This Birthing Better Childbirth Preparation resource is for both of you to think about and discuss.
What exactly is an ‘intervention’ when it comes to childbirth? (SEE WORDS).
This is certainly one of the loaded childbirth terms! People argue about it, argue about whether interventions are good or bad and argue about whether a birth can be natural if an intervention is performed.
Although the word ‘intervention’ is mostly attributed to medical maternity care is that accurate? There is such a huge amount of arguing about this one particular issue it can drive you to distraction.
The most commonly debated medical ‘interventions’ are:
- Induction of labour (stimulating labour instead of letting it naturally start)
- Augmentation of labour (stimulating labour contractions once labour has started)
- Pain relief
- Vaginal exams
- Continual monitoring of baby’s heart rate
- Episiotomy (cutting the vagina during delivery)
- Forceps or vacuum
- Caesarean
Then there are loads of others. And here is just a short list:
- Being shaved
- Having an enema
- Having to stay in bed
- Not being able to move around freely
- Not being able to eat or drink
- Don’t want to be told what to do … instead discover labour by oneself.
- Being moved from birthing room to another room to deliver
- Having to deliver in a certain position
- Having student practitioners present
- Having the cord cut before it stops pulsing
- Having the cord pulled to deliver the placenta
- Taking the baby away to exam it rather than placing it on the mother’s belly.
- No rooming in
- Not giving the baby the breast right after birth
There are many more lists of interventions and many more variations on any one of these.
Let’s just pick one and show you some variations: Having to stay in bed. This one thing can have many variations. So you also have to think about all of these.
- Whether you want to only stay in bed for short times if baby’s heart beat has to be monitored.
- If you want the ability to move around with an IV stand if there is a need for an IV.
- Do you want to be able to walk around in the hallways during labour?
- Do you want to be able to give birth on a mattress on the floor?
- Do you want access to shower, birth pool or tub?
- Do you want to be able to lie on your side if there are monitor straps on belly?
- Do you want to be able to put the head of the bed up?
- Do you want to or not to have to sit on the sacrum for delivery? (This is thrown in because most of you will not have a clue whether sitting on your sacrum for the delivery can help or hinder how easily your baby comes out of your body (SEE ? .. bony, soft, positions, progression?)
Most Birth Plans are designed around the more commonly recognized interventions. And most of the shame, blame and guilt expressed in many birth stories is based on whether an intervention (and it’s variations) was preformed during the birth. For example, a woman might mention ‘I don’t want a vaginal exam unless necessary’. Then in her birth she has a ‘failure to progress’ and accepts an exam but it is done roughly. Her birth story might well mention her anger at how rough the exam was (and forget to mention that it gave good information as to why the labour wasn’t progressing)
On the other hand most praise and relief is expressed in birth stories when an intervention is considered to have saved either a baby or mother whether than is accurate or not.
Natural birth movement is anti-intervention
Within the political debate about childbirth there is no doubt that the natural birth and midwifery movement supports a birth devoid of ‘interventions’. Since that word has not been clearly defined, the goal of a birth with absolutely no ‘intervention is extremely difficult to achieve.
However, there is a subjectively expressed goal by those women who want their birth to be classified as ‘natural’ compared to another woman’s birth that would be classified as ‘medical’.
But, suffice it to say, the natural birth movement sees interventions as negative, definitely medical and usually unnecessary unless there is a ‘need’. Since the word ‘need’ is not clearly defined then a natural birth is not considered to have been achieved if any medical assessments, monitoring or procedures occur. Birth stories often include these comments:
- ‘I wanted a natural birth but I had to …’
- ‘My goal to have a natural birth was ruined because …’
- ‘I would have had a natural birth except for …’
Or
- ‘I thought I had a natural birth in hospital but my friend told me no hospital birth could be natural’.
The medical maternity model is pro-intervention:
The medical childbirth model sees assessments, monitoring and procedures as essential to the well being of both mother and baby. In other words, most medical birth providers believe they are using necessary interventions that make the difference between a safe and unsafe birth.
- ‘Without augmentation …’
- ‘ Vaginal exams are essential because …’
- ‘If we don’t induce after 42 weeks then …’
This is what you will be faced with as you make decisions about your baby’s birth.
To the medical profession, monitoring your baby’s heart tones is an ‘assessment’ or a way of checking how well your baby is coping with it’s process. Yet, constant monitoring is often considered an ‘intervention’ by those who want ‘natural’ childbirth.
There is little distinction made between an assessment, monitoring or procedures … all fall into the category of ‘intervention’ … perceived of as either essential or unnecessary depending on your view point.
Both sides throw statistics around as though they mean anything. In reality only YOU and your baby are important. You are not a statistic. The birth you have will matter to you.
So what is an ‘intervention’ and are they only medical? And what should you do about them? And where does your Birthing Better Childbirth Preparation Package fit into this discussion?
What is an ‘intervention’?
Basically anything you do to change what is happening at the moment is an intervention. As broad a statement as this is … it is accurate. Everyone seems to agree that medical assessments, monitoring or procedures ARE types of interventions. The disagreement is whether to have them or if they harm the baby or mother.
The down side
Interventions can be bad (although not usually life threatening or injury producing). As unintended consequences the decision to use an intervention … even when appearing to be obvious … can have poor outcomes. This reality is part of the fuel in the fiery debate. Some times these negative consequences are immediately known and others not recognized until hindsight can be used. In fact, a great deal of the change in modern maternity care in the past 40 years comes from these unfortunate side effects.
- A baby is damaged by a forceps delivery
- A woman has pain having sexual relationships from an extensive tear that is poorly sown up.
- A woman’s uterus is more likely to split when a ‘classical Caesarean’ was performed.
- A premature baby became blind when given oxygen.
The medical profession has made every effort to make birth safer for both mother and baby … safe from what they have caused in trying to make birth safer if these things weren’t done.
In other words, the maternity system considers birth to be potentially unsafe (SEE IS BIRTH SAFE/UNSAFE) so forceps were invented in order to get a stuck baby out. Yet, forceps caused problems to both mothers and babies. So the medical profession developed the vacuum extractor that also causes problems and now Caesarean sections are often performed instead of trying to extract a baby.
The up side
Medical interventions can also be very good (helping the birth to be progressive, making the woman more comfortable or preventing potential injury). There is no doubt that being able to stop premature labours has helped to save many children. There is no doubt that women those who whose cervix opens in pregnancy has benefited from having the cervix sown closed until term.
The much debated ultrasound does show many birth defects or dangerous low lying placentas.
Then add this
The medical profession tends to view childbirth from an outcome driven perspective … ‘if the mother and baby are healthy’ what’s the grippe? The natural birth movement tends to look at childbirth also from the subjective viewpoint … how the woman felt about her experience.
Not only is it very difficult to determine before hand or at the time whether an intervention is good or bad but whether an intervention makes a woman feel good about her experience or whether it is actually good for her baby.
So we run into birth stories (SEE BIRTH STORIES) in which women talk about how they felt about the intervention done:
- “The doctor was so rough when she did the vaginal exams. I just hated them!’
- ‘My midwife made me lie on my back to have a VE even though I told her this made my contractions so much more painful!’
- ‘My doctor stripped my membranes when she did an internal without telling me and the contractions became unbearable’.
- ‘I’m so pissed off. I pushed for hours because my midwife didn’t think vaginal exams were necessary. My cervix swelled up and I ended up with more interventions that could have been prevented.’
- ‘The staff obstetrical nurse told my doctor that I was almost fully dilated but when my doctor checked my cervix was tightly closed and hard to reach. How could she have made such a mistake?’
- ‘I was told by my midwife that I wasn’t dilating. She had checked me several times and I was still 3 cms after 8 hours. She thought I might need to have my labour augmented. I felt my labour was moving along. The contractions were closer, longer and stronger but she worried me. Less than 40 minutes after the last time she checked, I gave birth to a baby girl. (About 30% of birth stories show that women can labour with almost no dilation until the last few hours and suddenly dilate very rapidly).
Those snippets all seem negative about interventions but you could just as easily hear these:
- ‘I hadn’t wanted vaginal exams but they were so helpful in telling me how my labour progressed’.
- ‘I’m so happy I had a Caesarean with my breech baby. I felt my baby would much safer.’
- ‘The ultrasound picked up a major birth defect so my husband and I were prepared’.
- ‘I was so happy to be induced. I just felt my baby wasn’t doing well.’
Because most of you will not have been present at many births … or any except your own you actually are not aware of all these variations or what you will be faced with. This all may seem insignificant IF this is your first child. If this is a subsequent child then you know all about this. There is no way to know what your birth will be like and there is no way to know how you will feel about what is done to you or around you at the time … or even how you will behave, think or act around the issue of interventions.
Interventions only medical?
There is an inaccurate assumption that an ‘intervention’ is only medical. Remember to ‘intervene’ simply means to change what is already happening.
Natural interventions exist frequently … often to prevent a medical one or to fulfill a philosophical belief that doing certain things will create a natural birth. Yet, as with medical interventions, the best intentions may have unexpected negative consequences that aren’t even picked up.
‘I took castor oil to stimulate labour and when my water broke, there was lots of meconium’.
‘My husband was told to press on my sacrum to ease my back labour but after learning how to open my sacrum with Birthing Better Childbirth Preparation, we realized we had just stalled the labour for hours.’
‘My early labour was niggling, so I walked, walked and walked and nipple stimulation. By the time I went into active labour I was so tired I ended up with lots of medical interventions.’
‘I didn’t know about preparing my vagina for birth. I was so tight that I tore.’
Where does your Birthing Better Childbirth Preparation fit into this?
Your Birthing Better Childbirth Preparation Package does not have an opinion about whether interventions are good or bad of interventions whether they are medical or natural. All interventions have an impact on you and your baby.
This resource is meant to confuse you, stimulate your emotions and let you know how many variations on this theme really exists and that any of them may have an impact on your birth experience.
When you feel confused then you open your mind to a deeper understanding of the power of your birth and coaching skills. What if any of these interventions happen to you?
In all likelihood any number of ‘interventions’ will happen. In other words, there will be many times throughout your birthing process that you or someone else will do something to change what is happening at the moment.
When you have birth and coaching skills you will be able to adjust to whatever is happening. This means you don’t have to focus on whether or not you will have an intervention. Along with whatever happens, you can continue to work with your baby’s efforts to be born.
When you prepare your pregnant body to give birth, learn your birth and coaching skills then use them in whatever birth unfolds then you will eliminate or reduce many of the common interventions that complicate what is a ‘natural’ physiological’ process that might have health issues requiring assessments, monitoring and procedure.
With skills you are much more likely to feel (subjective reality) that you have had a ‘natural birth’ in both natural and medical situations … because of how you manage, cope, act, behave, deal with and handle your birthing experience.
Here are some Birthing Better Childbirth Preparation and ‘intervention’ comments.
‘I knew being on all fours was actually slowing my contractions. As soon as I raised the upper part of my body, my contractions picked up’.
‘Leaning forward just a little bit put my contractions right off … don’t know why. I had to be very precise about my body postures to keep my contractions progressive’.
‘Whenever my labour picked up, I checked myself. That way I could feel the internal changes. Instead of feeling freaked, I knew I was progressing.’
Or consider these Birthing Better Childbirth Preparation experience
‘Although I didn’t want vaginal exams done, because we had done the internal work they weren’t bad … besides we used our breathing and relaxation skills as well.’
‘Although I agreed to being induced, our Birthing Better Childbirth Preparation skills permitted us to carry on. When we tell our birth story, we barely mention the induction.
‘Our doctor didn’t rush me to have my labour augmented although I stayed at 3cm for hours and hours. When I told him I knew my labour was progressing, he told me to let him know if I felt stuck. Our baby was shortly afterwards. It was great to know I felt the internal changes in my labour even though I wasn’t dilating consistently.’
‘ Although my labour was niggling, I decided to get on with my life, rest heaps, eat well instead of trying to push myself into labour. The end result … I was well rested when the labour really started and handled the next 7 hours before the birth really well.’
‘My baby was posterior and although I had researched all the techniques to turn him, I decided to work with the labour instead by using my Birthing Better Childbirth Preparation skills. Ten hours later my son was born sunny side up with no tears either. Without the skills I would have constantly been worried that he needed to turn.’
Conclusion
Interventions are part of life and part of giving birth. We’re almost never content with what is happening and most likely to try to do something to make ourselves or another person more comfortable. We’re also obsessed with just plan fiddling.