Hospital Labor Interventions
When preparing your birth plan, you should be aware of common hospital interventions in labor and delivery. Most of these are optional and can be refused by a laboring woman.
When preparing your birth plan, you should be aware of common hospital interventions in labor and delivery. Most of these are optional and can be refused by a laboring woman, but many women do not know that they have a choice. Many of these procedures are necessary for births with complications but may be completely unnecessary for normal births. Below are some common and some not so common interventions in hospital births.
When writing a birth plan, explore your own comfort levels with each of the following procedures. Consider the effects they may have on your own frame of mind while you are laboring. Some women find comfort in all the technology, and some women find it downright intrusive. The most important factor, barring any complications, is your own sense of security and confidence. Once your birth plan is written, show it to your doctor or midwife and have them sign it. Make sure your birth coach or doula is familiar with your wishes as well, so that they can be your advocate during the labor and birth process. Above all, remember that you have choices.
INTERVENTIONS IN HOSPITAL BIRTHS
1. Induction: Some labors are artificially stimulated with the use of drugs. There are a number of reasons why this might be done. This can increase the strength of contractions, making them more painful.
2. Breaking the Amniotic Sac: Some doctors will break the amniotic sac to speed up labor. This makes labor more intense because the buffer around the baby is gone. It also increases the risk of infection.
3. Vaginal Exams: The frequency of these exams vary from hospital to hospital, but they are performed to determine the progress of labor. In other words, the doctor or nurse is checking to see how much the cervix has dilated and has become effaced. Frequent vaginal exams can increase the risk of infection.
4. Intravenous Solution (I.V.): Some doctors will start an I.V. in order to have a vein open, usually with a glucose solution.
5. Denial of Food and Water: This is routine in hospital births because of the potential for surgery. It deprives the mother (and baby!) of needed nourishment during a process that is taxing her stamina. This can certainly lead to dehydration as well.
6. Episiotomy: This is an incision in the perineal tissue between the vagina and the anus. It is done to prevent tearing. Tearing during delivery is not inevitable, however, and perineal massage can reduce to risk or it happening.
7. Drugs for Pain Relief: These either relieve the pain or simply numb you from waist to thighs. There is a danger with spinal epidurals that it can spread to the lungs or the brain although this is rare. There is also a potential that you may be too numb to feel like pushing, at which point a cesarean section may be necessary.
8. Fetal Monitoring: An external fetal monitor involves straps around the mother's abdomen and uses ultrasounds. An internal fetal monitor involves an electrode being screwed into the baby's head and a catheter being inserted in the mother. Either monitor restricts movement. Needless to say, the internal fetal monitor can be stressful to the baby.
9. Cesarean Section: This is major surgery which involves making an incision into the mother's abdomen and physically extracting the baby. These are becoming more common in the United States and there is some controversy as to the necessity of many of the cesareans performed. The most common reasons for a c-section are breech position, placenta previa, and failure to progress. Discuss with your doctor which conditions he or she feels requires a cesarean.
10. Forceps: These are used when a mother cannot push the baby out either because she is too tired or her uterus cannot maintain contractions. Sometimes drugs can make a woman unable to push. The forceps are applied when the baby's head is engaged and a local anesthetic is injected into the mother's perineum.
11. Vacuum Extraction: A metal plate or cone is placed over the baby's head, and a vacuum is used to rotate the head and pull the baby out.
12. Cutting a Pulsing Cord: Doctors will often cut the umbilical cord immediately after birth. The baby can receive up to a third of his or her blood supply at birth through the umbilical cord. Additionally, cutting the cord before it stops pulsing forces the newborn to rely entirely on new lungs just as they are inflating. It only takes about five minutes for the cord to stop pulsing and the baby to transition from receiving oxygen through the cord to breathing it in.
13. Separation of Mother and Baby: Routinely, the newborn will be taken away from the mother immediately to be cleaned, weighed, and measured. These procedures may even be done in another room. These procedures can certainly be delayed while the mother and baby have an opportunity to bond.
14. Pitocin Shot After Delivery: A shot of pitocin is routinely administered to facilitate the delivery of the placenta. Nursing immediately will have the same effect by causing the uterus to contract.
15. Eye Drops: These are usually put in the baby's eyes immediately after birth in case the mother has chlamydia or gonorrhea. In some states it is the law that this procedure be done. It is possible to sign a waiver refusing the use of these eye drops.
16. Vitamin K Shot: This is routinely given to babies in order for their blood to clot, but there is some controversy about whether or not it is necessary. Many believe that all babies are born with a vitamin K deficiency for a reason. Most babies will have normal levels of vitamin K naturally within a week.