Abstract:
:Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a taxonomy of considerations that should inform a responsible framework for guideline development and highlight critical distinctions between types of guidelines that have been blurred in the past. We then forward 2 central claims. First, in otherwise uncomplicated birth after a single previous cesarean, both vaginal birth after cesarean and repeat cesarean should be regarded as reasonable options; women, rather than policymakers, providers, insurance carriers, or hospitals, should determine delivery approach. Second, in complicated cases, providers and policymakers should carefully calibrate the strength of evidence to ensure differential risk and cost are adequate to justify directive guidelines given important variations in values women bring to childbirth.
journal_name
Semin Perinatoljournal_title
Seminars in perinatologyauthors
Lyerly AD,Little MOdoi
10.1053/j.semperi.2010.05.007subject
Has Abstractpub_date
2010-10-01 00:00:00pages
337-44issue
5eissn
0146-0005issn
1558-075Xpii
S0146-0005(10)00053-4journal_volume
34pub_type
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journal_title:Seminars in perinatology
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journal_title:Seminars in perinatology
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
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journal_title:Seminars in perinatology
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journal_title:Seminars in perinatology
pub_type: 杂志文章
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journal_title:Seminars in perinatology
pub_type: 杂志文章
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:Seminars in perinatology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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