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Home :: Intervention
Intervention

Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine–nil nocere [Do no harm]. — (Dutch Professor of Obstetrics G. Kloosterman)

You have the right to informed consent and the right to refuse interventions

You have the right to informed consent and the right to refuse interventions

Birth is a natural event, humans are mammals and our bodies are designed beautifully by nature to birth and feed our young.

The majority of women can give birth naturally without the assistance of modern medicine.

In the last 100 years medicine has saved many women and babies lives when there have been complications in labour and birth.

Sadly at the same time nearly all births in our country are now medically managed in a hospital environments using common procedures and interventions on many women who would birth beautifully without them.

These interventions themselves carry many risks for both mum and baby.

Avoiding Unnecessary Intervention

Even the most confident and assertive women can find it hard to stop unnecessary intervention when it is suggested by the man or women in the white coat, especially when it is followed up with the comment “you want what’s best for your baby don’t you!”

The best way to avoid unnecessary intervention is to have one to one midwifery care at a home birth or at a birth centre. Sadly many low risk women are not confident enough to choose these very safe options, and those that are can find them almost impossible to access. The next best thing is to choose midwifery care in a hospital, and the last way is to choose a doctor or hospital with low rates of intervention.

The individual intervention rates of doctors can be hard to source. Not all doctors are happy or honest enough to offer their statistics to the public and unfortunately there is no law requiring them to do so.

Ted Weaver, the president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said having an epidural anaesthetic – more widely available in the private than the public system – increased the chance a woman would not be able to push out her baby independently. If the drug blocked all sensation, so the woman had no urge to push, “there’s a pretty high chance – more than 50 per cent – she’ll end up with [a vacuum extraction or forceps delivery]“, he said.Then, if forceps were used, “most women would end up with an episiotomy”, Dr Weaver said. It was not clear whether women knew about the link between these interventions.— (Sydney Morning Herald, 03/01/09)

The Cascade of Intervention

The term ‘cascade of intervention’ describes how accepting one medical intervention or test in your pregnancy or birth can create a flow on effect leading to more interventions like a domino effect.

Sadly many women have experienced this during their births, not understanding that research shows that the cascade of intervention is real and ended up having caesarean sections or forceps/vacum extraction births. An instrumental birth often means you have an episiotomy.

Even after the birth, many still do not understand the connection between their initial consent to an induction or continuous foetal monitoring and the final outcome of their birth.

Educate yourself before birth so that you understand the implications of the choices you make.

To avoid the cascade of intervention:

  • Avoid continuous foetal monitoing
  • Avoid induction
  • Consider carefully antenatal tests that may then require you to have either continuous foetal monitoring or induction if there is a positive result. Many of these tests have very high false positive rates.

CLICK ON THE RED BOXES BELOW TO LEARN MORE ABOUT EACH INTERVENTION.

Foetal Monitoring Epidurals induction Episiotomy forceps or vacuum extraction Caesarean Section

Edited image from -Sheila Kitzinger ‘Birth Your Way’

One concession led to another. First the IV, then the pitocin. Strapped to a monitor I had to lie on my back. The pain became intolerable after the pitocin, so I had an epidural, which made my blood pressure drop — which stressed the baby— so I had to have oxygen and lots of IV fluids. I couldn’t feel the urge to pee, so the nurses catheterized me four times. I couldn’t feel my contractions so I couldn’t push right, and in the end I had a Cesarean I know was unnecessary. I should have stood up to that doctor in his office. — Stacey

If you choose to birth in hospital, you may be offered many interventions routinely.

If you choose to birth in hospital, you may be offered many interventions routinely.

Photo credits:

http://www.flickr.com/photos/bellymotherbaby/ / CC BY-NC-SA 2.0
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