Intervention in labour & birth

Practical Parenting’s resident midwife, Anne Richley, weighs up the pros and cons of intervention in labour and birth

Posted: 13 July 2006

Some people see intervention as a symptom of over-medicalised childbirth. But sometimes, intervention can be lifesaving for both mum and baby. What’s important is to understand what form intervention can take and when it’s necessary.

Induction

Labour can be induced (brought on artificially) before or after your due date, and there’s usually a serious reason, such as:
*You have pre-eclampsia (a rise in blood pressure that can affect the baby’s growth).
*You’re well past your due date.

If you haven’t reached your due date, being induced increases the chance of having a caesarean, as your body’s not ready for labour. But if you or your baby is at risk, an induction is usually advised. It can be offered when you’re a week overdue (41 weeks), though most women will go into labour by 42 weeks without intervention.

Breaking your waters

Having your waters (sac of amniotic fluid around the baby) broken with an amnihook (like a crochet needle) used to be routine, to speed up a normal labour. Nowadays, your waters will only be broken during an induced labour or a very slow one.

Once this is done, the baby's head puts more pressure on the cervix, which can increase the intensity of contractions. Most women find labour easier to cope with if their waters break of their own accord – usually at the peak of a contraction – or not at all. Some babies are born still in the sac.

Speeding up labour

A labour that’s progressing well can slow down. It often happens when a woman arrives at the hospital as her body releases adrenalin in a strange or threatening environment and this can stop production of the labour hormone oxytocin.

The medical profession tends to worry that the baby might become distressed if labour goes on too long. Often they advise that a woman takes something called syntocinon, a strong drug that artificially accelerates labour. But it’s best to try other ways of speeding up labour first, such as:
*Walking around.
*Nipple stimulation.
*A relaxing bath.
*Boosting your energy with a snack.

Baby monitoring

Babies can be monitored with a hand-held Doppler (an ultrasound device), a pinnard (ear trumpet) or an immobile unit that continually monitors the baby’s heartbeat, via an instrument attached to the mum’s waist.

However, research shows that continual monitoring doesn’t improve the outcome in low-risk labours. It also restricts you so that you often end up lying down and this can slow down labour, which may lead to a syntocinon drip.

However, monitoring is advised where:
*There’s concern about the baby’s well being.
*The baby hasn’t been growing well.
*You’re being induced.
*You have very high blood pressure.

Birthing instruments

Forceps or ventouse can speed up the delivery. These may be advised if:
*The baby’s showing signs of distress.
*You’re becoming exhausted.
*The baby doesn’t seem to be moving down the birth canal.

However, if you stay upright and mobile, these are all less likely.