If you are set on having a natural birth, you’ll want to be mindful of medical interventions because they can quickly derail your natural birth plan. Here are 7 common birth interventions to avoid that you should be informed about.
Of course, every birth and pregnancy are different. Please work with your healthcare professional to determine what is necessary for your healthy pregnancy and safe birth.
1. Regular vaginal exams during labor
Vaginal exams during labor are a pretty accepted, albeit uncomfortable, part of labor care anywhere. Vaginal exams can help the care provider assess the baby’s positioning and the dilation of the cervix; however, there is little evidence they affect birth outcomes.
Some care providers may be willing to forgo or minimize these exams if you discuss your birth plan preferences beforehand.
2. Inducing labor with membrane stripping or sweeping
Care providers may recommend a membrane sweep, which is when they insert a finger into the vagina and sweep it in a circle around the opening to your cervix. This is a widely accepted practice – with conditions.
First, membrane sweeping should never be done without discussion and your consent. Nor should it be done before your 40-week due date because it does carry some risks:
Membrane stripping can reduce the chance of an overdue pregnancy and can be a more natural induction of labor than using induction drugs (which carry their own risks, see below); however, it can be very painful, may cause bleeding, and, in 10% of cases, causes the water to break, which increases the risk of infection and may make a C-section more likely.
3. IV during labor
For most women, having an IV during labor is unnecessary and restrictive. Often, sipping water or drinking a beverage like coconut water (which contains electrolytes) can maintain proper hydration.
Hydration via an IV during labor can lead to edema, that is, swelling from excess water retention, which can complicate breastfeeding. (An IV during labor can also give the impression that a mom-to-be is a patient in need of treatment, which can further encourage intervention.)
4. Continuous electronic fetal monitoring
Devices for continuous electronic fetal monitoring may be strapped to the mother’s stomach in order to track her contractions and the baby’s heartbeats in real-time.
Sounds amazing, maybe.
However, research shows these devices aren’t associated with better birth outcomes for women with low-risk pregnancies; periodically checking the baby’s heartbeat is just as good as continuous fetal monitoring during labor. Instead, these devices restrict movement and often provide inaccurate data due to their sensitivity, which may make care providers more likely to jump to conclusions and recommend an unnecessary C-section.
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5. Inducing labor with Pitocin (synthetic oxytocin)
Pitocin, the brand name for synthetic oxytocin, does have a time and place for the informed and consenting mother, generally when labor fails to progress.
However, “failure to progress” is a highly subjective diagnosis; most labors progress slowly and unevenly.
And inducing labor with Pitocin or generic oxytocin comes with trade-offs:
- required hydration via IV during labor
- required continuous fetal monitoring during labor, (potentially, a bladder catheter too);
- and sudden and greater pain, as inducing labor with Pitocin makes contractions go from 0 to 60 and inhibits your natural pain-relieving hormones.
Using oxytocin to induce labor also risks hyperstimulating the uterus, which can stress the baby or rupture the uterus, necessitating a C-section.
6. Performing an artificial rupture of membranes, i.e., an amniotomy
Assuming labor is progressing smoothly, with no fetal compromise, then performing an artificial rupture of membranes — also known as an amniotomy (you can think of it as artificial water breaking) — isn’t necessary and may create more problems.
The risk of infection after water breaks increases as time passes; there is also a risk of cord prolapse (when the umbilical cord falls through the cervix before the head), after artificial rupture of membranes, which can endanger the baby’s oxygen supply, among other issues.
7. Performing an episiotomy
An episiotomy — that is, a surgical cut to your perineum (your vaginal opening) — is a very outdated practice that is still unfortunately very common in India. And it occurs here in the US, too.
Contrary to previous thinking, the recovery time for episiotomy is longer than for a natural perineum tear during childbirth. And while it’s true cuts are easier to suture than tears, that is an argument to make the care provider’s job easier rather than the mother’s recovery.
In fact, if your perineum tears, you may not even require perineal stitches (it’s 50/50) – but with an episiotomy, you will 100% require suturing, as an episiotomy cuts through skin and muscle and typically does more damage than tearing.
Some care providers in India justify episiotomies by saying South Asian women’s perinea tear more than Caucasian women’s during birth. There may be a shard of truth to that — one study found Indian and Filipino women in the US were more likely to have severe perineal tears than other ethnicities.
Regardless, the risk of severe perineal tearing is very low for all women, no matter what skin color or nationality, and does not warrant routine use of episiotomy.
Discuss your care provider’s and the hospital’s policy on these practices ahead of time to avoid any unnecessary, outdated cuts and longer recovery after giving birth.
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