Understanding Birth Interventions: Gaining Deeper Insight
Let's delve into the world of birth interventions. What exactly do we mean by interventions in childbirth? Simply put, interventions encompass a variety of medical or holistic methods utilized to manage or alter the natural progression of labor and delivery.
What Are Interventions and Their Considerations?
Interventions in childbirth involve a delicate balance between risks and benefits. Some interventions are medically necessary, while others may be employed without a clear medical indication, potentially impacting both the birthing parent and the baby.
In our subsequent post, we'll delve deeper, providing you with essential tools and knowledge to make well-informed decisions throughout your pregnancy and birthing journey.
Let's talk about a few common interventions and their implications:
Induction of Labour is the artificial initiation of labour. It's a recommended procedure when there are medical concerns for the mother or babe's health or if the pregnancy extends beyond 41+ weeks. There are both holistic and medical ways to induce labour.
Some holistic methods include nipple stimulation (such as pumping), acupuncture, "castor oil concoction," and sex (with ejaculation/prostaglandin to soften the cervix).
Medical inductions can be pharmacological or mechanical, including cervical sweep, foley balloon, prostaglandin orally or vaginal suppository, and IV oxytocin.
While induction can be necessary for medical reasons like preeclampsia, placental insufficiency, or fetal growth restriction, to name a few, it's often overutilized. Inappropriate reasons for induction, such as going past the ‘due date’, "suspected large baby”, healthcare provider or parental agenda (mom ”done being pregnant”) , can lead to increased risks for both the mother and baby. This overuse might trigger a cascade of unnecessary medical interventions that might have otherwise been avoided. Ensuring induction is based on genuine medical necessity is crucial for the safety and well-being of both the mom and babe.
Monitoring During Labor allows your care team to gauge your baby's response to labour. It's done intermittently with a Doppler, continuously using sensors on your abdomen, or internally via a small electrode on your baby's head.
During active labor, it's essential to monitor the baby's well-being. Standard practice in normal situations is intermittent auscultation via Doppler, listening every 15-30 minutes following a contraction. Continuous monitoring may be necessary in certain situations, such as the use of oxytocin, adding challenges to labor but prioritizing the baby's well-being. Ideally, regardless of the monitoring method, you should have the flexibility to move, walk, change positions, or use a shower or tub if feasible, however the technology doesn't always allow this to work the way we hope.
Continuous fetal monitoring solely out of curiosity isn't safer for babies when there's no medical indication.
Epidural, commonly used for pain relief during labor, numbs the lower body. While beneficial, it's essential to understand the associated risks. In some settings, epidurals might be over-utilized, which can create discomfort among medical staff when women opt for natural labour. Epidurals have benefits but can lead to complications such as not working as effectivley as hoped, slowed contractions, difficulty walking or with position changes which in turn can lead to uneven dilation of the cervix, less-ideal baby position, and babies being uncoordinated while learning to feed in the first 24 hours after birth.
Understanding the risks and benefits is crucial before opting for an epidural. It's not meant to dissuade its use but to provide informed knowledge about its potential outcomes.
Artificial Rupture of Membranes (AROM), also referred to as breaking the water, AROM involves manually breaking the amniotic sac to initiate or expedite labour. It's utilized when labor progress is slow or to induce contractions, by allowing babe’s head to descend and apply pressure to the cervix yet. Once the "water breaks," the protective barrier between the outside world and the baby diminishes, heightening the risk of infection for both the mother and baby. This risk significantly increases with the number of vaginal exams performed. It's important to be mindful of these risks and discuss any concerns and other potential complications with your healthcare provider when considering AROM
Pitocin, a synthetic form of oxytocin, is utilized to induce or augment labor. Administered via an IV, it initiates or intensifies the frequency and strength of contractions. While Pitocin can be a necessary tool, it may lead to stronger contractions and an increased need for pain relief.
Sometimes, the need for Pitocin augmentation follows the use of an epidural, as contractions slow down due to the body's relaxation, or in extended labor situations where additional assistance is required. When Pitocin is used, continuous fetal monitoring becomes necessary to ensure the baby copes with labor
Having a detailed conversation with your healthcare provider (HCP) is important. Understanding the benefits and risks of Pitocin use, as well as exploring potential alternatives that may be better suited to your situation, empowers you to make an informed choice regarding your labor.
Stay tuned for our upcoming posts, where we'll guide you on accessing comprehensive information necessary for informed decision-making during pregnancy & birth.
Knowledge empowers choices. Let's embark on this journey together, well-informed and empowered.