Cesarean Birth

Mary’s 1st baby was delivered via cesarean section due to the baby being in the breech position.  She is requesting a VBAC (vaginal birth after cesarean section) for this her second baby.  By ultrasound, advice this baby is in the vertex position.  IN reviewing the postoperative report from her first surgery- It is noted that she had a low segment transverse uterine incision. What are your thoughts on having a vaginal birth with this second baby? What education can you provide to her? What is the risk to her and does this change your thoughts and advice? Mary is not progressing in labor appropriately and the decision has need made to move forward with a cesarean section.  She understands, agrees, and signs the consent for surgery.  You will again accept this patient I recover- or initial postpartum period. Recognize that you will complete the BUBBLEHE assessment. In addition, the abdominal assessment will also include an assessment of the incision.  Note the type of dressing used to cover the incision.  Is it approximated?  Is there any bleeding? Does she have bowel sounds?  Is the abdomen distended?  Is it soft?  Do you assess the fundus and where is it located? Should it be firm?

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