Normal birth might be painful but there is medicine to stop the pain from increasing or from you feeling it. Most women prefer normal birth than anything because they are aware of any complications. 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. Women are starting to oppose to c-sections because of the recovery aftermath. Most women say that recovering from a c-section hurts worse than getting hit by a large bus on the highway. Breastfeeding can be challenging in the days after a c-section because of the pain from a healing incision. That may cause may issues for women who plan on breastfeeding are currently are in the process the of doing so. It is well accepted that, for a long column, the effect of end conditions on the local buckling load can be ignored due to its less impact. However, such an assumption may be inappropriate for a stub column. According to the available literature, the research dealt with such a problem was found to be quite rare. In this scenario, this paper aims to derive novel local buckling formulae for cold-formed C-section column, which takes both the effects of cross-section plate element interactions and end conditions into account. Initially, an equivalent simplified web local buckling model was proposed, in which the cross-section plate element interaction of the flanges and the lips on the web were modeled by rotational springs and the loaded edges were assumed to be uniformly compressed and to be simply supported or fixed. Subsequently, based on the energy method and the theory of Bleich, explicit expressions for the local buckling load of the column were derived. Further, simplifications to the rigorous formulae were made to allow them to be easily used by the engineers. Finally, in order to verify the accuracy of the derived formulae, the results obtained from the derived formulae were compared with the numerical results obtained from the computer software CUFSM. The comparison results show that the formulae proposed in this paper can be used successfully in estimating the local buckling loads for pin-ended or fix-ended C-section columns with a practical length. Sometimes the decision by an obstetrician to perform a C-section is unplanned, and it is done for emergency reasons because the health of the mother, the baby, or both of them is in jeopardy. This may occur because of a problem during pregnancy or after a woman has gone into labor, such as if labor is happening too slowly or if the baby is not getting enough oxygen. Some C-sections are considered elective, meaning they are requested by the mother for non-medical reasons before she goes into labor. A woman may choose to have a C-section if she wants to plan when she delivers or if she previously had a complicated vaginal delivery. Although C-sections are generally considered safe and, in some situations life saving, they carry additional risks compared with a vaginal birth. They are a major surgery and involve opening up a pregnant woman’s abdomen and removing the baby from her uterus because a vaginal birth is considered too dangerous or difficult. Because C-sections in first-time mothers often lead to repeat C-sections in future pregnancies, a vaginal birth is generally the preferred method of delivery. It’s the way two in three babies in the United States are born. In general, women say that giving birth vaginally feels like more of a natural experience, said Dr. Allison Bryant, a maternal fetal medicine specialist at Massachusetts General Hospital in Boston. Women may feel as if they are giving birth the way nature intended them to, she added. Regardless of how they decide to give birth, “women should be as informed as possible about their childbirth options, so they can have a voice in the process, advocate for what they want and make the most informed choice,” Bryant said. Here is more information about the pros and cons of the two birthing methods. Going through labor and having a vaginal delivery is a long process that can be physically grueling and hard work for the mother. But one of the benefits of having a vaginal birth is that it has a shorter hospital stay and recovery time compared with a C-section. Although state laws vary, the typical length of a hospital stay for a woman following a vaginal delivery is between 24 and 48 hours. If a woman is feeling up to it, she may elect to leave the hospital sooner than the allowable time period permitted in her state, Bryant told Live Science. Women who undergo vaginal births avoid major surgery and its associated risks, such as severe bleeding, scarring, infections, reactions to anesthesia and more longer-lasting pain. And because a mother will be less woozy from surgery, she could hold her baby and begin breastfeeding sooner after she delivers. Cons of vaginal birth for the mother During a vaginal delivery, there is a risk that the skin and tissues around the vagina can stretch and tear while the fetus moves through the birth canal. If stretching and tearing is severe, a woman may need stitches or this could cause weakness or injury to pelvic muscles that control her urine and bowel function. Some studies have found that women who have delivered vaginally are more likely to have problems with bowel or urinary incontinence than women who have had C-sections. They may also be more prone to leak urine when they cough, sneeze or laugh. After a vaginal delivery, a woman may also experience lingering pain in the perineum, the area between her vagina and anus. Pros and cons of vaginal birth for the baby One advantage for the baby of a vaginal delivery is that a mother will have more early contact with her baby than a woman who has undergone surgery, and she can initiate breastfeeding sooner, Bryant said. During a vaginal delivery, muscles involved in the process are more likely to squeeze out fluid found in a newborn’s lungs, Bryant said, which is a benefit because it makes babies less likely to suffer breathing problems at birth. Babies born vaginally also receive an early dose of good bacteria as they travel through their mother’s birth canal, which may boost their immune systems and protect their intestinal tracts. If a woman has had a long labor or if the baby is large and delivered vaginally, the baby may get injured during the birth process itself, such as having a bruised scalp or a fractured collarbone, according to the Stanford School of Medicine. Pros of C-section for the mother There are not a lot of advantages to having a C-section if a woman is eligible to have a vaginal delivery, Bryant said. However, if a pregnant woman knows that she will need a C-section, a surgical birth can be scheduled in advance, making it more convenient and predictable than a vaginal birth and going through a long labor. Cons of C-section for the mother A woman who has had a C-section typically stays in the hospital longer, two to four days on average, compared with a woman who has a vaginal delivery. Having a C-section also increases a woman’s risk for more physical complaints following delivery, such as pain at the site of the incision and longer-lasting soreness. Because a woman is undergoing surgery, a C-section involves an increased risk of blood loss and a greater risk of infection, Bryant said. The bowel or bladder can be injured during the operation or a blood clot may form, she said. The recovery period after delivering is also longer because a woman may have more pain and discomfort in her abdomen as the skin and nerves surrounding her surgical scar need time to heal, often at least two months. Women are three times more likely to die during Caesarean delivery than a vaginal birth, due mostly to blood clots, infections and complications from anesthesia, according to a French study. Once a woman has had her first C-section, she is more likely to have a C-section in her future deliveries, Bryant said. She may also be at greater risk of future pregnancy complications, such as uterine rupture, which is when the C-section scar in her uterus ruptures, and placenta abnormalities. The risk for placenta problems continues to increase with every C-section a woman has. Pros and cons of C-section for the baby Babies born by Caesarean section may be more likely to have breathing problems at birth and even during childhood, such as asthma. They may also be at greater risk for stillbirth. During a C-section, there is a small risk that a baby can get nicked during the surgery, Bryant said. Some studies have also suggested a link between babies delivered by C-section and a greater risk of becoming obese as children and even as adults for reasons that remain unclear. One possibility is that women who are obese or have pregnancy-related diabetes may be more likely to have a C-section. It has been suggested that the effect of the development of an artificial womb on the mother–child relationship is a vital question that should be investigated as thoroughly as possible before such equipment becomes available. In the present exploratory study, assuming that there is an association between prenatal and postnatal attachment, a structured interview of open-ended questions was used to provide an initial insight into women’s perceptions on this theme. A convenience sample of 20 Israeli women reflected and described their views of concepts such as natural womb, pregnancy, childbirth and artificial womb. While women’s natural wombs were seen by the sample as the symbol of femininity, intimacy, and tenderness and a safe haven for the fetus, the idea of an artificial womb raised feelings of shock, detachment, and possible harm to the mother–child relationship. Still, despite their fear of the disadvantages of the possible use of an artificial womb, the majority of the sample would approve its use were there no alternative means of achieving motherhood. The findings are discussed in view of the processes of bonding between mother and child in attachment theory and in the context of the Israeli society. Gujarat, a western state of India, has seen a steep rise in the proportion of institutional deliveries over the last decade. However, there has been a limited access to cesarean section (C-Section) deliveries for complicated obstetric cases especially for poor rural women. C-section is a lifesaving intervention that can prevent both maternal and perinatal mortality. Poor women bear a disproportionate burden of maternal mortality, and lack of access to C-section, especially for these women, is an important contributor for high maternal and perinatal mortality in resource limited settings. To improve access for this underserved population in the context of inadequate public provision of emergency obstetric services, the state government of Gujarat initiated a public private partnership program called “Chiranjeevi Yojana” (CY) in 2005 to increase the number of facilities providing free C-section services. This study aimed to analyze the current availability of these services in three districts of Gujarat and to identify the best locations for additional service centres to optimize access to free C-section services using Geographic Information System technology. Methodology: Supply and demand for obstetric care were calculated using secondary data from sources such as Census and primary data from cross-sectional facility survey. The study is unique in using primary data from facilities, which was collected in 2012–13. Information on obstetric beds and functionality of facilities to calculate supply was collected using pretested questionnaire by trained researchers after obtaining written consent from the participating facilities. Census data of population and birth rates for the study districts was used for demand calculations. Location-allocation model of ArcGIS 10 was used for analyses. Results: Currently, about 50 to 84% of populations in all three study districts have access to free C-section facilities within a 20km radius. The model suggests that about 80–96% of the population can be covered for free C-section services with addition of 4–6 centres in critical but underserved regions. It was also suggested that upgrading of public sector facilities with minimal investment can improve the services. Conclusion: This study highlights utility of Geographic Information System technology for planning service centres to optimize access to vital lifesaving procedure such as C-section. Although the location allocation methodology has been available for decades, it has been used sparsely by public health professionals. This paper makes an important contribution to the literature for use of the method for planning in resource limited settings. The objective of the study was to compare the change in diastolic function, E/A ratio, in response to prolonged exercise in low birth weight and normal birth weight individuals. Using a case–control study design, 23 students of the University of Zimbabwe College of Health Sciences who had neonatal clinic cards as proof of birth weight were recruited into the study. Measurements of diastolic function, E/A ratio, were obtained using an echocardiogram before and after 75 minutes of exercise. Among the cohort, seven had low birth weight – <2500 g, three female patients and four male patients – and 16 had normal birth weight – six female patients and 10 male patients). The mean age was 20.7±3.3 years. After prolonged exercise for 75 minutes of running on a treadmill, decreases in diastolic function, E/A ratio, were significantly greater in low birthweight than in normal birth weight individuals (0.48±0.27 versus 0.19±0.18 p<0.05, respectively). There was a significant association between low birth weight and exercise-induced cardiac fatigue (the ?2 test p<0.05, odds ratio 4.64, 95% confidence interval 1.19–18.1). We conclude that low birth weight is associated with exercise-induced diastolic dysfunction in young adults. In Ethiopia, 20,000 women die each year from complications related to pregnancy, childbirth and post-partum. For every woman that dies, 20 more experience injury, infection, disease, or disability. "Maternal near miss" (MNM), defined by the World Health Organization (WHO) as a woman who nearly dies, but survives a complication during pregnancy, childbirth or within 42 days of a termination, is a proxy indicator of maternal mortality and quality of obstetric care. In Ethiopia, few studies have examined MNM. This study aims to identify determinants of MNM among a small population of women in Tigray, Ethiopia. Methods: Unmatched case-control study was conducted in hospitals in Tigray Region, Northern Ethiopia, from January 30-March 30, 2016. The sample included 103 cases and 205 controls recruited from among women seeking obstetric care at six (6) public hospitals. Clients with life-threatening obstetric complications, including hemorrhage, hypertensive diseases of pregnancy, dystocia, infection, and anemia or clinical signs of severe anemia (in women without hemorrhage) were taken as cases and those with normal obstetric outcomes were controls. Cases were selected based on proportion to size allocation while systematic sampling was employed for controls. Binary and multiple variable logistic regression ("odds ratio") analyses were calculated at 95% CI. Results: Roughly 90% of cases and controls were married and 25% experienced their first pregnancy before the age of 16 years. About two-thirds of controls and 45.6% of cases had gestational ages between 37–41 weeks. Among cases, severe obstetric hemorrhage (44.7%), hypertensive disorders (38.8%), dystocia (17.5%), sepsis (9.7%) and severe anemia (2.9%) were leading causes of MNM. Histories of chronic maternal medical problems like hypertension, diabetes were reported in 55.3% of cases and 33.2% of controls. Women with no formal education AOR = 3.2;95%CI:1.24, 8.12, being less than 16 years of age at first pregnancy AOR = 2.5;95%CI:1.12,5.63, induced laborAOR = 3.0; 95%CI:1.44, 6.17, history of cesarean sectionAOR = 4.6; 95% CI: 1.98, 7.61 or chronic medical disorderAOR = 3.5;95%CI:1.78, 6.93, and women who traveled more than 60 minutes before reaching their final place of careAOR = 2.8;95% CI: 1.19,6.35 had higher odds of experiencing MNM. Conclusions: Macro-developments like increasing road and health facility access as well as expanding education will all help reduce MNM. Work should be continued to educate women and providers about common predictors of MNM like history of C-section and chronic illness as well as teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. Targeted follow-up with women with history of chronic disease and C-section could also help reduce MNM. To validate the prediction model for successful vaginal birth after cesarean delivery (VBAC) based on variables easily obtainable at the first antenatal visit, in a Spanish population.
