The more procedures done to a laboring mother, the greater the chance of needing increasingly invasive procedures. Even such simple things as wearing a hospital gown can influence the way the woman perceives her power. When you walk into a hospital, put on the gown, hop on the bed, and allow yourself to be poked and prodded into submission, you are giving up the right to find your own rhythm for the birth. In your own home, in your own clothes, you feel so much more "normal" and comfortable.
If you are put on a fetal heart rate monitor, it becomes your responsibility to lie in a position for optimal reception. If you move out of that position, things start beeping and buzzing, reminding you to lie still. Lying still waiting for the next contraction increases the chance that the pain will become overwhelming and you will soon request pain relief. Wild Rose Clinic practices intermittent monitoring with a doppler.
Having an intravenous fluid drip is another way you are held "captive" to the machine. First of all, it hurts! And often the pain is not only when it is inserted, but also whenever you move your arm. And if you move too much, here comes the beeping and buzzing, telling you to be still. Moving around during labor, including walking to stimulate contractions, becomes difficult due to the inconvenience of pulling the top heavy IV machine around with you. We do not start intravenous lines on our patients unless there is a compelling medical reason.
Sometimes providers prohibit oral food and fluids, especially if you intend to have an epidural. Some nurses choose to limit your intake to fluids despite what your provider has ordered! In general, if you plan on an epidural, your risk for cesarean birth is increased so the anesthetists and surgeons prefer that food and fluids are kept to a minimum. We encourage you to drink to thirst (we will probably even encourage you to drink more) and eat what you want during labor. You need the energy, you are working hard! If you tend to feel nausea during labor, make sure you have hard candies and popcycles to help provide the fluids and calories you need.
Another "unseen" intervention is the frequency of cervical exams during labor. This is not only uncomfortable, but can introduce bacteria into the uterus. We tend to avoid exams except for an initial evaluation and occasional rechecks to document change, usually every 3-4 hours. In general, your midwife does all of the exams during your labor so they are not only kept to a minimum but you are not subjected to a variety of providers. There is little that is more distressing to a laboring woman than a complete stranger walking into the room and wanting to check you! Often providers assess dilation differently, and it is important to have one or at most two examiners for an accurate evaluation.
Although these are very small interventions, relatively speaking, lying in bed with elastic belts tied around your middle, an IV in your arm, beeping and buzzing, and having vaginal exams by one nurse after another is uncomfortable for most people, and very disturbing to some of us. No wonder many women end up wanting to be numbed into oblivion so that they can tolerate not the LABOR but the INTERVENTIONS!!
We think that Mother Natures plan for childbirth rarely needs much assistance, and enjoy watching the process unfold naturally. The fewer "minor" interventions you allow, the fewer "major" interventions you will need.
Minor Interventions | Major Interventions |
| Hospital gown | Augmentation or Induction |
| Continuous electronic fetal monitor | Fetal scalp electrode |
| Intravenous drip | Intrauterine pressure catheter |
| Continuous blood pressure monitor | Bladder catheter |
| Narcotic pain medication | Epidural anesthetic |
| Restriction of activity | Vacuum assisted birth |
| Frequent vaginal exams | Forceps assisted birth |
| Artificial rupture of membranes | Caesarian birh |
| Unnecessary newborn nursery procedures | Interruption of breastfeeding/bonding |
While many of these procedures can be necessary and life saving, they have all too often become routine. No procedure should be performed on a laboring woman without a medical indication. We have finally (mostly) gotten rid of the shave prep, enema and episiotomy, let's get rid of the rest of the minor interventions and bring our major intervention rate down to a reasonable number!
Out of hospital birth is the best way to avoid unnecessary interventions.