Throughout your pregnancy you may be thinking, “I feel good, my body knows what it’s doing, I got this, baby.”
And you’re not wrong.
Your body is designed to deliver a baby naturally. But, sometimes, medical professionals—and nature itself—have other ideas.
Your goal may be a vaginal birth, and to help you achieve that, your doctor may intervene. Or you may discover your hospital includes some interventions as standard practice.
Medical interventions can be life-saving modern wonders in certain situations. At other times, they may not be absolutely required. In fact, some interventions (including cesarean sections) have been performed more for convenience than medical necessity in recent years.
It’s your body and your baby.
Turns out, simply because technology is at our fingertips doesn’t mean using it is always
needed or even results in the best outcome. And interventions can carry risks and benefits that vary by situation.
And if you do end up needing help with labor or delivery? Don’t worry, getting assistance with one aspect of childbirth doesn’t necessarily lead to interventions in others. In other words, the rumored snowball effect (or cascade of interventions) is more myth than reality.
Just remember: It’s your body and your baby. You should absolutely feel empowered to inform yourself and ask all the questions you need to feel comfortable before undergoing a procedure—or considering another option.
Intervention: What it is
An intervention is the use of medical treatments or procedures to induce labor or assist with delivery.
Though it varies depending on your specific circumstances, a woman is typically considered low-risk and likely not needing medical interventions if she has had an uncomplicated pregnancy and goes into labor at full-term and spontaneously.
Of course, in childbirth things can escalate quickly. The key is active monitoring, so a changing situation isn’t missed.
Common Labor Interventions
- Electronic Fetal Monitoring
- Labor is stressful for your baby, too. That’s why monitors are used to evaluate how your baby is responding to contractions. External monitors use telemetry to evaluate the baby’s heart rate, and some allow you more freedom of movement. Internal monitors are generally used to get a more accurate reading if necessary.
- Induction is the use of medications or other rnethods to bring about labor, with the goal of a vaginal birth. There are several reasons why your doctor may recommend induction. They include:
- Your cervix isn’t dilating.
- Your pregnancy is more than 39 weeks without contractions.
- You or your baby’s health is at risk.
Cervical Ripening Agents
The first step of induction is cervical ripening. If your cervix isn’t dilating on its own, you may need some help. Some options are not FDA-approved, so it’s best to speak to your OB or midwife well before your due date to discuss your options, as this will help you prepare in the event an induction is required. Below is a list of treatment options that may be used during labor.
- Dinoprostone Vaginal Insert
- An FDA-approved medicated removable vaginal insert similar to a tampon that is placed by your OB or midwife.
- Dinoprostone Gel
- Another form of the FDA-approved medication dinoprostone. It is administered by a doctor, who will release the gel into the cervix using a syringe.
- Pill (Cytotec®/misoprostol)
- A medication given orally or vaginally. This option is not FDA-approved for use in cervical ripening.
- Balloon Catheter
- A device with a small inflatable balloon on one end. Some balloon catheters are FDA-approved.
- Stripping the Membrane
- A procedure performed by your OB or midwife that involves gently separating the membrane connecting the amniotic sac to the wall of the uterus. This triggers the release of prostaglandins and produces contractions.
Note: All drugs must be proven safe and effective to FDA’s regulations before companies can market them. If the FDA grants approval to a drug, it means they have determined that the benefits of the product outweigh the risks for the intended use.
In instances where your contractions don’t begin naturally, assistance may be needed. Below, you’ll find several different approaches that may help trigger the contraction process.
If your contractions don’t start occurring naturally, stimulation may be needed.
- IV Drip (Pitocin®/oxytocin)
- A medication, like the hormone oxytocin, is used to encourage contractions. An IV with a small dose is administered initially, then the dose is gradually increased until contractions are strong and frequent enough to deliver.
- Breaking Your Water
- A procedure performed using a small hook to rupture the amniotic sac (break your water) to begin producing contractions.
- Nipple Stimulation
- A natural method that involves stimulating the nipples, either manually or with an electric breast pump, to produce the oxytocin hormone, which triggers contractions.
Common Delivery Interventions
There are times when you may need assistance during delivery. This assistance can come in many forms and may be done for a variety of reasons. Below, you’ll find a few interventions that are common in delivery.
- An incision to enlarge the vaginal opening to facilitate delivery. Once routine, episiotomies are now not recommended (fortunately) except in cases of fetal or maternal distress, or for an exceptionally large baby.
- Cesarean Section (C-Section)
- Major surgery that involves cutting into the abdomen and uterus in order to deliver the baby through the incision. Most medically necessary C-sections are performed in urgent situations.
- Forceps or Vacuum Assistance
- Forceps, a metal instrument similar to tongs, or a vacuum device attached to the baby’s head are used to assist pulling the baby from the birth canal while the mother pushes. Both are used as a last resort.