Patient-Choice Vaginal Delivery?

Patient choice cesarean delivery: ethical issues.

PURPOSE OF REVIEW We have recently identified three salient questions within the patient choice cesarean delivery controversy. First, is performing cesarean delivery on maternal request consistent with good professional medial practice? Second, how should physicians respond to or counsel patients who request patient choice cesarean delivery? Third, should patient choice cesarean delivery be rou...

Vacuum-assisted vaginal delivery.

The second stage of labor is a dynamic event that may require assistance when maternal efforts fail to effect delivery or when there are nonreassuring fetal heart tones. Therefore, knowing how to perform an operative vaginal delivery with forceps or vacuum is vital for family physicians who provide maternity care. Vacuum is rapidly replacing forceps as the predominant instrument, but each has a...

Operative Vaginal Delivery

Operative vaginal delivery is used to achieve or expedite safe vaginal delivery for maternal or fetal indications. Examples include maternal exhaustion and an inability to push effectively; medical indications such as maternal cardiac disease and a need to avoid pushing in the second stage of labor; prolonged second stage of labor, arrest of descent, or rotation of the fetal head; and nonreassu...

Advantages of vaginal delivery.

Despite an impressive amount of effort and extensive research, our knowledge of parturition remains limited. Scientists have exhaustively investigated ‘‘the timing of birth’’; yet, we still have a limited understanding of the biologic mechanisms that control the events initiating delivery, and consequently, we lack tools to prevent these mechanisms from acting inappropriately. A multitude of fa...

The occasional vaginal delivery.