Highlights
- An intervention is an action taken by a doctor or midwife in the birthing process to help with the birth of your baby.
- Different types of interventions can help at different stages of labour and birth.
- Types of interventions in labour include induction of labour, augmentation of labour, assisted birth, episiotomy, and caesarean section.
- A birth plan can help your healthcare team understand your preferences regarding interventions, including any you would prefer to avoid.
- It’s important to understand that you may also need to change your plans during labour if unexpected complications occur.
In This Article
- What is an intervention during labour?
- Reasons for needing an intervention
- Types of interventions available during labour
- Making the decision about interventions
- Your right to refuse an intervention
- When your doctor or midwife may override your choice
- Risks of declining an intervention
- Tools and Assistance
What is an intervention during labour?
An intervention during labour is any action taken by a doctor or midwife to assist with the birth of your baby. Since every labour and birth is unique, there may be situations where intervention is necessary to ensure the safety and health of both the mother and baby.
Reasons for needing an intervention
Various interventions may be needed at different stages of labour. You might require an intervention for the following reasons:
- To help initiate labour (induction)
- To support labour progression (augmentation)
- To directly assist in the birth (assisted birth or caesarean section)
Specific circumstances where an intervention might be needed include:
- Health conditions that increase the risk of complications during labour
- Previous complications in pregnancy or labour
- When the waters break but labour doesn’t begin
- Labour progressing too slowly
- The baby is in a difficult position for vaginal birth
- The baby is showing signs of distress
Types of interventions available during labour
Induction of labour
Induction of labour refers to medical methods used to initiate labour when it doesn’t begin naturally. Methods for induction include:
- Medicines given intravenously (IV)
- Medicines placed in the vagina
- Artificial rupture of membranes (breaking the waters)
Your doctor or midwife will choose the induction method based on your health, the baby’s health, your pregnancy stage, and the condition of your cervix. Often, a combination of these methods may be used to successfully induce labour.
Augmentation of labour
Labour augmentation is aimed at increasing the intensity or frequency of contractions to help progress labour. Common methods of augmentation include:
- Breaking the waters (artificial rupture of membranes)
- Administering medication via an IV to stimulate stronger contractions
Assisted birth
An assisted birth, also known as instrumental delivery, uses tools like forceps or a vacuum cup (ventouse) to assist the baby’s descent through the birth canal. This intervention is typically recommended if the baby needs help to move through the birth canal or if there are concerns about the mother’s ability to push effectively.
Episiotomy
An episiotomy is a surgical cut made in the perineum (the area between the vagina and anus) to enlarge the vaginal opening. This procedure is sometimes necessary during an assisted birth or if the baby is in distress and needs to be born quickly.
Caesarean section
A caesarean section (C-section) is a surgical procedure in which the baby is delivered through an incision in the abdomen and uterus. There are two types of caesarean births:
- Planned caesarean: This is usually scheduled due to medical reasons, either for the health of the mother or baby.
- Emergency caesarean: This is performed when complications arise during labour, such as stalled progress, signs of baby distress, or any life-threatening conditions for the mother or baby.
A doctor or midwife may recommend a caesarean if:
- Labour is not progressing
- The baby shows signs of distress
- There is a complication that poses a risk to the mother or baby’s health
Making the decision about interventions
Before labour begins, it’s important to consider your preferences regarding interventions. One way to express your preferences is by creating a birth plan. This helps your healthcare team understand what you would like, including which interventions you might want to avoid.
However, it’s essential to be prepared to adjust your plans if complications arise during labour. Doctors and midwives are there to support you and ensure the health and safety of both you and your baby. They are trained to handle unexpected situations if they occur.
In most cases, your doctor or midwife will have time to explain the reasons for an intervention. You will also be able to discuss options with them. Shared decision-making, where both the patient and healthcare professional discuss and decide on the best course of action together, is encouraged.
It’s important to weigh the risks and benefits of the recommended intervention. It’s also vital to understand the potential risks of not proceeding with an intervention.
Some questions you may want to ask include:
- Why has this intervention been suggested?
- What does the intervention involve?
- What are the potential risks of this intervention?
- What are the risks of not having the intervention?
- What are the risks of waiting before making a decision?
Your right to refuse an intervention
You have the right to make your own decisions regarding interventions during labour. If you are uncertain about a particular intervention, ask your doctor or midwife for more information to help you decide. Many women also find it helpful to involve their partner or another support person when making these decisions.
When your doctor or midwife may override your choice
In emergencies, your doctor or midwife may make decisions on your behalf to protect the health and safety of you or your baby. If you are unconscious or unable to make decisions, your healthcare team will consult with your partner or family members, if possible, to understand your preferences.
It’s also important to note that healthcare professionals are legally required to act in the best interest of you and your baby, unless you have clearly stated otherwise. If you don’t want certain life-saving treatments, such as blood transfusions, even in an emergency, it’s important to have these wishes documented in an advance care directive. Ensure your healthcare team is aware of your preferences.
Risks of declining an intervention
The risks of declining an intervention vary depending on the specific situation. Your doctor or midwife may recommend interventions because they believe they are in the best interest of you and your baby. It’s important to understand these risks and consider them before making a decision.
Discussing your concerns and preferences with your healthcare team before labour starts will help you feel more confident in making decisions during labour. It’s also beneficial to involve your birthing partner in the decision-making process.
Tools and Assistance
Birth Plan Template
A birth plan outlines your preferences for labour, including pain relief, positions, and interventions you want or wish to avoid. It helps communicate your wishes to your healthcare team.
Support from a Birth Doula
A doula provides emotional and physical support during labour, helping with decisions, comfort measures, and acting as an advocate between you and your medical team.
Pain Relief Options Guide
Understand your pain relief options, from natural methods like breathing exercises to medical interventions like epidurals or medications. This knowledge helps you make informed choices during labour.
Informed Consent Process
Before any intervention, your healthcare provider should explain the procedure, risks, benefits, and alternatives, allowing you to make an informed decision.
Communication Tools
Having clear questions ready and a supportive partner can help ensure open communication with your healthcare team. Don’t hesitate to ask for clarification if needed.
Postpartum Support and Resources
After birth, postpartum support resources like lactation consultants and recovery guidance can assist with physical and emotional recovery, ensuring a smoother transition.
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