Routine Interventions During Labor

This is a short overview of some of the typical interventions that you may be faced with when you are having a baby at the hospital. Some hospitals are more “natural” than others, but in general, most hospitals use these techniques to manage your labor and birth. 

 Pitocin: A synthetic version of oxytocin. Used to induce contractions or speed up labor.

Benefits: Can start or augment labor when mother and/or baby would benefit from managed or immediate delivery. Can also control post birth hemorrhaging.

Risks: Natural oxytocin is produced in spurts; pitocin is administered at a steady rate. Pit-produced contractions are stronger, longer and usually closer together. Because of the rapid and prolonged contractions, uterine blood flow could decrease which would result in lower delivery of oxygen to the baby. Studies have also shown a higher incidence of jaundice in the newborn. Additionally, pitocin usually confines the mother to her bed, which makes dealing with the contractions much more difficult.

Alternatives: Nipple stimulation, walking, prostaglandin suppository

 

Episiotomy: A cut of the stretched skin of the vagina and underlying tissues about 2 inches long.

Benefits: To make extra space in the vaginal opening to allow for the use of forceps. It can also shorten the pushing stage of labor.

Risks: Postpartum discomfort, infection of the stitches, abscess extending to the rectum causing rectal-vaginal fistula, hemorrhage or hematoma, painful intercourse for up to a year following delivery.

Alternatives: Upright or side-lying birth positions (put less strain on perineal tissues), perineal massage before and during labor, short and gentle bearing down (push as it comes naturally)

 

Artificial Rupture of Membranes (AROM):When the practitioner inserts a small, hooked instrument in the vagina and snags or rips the bag of waters.

Benefits: Speeds up labor by allowing baby’s head to make direct contact with the cervix.

Risks: Increased chance of infection, cord prolapsed, put on unnecessary hospital timeline.

Alternatives: Walking, squatting, climb stairs, sit on a birth ball

It is important to remember that birth is a natural and normal process. These interventions should be reserved for cases where mother and/or baby are in distress and would benefit from the use of them. When a new intervention is presented to you, please ask your caregiver for more information. Use ‘BRA’ as a guide. What are the Benefits? What are the Risks? And lastly, what are the Alternatives?

 

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