Planning a hospital birth can be a daunting task, especially when you are a first time mom. Even for moms who already have children, the planning and preparation mentally, physically, and logistically can be an overwhelming experience. If you are planning on having a hospital birth there are many procedures that are considered “routine” that may be performed without your explicit consent because these are deemed as necessary and typical in a hospital.
As with any medical procedure, you have a right to be informed and consent or decline anything your doctors suggest, or even push for you to agree to. Knowing what these interventions are and the purpose of such procedures before you go into labor will help you make an informed decision prior to being overwhelmed by the imminent arrival of your bundle of joy. Unfortunately, here in America labor and delivery are viewed by the medical community as an accident waiting to happen and many of the interventions are aimed at reducing the chances of problems, as well as convenience for the staff. Don’t get me wrong, I’m not bashing the hospital staff: there are many OBs and nurses who will respect your wishes. By educating yourself and adding your choices about interventions to your birth plan, (and hiring a doula,) you stand a much better chance of having your wishes respected.
So what is an “intervention”?
Interventions are defined by the dictionary as “to come between two things, to modify or hinder” (paraphrased from www.dictionary.com). Many people in the birthing community define birthing interventions as anything that is not a natural part of the labor and delivery process; interventions are often pushed by hospital staff for the presumed ease of managing labor. Many people also feel that even minor interventions can create a domino effect leading to more interventions. For example, a woman who is in first stage labor and is not dilating may have her membranes stripped. Contractions from the stripping of membranes are often reported by women as being more intense than contractions that began naturally. The intensity of the contractions leads to a pain and the consideration of an epidural, which has the potential side effect of slowing early labor. If labor does not progress, the hospital staff may begin to push for a c-section and cite the increased risk of infection and fetal distress. These reasons are understandable in theory; however, had the mom been allowed to labor naturally as her body needed to, the increased risk of infection and fetal distress would not be a concern. It’s a slippery slope, and unfortunately the farther down one travels, the more quickly the onslaught of interventions may be deemed “necessary” by the hospital staff.
I have compiled a list of many of the common interventions and a brief description of the benefits and drawbacks from each. A Google search will also yield a number of results, however be careful when reading about these interventions on medical websites. I’d like to believe that OB’s have the best interest in the mamas and babies they are trying to help, but some OBs and hospitals who provide the information may provide misleading information. As usual, I’ve included links to various sites for you to read more. While I’m not usually a Wikipedia person, I found that the description of various medications I discuss was much more understandable for those without medical training than some of the medical sites.
There are a few different methods of induction that may also be used as procedures to quicken a slow to progress labor. With all forms of medical induction, EFM or IFM is highly recommended (and usually required in hospitals) due to the increased risks of uterine rupture and fetal distress.
Interventions During Labor
There are a number of interventions that may be used once labor starts. While EFM and IFM will continue throughout the duration of labor (if done at all), the following interventions are common during active or second stage labor.
Perhaps the most intense topic, (aside from c-sections) about labor and delivery is the management of pain. Many moms who birth without pain medication will report that the experience of labor and delivery is intense, but was easier to manage by their ability to remain medication free so they could walk through contractions, get in a birth tub or pool, and find a comfortable position on their own. With almost any pain medication, an IV is typically required to ensure the mother remains hydrated and that medication can be administered quickly to counteract any adverse reactions to the medications. The mother will also typically need to remain within the confines of her hospital bed in order to monitor the baby for distress (a potential side effect of pain medication).
Interventions During the Pushing Phase
Can you believe we are only halfway done with common hospital interventions? Well we’ve made our way through most of the common labor interventions and we’re on to interventions that usually occur late in labor or during the pushing and delivery phase.
There are a number of procedures that are common to perform on newborns. While this is not a complete list, these are many of the common procedures performed in hospitals that may or may not occur without your explicit consent. Having a birth plan and discussing these with your OB, the hospital staff, and pediatrician before birth will help you ensure that your wishes are respected.
Wow! All this can happen in the matter of one day, perhaps even just a few hours for a mother and baby who have a short labor! While this is not a complete list of every intervention used, it should give you a good starting point about what to discuss with your provider. Many people don’t see some of these things as true “interventions,” such as placement of the baby after birth or suctioning. Those in the natural birth community understand and recognize that there are instances where some of these things may be necessary to protect both the mother and baby, but routine use of these interventions may be inappropriate because “routine procedure” discounts a mother’s right to chose what is best for her and her baby. Also, all mothers, babies, pregnancies, and labors are different.
Even if you are not sure about what you want to choose for some of these things, I hope it gave you food for thought. The first few hours of life are a critical period for the baby while he transitions to life in the outside world. The more opportunity the baby has to spend skin to skin in peace with his mother, the more positive his first experiences of life and bonding will be. The less we intrude and insist on poking and prodding this precious little life, the more he will be able to rest and allow his body to continue to work with his mother’s to help him adjust to his new life in the outside world.
Go back to Step #4: Developing a Birth Plan
Go ahead to: Step #6: Preparing for Life with a New Baby
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