Course Content
Introduction to Hospital Interventions during Labor and Birth
Whether you're planning for an unmedicated birth or considering pain management options, this lesson will give you the foundation you need to make informed decisions and advocate for yourself and your baby and it all starts with understanding the various interventions so that you can make informed decisions about your birth preferences. You'll gain a comprehensive understanding of the interventions commonly used in a hospital setting and how they can impact your birth experience. So let's get started! Here's to you and a safe and positive birth.
Pain Management Options
In this lesson, we'll dive into the different ways you can manage pain during childbirth, from non-medical options like breathing techniques and massage to medical options like epidurals and other medications. It's important to know about all options, even if you have a specific birth plan in mind, because labor and birth can be unpredictable. By being prepared for all scenarios, you can make informed decisions and have a more positive birth experience. I understand that the fear of pain can be overwhelming, but don't let that fear get in the way of learning these valuable insights. With the right tools and knowledge, you will feel more confident as you learn how to manage pain like a pro! Remember you have MONTHS to prepare. So let's get started.
The Stages of Labor
I've included this section because it's important to understand the normal physiological progress of labor so that you can recognise when interventions may be required or recommended.
Episiotomy and Perineal Tears
you may have heard of episiotomy or perineal tears during childbirth, and it's understandable if you feel fearful or anxious about these possibilities. The thought of experiencing pain and discomfort in such a delicate area can be overwhelming, but it's important to know that you are not alone in this fear. However, I want to reassure you that this module is designed to help address these fears and provide you with tools and techniques to prepare your perineum and pelvic floor for childbirth. We will explore ways to prevent tears and minimize the need for episiotomy, as well as ways to promote healing and recovery if they do occur. Many women choose to opt for a c-section due to the fear of perineal tears, but research has shown that elective c-sections come with their own risks and potential complications. It's important to be informed about all of your options and to make the decision that is best for you and your baby. So, let's work together to prepare your body and mind for childbirth, and alleviate any fears or concerns you may have about episiotomy and perineal tears. Remember, you are strong, capable, and capable of birthing your baby in the way that feels right for you.
Hospital Interventions
    About Lesson

    The Cascade of Interventions

    The Cascade of Interventions is a term used to describe the phenomenon where one medical intervention during labor can lead to a cascade of further interventions, often resulting in an increase in the likelihood of a cesarean section. For example,  medication to induce or speed up labor may lead to an increased likelihood of fetal distress, which can then result in a recommendation for a cesarean section.

    Why is it important to understand?

    It is important to understand the Cascade of Interventions because it can have a significant impact on birth outcomes. Women who receive medical interventions during labor are more likely to have cesarean sections, which can lead to longer recovery times and increased risks of complications for both the mother and baby. Understanding the cascade of interventions can help you make informed decisions about your childbirth preferences and be an advocate for yourself during labor.

    What are some common interventions that can lead to the cascade?

    1. Induction of labor without any medical indications. 
    2. AROM or Artificial rupture of the membranes surrounding the baby before or during labor.
    3. Augmenting  a naturally progressing labor with synthetic oxytocin (Syntocin or Pitocin) to make labor move faster.
    4. Giving medications for pain relief when not requested by you, with a full understanding of the risk/benefit ratio. 
    5. Being confined to bed during labor versus being upright and moving about.

    In many cases, these practices cause problems because they disrupt the normal physiology of pregnancy, labor and birth by:

    1. Interfering with hormones oxytocin and endorphins that move labor and birth along and help you to cope with the intensity of the sensations and physical challenge. 
    2. Increasing the opportunities for infection (for you and your baby)
    3. Possible undesirable effects on your baby causing fetal distress.
    4. Making it harder for you to push your baby out.
    5. increasing pressure on you to “perform” according to hospital protocols and expected norms.

    Therein lies the key to navigating interventions.

    You always need to look at the big picture.

    Here are some questions you might want to ask the staff and take into consideration. 

    • What is the situation we are dealing with?
    • Was my labor progressing normally until now? What changed? 
    • What are we trying to achieve? What is the best case scenario? Could we achieve this with watchful waiting or is an intervention necessary? 
    • How far off the “expected norm” am I at the moment?  Could this change? 

    Whenever a decision is required you want to make sure that you have all the relevant information and then engage in a conversation with the staff to make a decision that works for both of you.

    Key elements of decision making include clarifying that there is a decision to make, identifying the options, presenting pros and cons of the options and helping you think about how the options might align with your values and preferences.

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