Interventions during Labor and Delivery

Interventions during Labor and Delivery

If you are a mother-to-be for the first time, you may be hoping for natural childbirth. However, deliveries do not always go as planned and your obstetrician may have to intervene in the birthing process to ensure that you and your baby are safe and healthy. This type of medical assistance during childbirth is called an intervention.



Common Interventions during Childbirth

There are several kinds of interventions may be done during your labour and delivery process. These include:



1. Labour Induction Using Pitocin

This is a method of artificially inducing labour.

What is It?




It is a method of inducing labour through synthetic oxytocin, called Pitocin, given through an intravenous drip. It stimulates labour contractions in your uterus.

Why is it Done?





Induction with Pitocin is done if you are more than 2 weeks past your due date, diabetic, carrying multiples or low amniotic fluid levels.

How to Lower the Risk?




If induction is absolutely unavoidable, talk about the dosage and how to manage the pain if it is excessive. It should be done only if the baby is in danger and this risk outweighs other risks occurring due to the induction process.

Labour Induction Using Pitocin

2. Labour Induction with Membrane Sweep

A method of induction to speed up labour.





What is It?

It is induction done manually by the obstetrician. The doctor will insert her finger into the opening of the cervix and move it around in a circular sweep to separate the amniotic membranes from the cervix. This induces labour.




Why is it Done?

 A membrane sweep is done to induce or speed up labour if you are past your due date.





How to Lower the Risk?

If you do not prefer this intervention, make it clear to the obstetrician during your birthing plan discussion. To reduce discomfort and pain, try the breathing exercises you practised in birthing class.




3. Amniotomy

This is an invasive method of labour induction.

What is It?





It is rupturing of the amniotic sac using a hook-like instrument inserted through the vagina to kick-start the labour process or speed it up.

Why is it Done? 




 It is done because the baby is at risk inside the womb and needs to be delivered as soon as possible.

How to Lower the Risks? 


To lower the risk of infection, sterile equipment is used. If you do not want this intervention, make it clear to your gynaecologist well in advance. Try natural ways of labour induction like nipple stimulation.

Amniotomy

4. Episiotomy

An invasive intervention is done during a vaginal delivery.

What is It?

The obstetrician makes an incision in your perineum (the membrane of skin separating the vagina and anus) using surgical scissors during a natural delivery.


Why is it Done?

Episiotomy is done to widen the vaginal opening to make the delivery easier and quicker.

How to Lower the Risks?

Studies have shown that an episiotomy is not beneficial to the mom or baby. Tell your doctor you wish to avoid an episiotomy unless it is absolutely unavoidable. To lower the risk of infection post-episiotomy, proper after-care of the stitches is required.


5. Electronic Foetal Monitoring (EFM)

The vital signs of the foetus are monitored to ensure that the baby is doing well.

What is It?

This is a method of monitoring the baby’s heart rate during the delivery to ensure that the baby is healthy. It can be done externally using a Doppler device or internally with a foetal scalp electrode.

Why is it Done?


Foetal monitoring is necessary if the baby is at high risk or if you are having labour induction or an epidural.

How to Lower the Risks?

To lower the risks, ask your ObGyn how to plan the birthing process with minimal interventions. Internal foetal monitoring is invasive and is used only for deliveries where the baby is at very high risk. Opt for external monitoring and try not to remain in bed continuously during labour.

Electronic Foetal Monitoring

6. Epidural

This is an anaesthetic given to mothers.

What is It?

An epidural is a spinal anaesthetic given to the mother to reduce the labour pain.

Why is it Done? 

It is done if the mother is in too much pain and asks for pain relief medication.

How to Lower the Risks? 

To lower the risks associated with an epidural, opt for epidural-free childbirth. Manage the labour pain using breathing exercises that you practised in birthing class.

7. Assisted Vaginal Delivery

Sometimes, a vaginal delivery does not happen smoothly and requires assistance.

What is It?

The obstetrician helps deliver the baby vaginally using forceps or a vacuum extractor.

Why is it Done?

It is done if the baby is stuck in the birthing canal and has breathing difficulties.

How to Lower the Risks? 

 Avoid forceps to lower the risk of injury to the baby and the mother. Opt for a vacuum pump or C-section to deliver quickly if the baby is in distress.

Assisted Vaginal Delivery

8. Caesarean Section or C-section

This is the last resort and is done when there is no possibility of a safe vaginal delivery.

What is It?

 It is a surgical procedure done with the mother under epidural anaesthesia. The baby is removed from the mother’s uterus via an incision made in her abdomen.

Why is it Done?

It is done if the baby is in danger and needs to be delivered immediately. It is also done if the baby is in breech position.

How to Lower the Risks? 

To lower the risk of C-sections, make a comprehensive natural birthing plan with your gynaecologist and choose a doctor having a low C-section rate. If it is unavoidable, proper after-care is necessary to avoid infection at the site of surgery.

How to Avoid Unnecessary Birth Interventions?

Here are some tips to avoid unnecessary birthing interventions:

1. Childbirth Classes

Taking birthing classes will help you prepare for your delivery, and you will learn breathing techniques to manage the pain.

2. Proper Birthing Plan

Having a proper birthing plan chalked out with your doctor and making your preferences about various interventions very clear will help you avoid unnecessary interventions

3. Consider a Midwife or a Doula

Women who worked with a midwife and had continuous support from a doula during delivery were found less likely to have interventions like epidurals, assisted deliveries or C-sections.

Birth interventions have varying degrees of risks associated with them. Before your due date, discuss different kinds of interventions you need to be ready for with your gynaecologist. Preparing well in advance is the key to a smooth and safe delivery!

Also Read: Tips on Choosing a Hospital for Giving Birth