What interventions are available to help a mother during labor? At what point in labor is intervention necessary?
As an expectant mother, your mind often wanders to that day you are going to meet the little one you are carrying.
It is common to fear the unknown, but yet remain optimistic. A part of your fear can be eased if you know there are methods of intervention that can be used to help you if you are struggling.
It is best to be prepared for the worst, rather than be clueless if the moment comes and you need assistance with your labor.
Many labors will go on without a hitch, but just in case, you will be glad you were prepared.
What Is Labor Intervention?
Labor intervention is any action that is taken to intervene and assist with the delivery of your baby (source).
Why Are There Labor Interventions?
Sometimes things are out of your control even during your labor, and no matter how hard you try to stay in control, it just isn’t in your cards.
Labor interventions are around to help a mother successfully bring her baby into this world in as safe a way as possible. There is nothing wrong with needing a bit of help, even if you had your mind set on that natural birth.
If your doctor decides to intervene in your labor it is for health and safety reasons, not to spite you. In the end, as long as you have a healthy baby, nothing else should matter.
Weigh Your Options
Different Types Of Labor Interventions
There are many different labor interventions and some are much more invasive than others. It is beneficial to be familiar with all types of interventions because labor is unpredictable and you never know how your labor may unfold.
Here are some common labor inductions you should know about.
Induction is an artificial way to start labor. It is usually conducted in several ways, or a combination.
- Membrane stripping: Your doctor will strip your membranes by using his or her finger to separate the tissue around your baby’s head from your cervix.
- Rupture of membranes, also known as breaking your water: An amnihook is inserted into your vagina and scratched against your bag of waters to rupture them. This usually isn’t painful, you will just feel a lot of pressure. It is believed that rupturing your membranes will speed up labor.
- Cervical ripening: A prostaglandin gel or a balloon-like catheter will be inserted to encourage your cervix to efface and dilate.
- Pitocin: This is given via an IV and it is a synthetic hormone that will stimulate contractions.
There have been many reports that induced labors bring about more intense contractions than labors that begin naturally.
Induction is probably the most common type of labor intervention that is conducted when not medically necessary. The reasons these are conducted vary, but one of them is to give the mother more control.
Inductions can be given if:
- You are past your due date.
- You are carrying a large baby.
- Your doctor needs to fit you into his schedule.
- You have low levels of amniotic fluid.
- You have diabetes.
- You have kidney problems.
- You have high blood pressure.
- You are carrying multiples.
Inductions can be beneficial, but there is probably an underlying reason your body has not started labor yet and that is because it isn’t ready.
You should thoroughly discuss your situation with your doctor to ensure that induction is a wise choice for you and your baby.
2. Continuous Fetal Monitoring
There are different types of fetal monitoring, including the commonly used external and internal monitoring. External monitoring is more favorable as it does not inhibit your range of motion or ability to change positions.
External monitors involve using a device that picks up the baby’s heartbeat and contractions that is placed on the abdomen (outside of the uterus). Internal monitors measure the baby’s heartbeat using a scalp electrode screwed onto the baby’s head. An internal pressure catheter measures the pressure inside the uterus and measures contractions through a catheter inserted into the cervix.
These monitors allow doctors to understand better how your baby is tolerating labor. The monitors will pick up your baby’s heartbeat and allow you to know if your baby is in distress and if other interventions need to be used.
If you have an epidural, Pitocin, or induction, you will most likely require constant fetal monitoring. Other times, monitoring is checked every 30 minutes.
The main reason why fetal monitoring increases the cesarean rate is that it can pick up minor fetal distress that wouldn’t otherwise have been noticed and may lead the doctor to decide that a cesarean is necessary. It’s a tradeoff because not identifying real fetal distress is a downside of not doing continuous fetal monitoring, which could be harmful to the baby.
Editor's Note:Christine Traxler, MD, BS
For most expectant mothers, the epidural will soon be your best friend. Labor is painful, and an epidural is sometimes your only hope at relief other than giving birth.
It’s Not All Sunshine and Rainbows
An epidural can sometimes make labor more difficult because your pelvic area becomes numb. This can cause you not to know when you should push, so sometimes labor is stalled.
If you choose to get an epidural, you will also receive other labor interventions like the constant external fetal monitors.
Although the epidurals cause the pelvic area to become numb, this also means they help the pelvic area relax. A relaxed pelvic area can make it easier for a mom to give birth.
There are many different sizes and shapes of forceps, but they pretty much resemble salad tongs. The forceps are entered one at a time into the mother’s vagina and placed on both sides of the baby’s head.
When the mother pushes, the doctor will pull. Forceps are used to help bring your baby into this world if your pushes aren’t quite getting the job done.
Forceps are sometimes also used to reposition a baby before the mother begins pushing.
It is not uncommon for forceps to sometimes bruise the mother and the baby.
5. Vacuum Extraction
A vacuum extractor has a pump on one side and a suction on the other. It has sucking power like a vacuum, and it is used to help pull your baby out.
Much like the forceps, the doctor will pull while the mother pushes. Vacuum extraction has become much more popular and has started to be used more often than forceps.
Vacuum extraction has a higher reach than forceps and is less damaging to the mother, but it can cause more trauma to the baby.
Some moms want to do everything possible to avoid a C-section, but sometimes it may become the only option. Don’t be discouraged if you have to have a C-section, you are still birthing a baby, just in a different way than you may have planned.
No matter your stance on C-sections, they do save lives. Over 30 percent of births in the United States are done as a C-section.
A C-section is when a surgical incision is made into the abdomen and uterus to retrieve your baby. These are usually conducted when vaginal delivery is not the safest method.
It is believed that the more labor interventions you use, the more likely your chances of having a C-section become.
An episiotomy is a procedure that is conducted during labor. It is done to widen your vagina to make it easier for you to deliver your baby. A cut is usually made between your vagina and your anus (source).
Episiotomies are often performed so the intervention of forceps or vacuum extraction can occur more easily or if there is fetal distress so the pushing stage can be completed faster.
If the doctor believes the mother will endure significant tearing from delivering the baby, an episiotomy may be conducted to ensure a clean cut, rather than a messy tear (source).
Trying to Avoid Interventions
All of the interventions mentioned above come with their own list of serious risks that can occur. It may be likely the benefits outweigh the risks, but the only way to reduce your risks is to reduce your interventions.
If it turns out you do need interventions, don’t feel bad about it.
Just because your labor needs interventions does not mean you have failed. Many mothers receive some interventions during their labor. There is no shame in choosing the safest options for delivering your baby over a natural birth.
There is no 100 percent way for you to ensure your labor will be intervention free. After all, each labor is unique and can be full of surprises.
You can however, take certain steps that can possibly reduce your likelihood of receiving interventions.
1. Have A Birth Plan
If you take the time to plan your birth and your wants and needs, others will take the time to look at it. Everyone on your birthing team will know your wishes and be able to respect them as best as they can. There is the possibility your birth plan will not be able to be followed exactly, but that’s because the safety of your baby is more important.
2. Use A Midwife
Midwives usually work at your home or at birthing centers that reduce the risk of interventions. The specialized care provided by a midwife can increase your chances of having a natural birth by almost 95 percent (source).
3. Take A Birthing Class
You can take a birthing class that can help you focus on natural birthing techniques. By exposing yourself to this knowledge, you will feel more empowered once labor begins and less likely to need interventions. A birthing class can also help reduce fear and anxiety surrounding labor.
4. Use A Doula
If you decide to give birth in a hospital, a doula can help ensure that necessary labor interventions are avoided. There have been studies that show women who utilize doulas are less likely to need pain meds, an epidural, assisted birth, or a C-section. A doula will also offer physical, emotional, and educational support.
5. Educate Yourself About Birth
It’s surprising how many mothers are preparing to give birth and have not properly prepared themselves to do so. The less you know about the birthing process, the more likely you are to be scared.
Fear can stall birth, and a stalled birth can result in the use of interventions. Trust your body and believe in yourself. A little education and a great support system can go a long way.
It isn’t called labor for nothing. Bringing a baby into this world is a job. Sometimes it takes a little help to complete that job.
Labor interventions were designed with safety in mind. Everyone wants the same result, a healthy mom and baby.
If you have to have an intervention in your labor, don’t be discouraged. It is okay to rightfully choose to have a couple of interventions before you even go into labor — just make sure you are aware of their potential risks.
Try not to rely on interventions to get you through labor. The more interventions used, the more likely you are to have to have the ultimate intervention — a C-section.
In the end, as long as you are healthy and you deliver a healthy baby, you won’t be concerned with the interventions that had to be used to get that baby here. If you are lucky enough to avoid all interventions, congrats to you!
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