Cesarean Delivery
● Negative Effect On Mother’s Emotions
○ “The psychosocial outcomes of an unplanned or emergency cesarean
birth are usually more pronounced and negative…”
○ Kjerullf and Brubaker (2017) concluded that women who had an
unplanned cesarean birth had the least positive feelings overall.
○ These mothers were more likely to feel disappointed and like a failure
compared to the mothers who had a spontaneous vaginal delivery.
○ These women did not feel proud of themselves.
Maternal Benefits - Cesarean Delivery

● Perineal Preservation
○ Women who undergo a cesarean delivery do not
have to experience any possible tearing of the
perineum.
○ There will be no need for an episiotomy, or
repairing of the perineum from any lacerations or
tears that could occur during the second stage of
labor (i.e pushing),
○ Episiotomies can become extensive depending on
Maternal Benefits - Cesarean Delivery

● The feeling of control

○ A psychological benefit for the mother
experiencing a cesarean delivery
○ This would happen with a planned cesarean
delivery
○ The mothers will be aware of the procedure and
might feel they have the birth process under
control.
○ Rather during vaginal births, mothers often start
 Maternal Risks- Vaginal Delivery
● Urinary Incontinence
○ Stress incontinence is main type (caused
by coughing, sneezing, pressure, etc.)
○ Up to 12 months after delivery
■ Affects them the most in the first 6 weeks after
delivery
○ Interferes with activities of daily living
(ADL’s)
Maternal Risk- Vaginal Delivery
● Pelvic Floor Dysfunction
○ “Pelvic floor prolapse comprises disorders that include

stress urinary incontinence (SUI), overactive bladder,

pelvic organ prolapse (POP), and fecal incontinence”

(Araujo, Coelho, Stahlschmidt, and Juliato, 2018, p. 639).

○ Maternal expulsive efforts, damage to certain muscles,

floor muscles being stretched during fetal crowning, Levator ani muscle
highlighted
 Maternal Benefits- Vaginal Delivery

● Breastfeeding
○ Much higher prevalence
○ Sense of empowerment and
bonding
○ Faster involution of uterus
and lower risk of postpartum
hemorrhage
 Maternal Benefits- Vaginal Delivery
● Fertility
○ Healthier babies in the short and
long term
○ 10% more likely to have children
○ Healthier children in the short and
long term
Maternal Benefits- Vaginal Delivery
● Cost Effectiveness
○ Cost of birth itself
■ “Charges for uncomplicated cesarean births were $5,845 (68%) higher

than charges for uncomplicated vaginal births” (Transforming

Maternity Care, n.d.)- Average across the United States.

■ At University Hospitals, Rainbow Babies and Children’s hospital, the

cost for a normal delivery is $2,872. The cost for a c-section is

$6,291.
● Anesthesia, doctor fees, etc. are not factored into that cost
○ Length of hospital stay
Infant Risks - Cesarean Section

● Decreased respiratory function

○ Leading unintended effect of c-sections
○ More likely to be placed on mechanical ventilation
○ Asthma
● Digestive system disorders
● Higher neonatal and post-neonatal death
● “At birth we find that infants delivered by c-section have higher Apgar scores
and lower rates of birth-related injuries but are more likely to be placed on
mechanical ventilation, consistent with previous studies which point to
decreased lung function as a leading unintended effect of c-section.”
Infant Risks - Cesarean Section
● Card, Fridizia, and Silver concluded:

“Across the board a general finding is that babies delivered by c-

section fare worse: higher neonatal and post-neonatal death; elevated
risks of respiratory system problems including asthma; evidence of
digestive system disorders, and lower rates of breastfeeding”
Infant Risks - Cesarean Section
● Study done by Hobbs, Mannion, McDonald, Brockway, and Tough (2016)
● 3,021 moms
● Chi-squares & cross-tabulation tests
○ More women who delivered by planned c-section had no intention to breastfeed or did not initiate
breastfeeding when compared to women with vaginal births
○ Women who delivered by emergency c-section were found to have a higher proportion of
breastfeeding difficulties
○ Women who delivered with a planned c-section were more likely to discontinue breastfeeding
before 12 weeks postpartum compared to those who delivered vaginally
● “Emergency and planned c-sections may adversely affect breastfeeding initiation, milk
supply and infant breastfeeding receptivity compared to vaginal deliveries.”
● Reached the conclusion that planned c-sections are associated with early breastfeeding
cessation
Infant Benefits - Cesarean Section

● Higher Apgar scores

● Lower rates of birth-related injuries
● Life-saving procedure
Vaginal Birth: Potential complications for
the Baby
● Forceps Induced Birth Injuries ● Other
○ Bruising of the fetal face/head ○ All types of Intracranial
○ Facial Palsy Hemorrhages
○ Subdural Hematoma ○ Complicated breech
● Vacuum Induced birth injuries delivery
○ shoulder Dystocia
○ Caput Succedaneum
○ Fractures
○ Cephalohematoma ○ Brachial Plexus Injury
○ Scalp Lacerations
○ Subdural Hematoma
Vaginal Birth: Benefits for the Baby

● Babies are anatomically structured

to be born in this way
● Trauma endured resolves quickly in
the resilient infant
Immediate Benefits

● Less breastfeeding problems

● Immediate skin-to-skin contact with the mother
● Immediate bonding
● Gut microbiota attained from birth canal
● ↓ incidence of hypothermia, jaundice, respiratory infections,
GI disorder, and eczema
● Improved lung function, better metabolism, less altered
pressures
Long-term benefits

● ↓ risk of obesity, diabetes, and

asthma through life
● Gut microbiota attained gives them
↓ risk for future allergies and
immunological problems
Conclusion
● There are Benefits and risks seen with both modes of delivery
● the research shows that vaginal birth is more favorable, due to:
○ More favorable long-term and immediate outcomes for mom and baby
○ Quicker recovery from complications for vaginal births than c-sections
○ resilient babies
○ Natural and safe process
● Ultimate goal is a safe mom and baby, regardless of the mode of delivery!