When The Birth You Planned Turns From A Vaginal To A Caesarean And All The Things In-Between

Written by: Nicole Davenport, Executive Contributor

Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.

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Meaning: How one intervention can lead to another then another and so forth…

Unfortunately, many maternity interventions have unintended effects during labour and birth. Each intervention can cause a problem that then leads to the next intervention until you find that your intended natural birth has been completely high-jacked and you experience what is known as the “Cascade of Intervention”.

Maternity practices that can lead you into the cascade of intervention.

• The application of various medications to induce labour.

• Artificially breaking the membranes (water around the baby) and releasing amniotic fluid before or during labour.

• Using synthetic oxytocin medicine (Pitocin) to speed up labour.

• The use of medications for pain relief.

• Not moving around and being upright during labour.

In many instances, these practices cause problems as they disrupt the normal physiology of pregnancy, labour and birth by:

• Interfering with hormones that naturally help progress labour and birth.

• Creating opportunities for infection.

• May make it harder to push your baby out naturally.

Often when these effects happen women feel a sense of failure that they were unable to naturally birth their baby. But in reality, any problems that have occurred are usually triggered by the Cascade of Intervention.

Limiting the cascade of intervention

Almost every intervention has some potential to cause harm. Use care in deciding if and what interventions you are willing to accept. This is a good acronym to remember:

B - Benefits ‒ Are there any?

R - Risks ‒ What are they?

A - Alternatives ‒ What alternatives are available?

I - Intuition ‒ Listen to what your gut is telling you.

N - Nothing ‒ What will happen if you choose to do nothing?

Tips for avoiding unnecessary interventions

• Choose a care provider and birth setting that have a low rate of using common interventions.

• Research what is likely to trigger a cascade of intervention, including induction of labour,

• Epidural and other pain medication and caesarean section.

• Have an honest conversation with your care provider and set a birthing plan in place.

• Discuss with your care provider alternatives to medical interventions. Clearly communicate your birth wishes to your care provider and you partner prior to labour.

• Hire a Doula if you feel you and your partner may benefit from extra support to help ensure you achieve the best outcome for you and your baby.

• Know you have the right to question everything. You can refuse procedures, drugs and tests.

• It’s your body, your baby, your choice.

Cascade of intervention in action

Example:

Epidural analgesia is good for pain relief but increases:

• Risk of sudden drop in blood pressure.

• A longer labour.

• Difficulty in remaining active in labour.

• Difficulty urinating.

• Difficulty in pushing baby out.

• Fever and other negative effects.

Interventions like electronic foetal monitoring and intravenous fluids are often used with epidurals to monitor and treat these affects. And others become more likely to be used…

• Synthetic oxytocin to strengthen contractions.

• A catheter to empty the bladder.

• Vacuum extractor or forceps to help deliver baby. These can lead to more side effects so in turn more interventions.

• Your baby can also be affected.

Example:

A woman is more likely to develop a fever with an epidural, which leads doctors to worry that the baby may develop a fever also. That then leads to antibiotics being given to both mother and baby. And in some cases, the baby may need to be monitored which interrupts the first moments of skin-to-skin bonding and breast-feeding.

All this being said, I also believe that medical intervention does have a place. It would be naive to think otherwise. So many mothers and babies are saved the trauma of unnecessary and tragic outcomes through the use of medical interventions. It comes down to educating yourself and your birth partner. Research and don’t be afraid to ask questions. This can be such a special and powerful experience that you will remember with happiness and joy.

Your baby, your choice.

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Nicole Davenport, Executive Contributor Brainz Magazine

As a mother to four beautiful children, Nikki is so excited and passionate about what she does. She was well supported by amazing midwives and friends when she became a mother herself. With the understanding that not all women receive the same support that was given to her, she wants to use her lived experience and passion to help others. Nikki graduated from the Australian Doula College in August of 2021 and has started her journey in supporting women and families within the Doula space. She is continuing her studies and expanding her knowledge in particular areas she is passionate about, such as supporting at risk women and babies, and educating people in their rights as pregnant and birthing women.