Childbirth interventions vs natural birth
One of the biggest debates in childbirth today is about INTERVENTIONS. Goodness, what does the word ‘intervention’ mean to you? Any pregnant woman and dad-to-be would want a medical intervention if there was some medical issue. You’d be absolutely delighted and thankful that you lived in a country where you have access to medical care and all the interventions possible if you or your baby had a medical issue in pregnancy and birth. But the word interventions is not being used that way when you read child birth books or do any research about natural health. The word intervention when discussed within these natural birth circles imply they are unnecessary, imposed on women and what prevents a woman from achieving an empowered and positive birth. In other words if you have any intervention in birth you can only have a medical birth and that’s the dreaded birth experience that someone who wants a natural birth ends up happening. The results of having interventions in childbirth means that you are more likely to see your birth through the lens of shame, blame, guilt, disappointment and anger.
This conversation around birth is complex. There is no definition of ‘normal’ or ‘natural’ birth. You might have your own definition but it may not be shared by other mothers and fathers. The truth about childbirth that many people want to avoid is this: in places without access to healthcare, any occurance that happens during birth can be considered normal or natural. Our naive obsession with so-called ‘natural’ birth is based on many false assumptions. We have to nut this out.
Let it be known right now that Birthing Better families almost never used the word ‘intervention’ (or they corrected themselves when they slipped into that common word) when talking about what they wanted and didn’t want in their birth and how they felt about medical care they may experience in birth. Instead they used the words assessments, monitoring and procedures (AMPs). This meant they could look at each AMP and figure out what really matter and why. We encourage you to shift your language. If you have any AMP will you feel as put upon as if you have an intervention?
What does natural childbirth really mean?
Around the globe many women give birth with no access to medical care, completely unassisted or perhaps assisted by a close family member whose only experience may have been giving birth herself. In these situations, a natural birth can mean anything and everything, including the death of the child or the mother.
Is that what we mean in developed countries when we say “natural birth”? Of course not.
Somehow we have conceived a world where a “natural” childbirth means not using medical interventions, birthing at home, or even birth with the assistance of a midwife rather than at a hospital with a doctor. We have taken ‘natural’ to mean good, organic, instinctual, and unadulterated. We have been led to believe that this type of birth is idyllic and brings the birthing mother closer to some primal state in which her birth can be a moment of ecstasy.
This is not reality, it is a fantasy.
In reality birth is not an instinctual process. It is not something women “just know how to do”. It is an active process in which women and those who support them must involve themselves thoroughly so that they can self-learn the skills needed to make birth positive.
Here are some examples of how confusing the over arching word ‘interventions’ gets.
- Is a childbirth intervention artificially rupturing membranes at a home birth? That happens more than you might think. Or is rupturing the membranes in hospital by an obstetrician an intervention but not if it’s done by a midwife? Would you feel different? Would you feel that ‘male medical’ obstetrician is imposing something on you but a midwife would only have your best interest at heart and therefore rupturing your membranes is ok? Or do you think a midwife will be more gentle and therefore it’s ok?
- Is taking castor oil to stimulate labor in an overdue pregnant mother having a homebirth an intervention? Doing so often causes the baby to also move it’s bowels and meconium stained fluid comes out when the membranes rupture.
- Is doing version to get a breech baby an intervention or something positive?
Childbirth interventions are not just the medical ones like induction of labor, epidurals or a Cesarean.
Here’s what we’d like you to do as you create your Birth Plan. Don’t use the word ‘intervention’. Any medical care you may be getting or have in the future divide them into assessments (A), monitoring (M) and procedures (P).
This is what you’ll discover. Much of modern maternity care you’re fine with. You want your obstetrician or midwife to listen to your baby’s heart rate (A) or follow your Blood Pressure if it’s high (M) or an ultra-sound (P). Are you going to be freaked if your obstetrician or midwife does a vaginal exam or an ‘internal’ (A and P)? Would you be freaked if it was done gently or roughly? Would it just feel like an assessment if the VE was done gently and an ‘intervention’ if done roughly?
We need to think more deeply.
Natural birth exists in two forms:
- The only ‘natural’ thing about birth is that it comes after pregnancy. 100% of pregnant women will give birth one way or another. Birth will follow pregnancy. Without medical ‘interventions’ anything that happens to the birthing mother or baby is both ‘natural’ and ‘normal’ even if unpleasant. There is nothing unnatural or abnormal about any birth. Birth is birth.
- An intervention during birth is absolutely anything anyone does in a birth … from rubbing a back, changing position, talking to the woman or medical ones we commonly think of such as epidurals etc.
Oh, you say that’s silly. Actually, it isn’t. There are many birthing women who have been distracted by a well meaning husband or other birth support person. At that moment her process was interfered with. We might as well change the terminology to ‘childbirth interferences’ rather than interventions, because sometimes a distraction at the wrong moment (even if it is a well meant distraction) can extend labor and cause complications rather than neutralize them.
Birthing Better families want to encourage you to think very differently. Unless you birth at home alone without any birth provider, you will have some AMPs whether you want them or not. They are called ‘standards of care’ and ‘guidelines to practice’ and ‘evidence based practice’. No matter what your Birth Plan outlines, you will have AMPs. You can negotiate if possible and that’s great but you might not be able to do that given legal constraints of your hospital, obstetrician or midwife who have practice guidelines they are legally required to follow. However just by shifting your thinking to AMPs compared to Interventions you’ll begin to think more clearly and discern which ones you are comfortable with and which ones you want to negotiate.
Usually it’s the constant foetal monitoring and procedures such as induction of labour, augmentation of labor, medial pain relief and things like forceps, ventouse or Caesarean that are what pregnant and birthing women are most concerned about. There are two things to know:
- Preparing your pregnant body to become a birthing body can reduce and prevent the long, delayed labours that often cause more AMPs. No one wants a birthing woman to be overwhelmed or exhausted?
- Learning, practicing and using birth and birth-coaching skills reduce and prevent many of the long, delayed labors that cause women to have more AMPs.
Medical interventions do not need to trip your birth up
Birthing Better Childbirth Preparation skills work with medical interventions which are assessments, monitoring and procedures. With childbirth skills, you, as the birthing mother can continue to work with your baby’s efforts to be born. As a father-to-be, friend or relative who takes the role of birth coach, birth support or birth helper you can help the birthing woman work alongside the medical birth interventions even if the mother-to-be is pissed off, delighted, or just plain exhausted.
Birth skills are about what you do, not what happens to you.
Birthing better can occur in any birth whether natural or loaded to the gills with medical interventions.
When a father-to-be skillfully helps his birthing partner to stay on top of the naturally occurring pain of labor contractions, he is also intervening, and she is grateful he knows how. To learn childbirth skills is the best way to intervene positively in your own birth, and Birthing Better skills can provide the resource you need to obtain these skills.
‘Everyone who is into natural birth would say mine wasn’t. Yup, it wasn’t except I had a wonderful birth because I used my pink kit skills’.
Shirly Y …
‘We didn’t think we would have any interventions, but when I lit the incense my wife insisted on in our Birth Plan, she totally freaked out with the smell. That sure was an intervention. It took hours to ventilate the house and she was cranky for most of that time’.
Jimmy C …
Arm yourself with wonderful birth skills and birth coaching skills. Then you can look back on your birth positively, regardless of whether it was ‘natural’ or full of medical (AMPs) or interventions, knowing you did what you could to make your birth the best it could be.