Choose a Better Birth!

Cascade of Interventions

Medical Interventions can be life-saving and vital in some births, however they are often used when they are NOT medically indicated or necessary.  When an intervention is used it brings with it not only the risk of some complications but those complications often include the use of another intervention. This is what is called a “Cascade of Interventions”.

  • -Getting Induced or arriving early to the hospital (before labor is well established)
  • Possible Result:
  • -AROM – Artificial Rupture of Membranes (more commonly known as “breaking the water bag”)
  • Possible Result of AROM:
  • - Fetal distress or poorly positioned baby that is wedged into the pelvis and cannot move as well as before AROM
  • Possible Result of Fetal Distress:
  • -Cesarean section (surgical birth)
  • Possible Result of Poorly positioned baby:
  • -Longer and harder labor and fetal distress
  • Possible result of a longer or harder labor:
  • -pain medications/epidural
  • -a labor that goes on too long (12-18 hours is the standard limit) in the hospital will likely end in cesarean section
  • Possible Result of Epidural:
  • -Stalled labor or rising maternal temp. over time
  • -Fetal distress due to sudden drop in blood presure
  • Possible Result of Stalled labor:
  • -Pitocin use to strengthen and regulate contractions
  • Possible Result of Pitocin:
  • -Strong contractions that can lead to fetal distress 
  • - If used without an epidural Pitocin can cause very strong and hard to handle contractions

 Obviously, this isn’t going to be the case every time.  But when you are considering an intervention, it is best to know all the possible follow-up interventions that it can lead to.  There are many variations to this concept, but the basic idea is to avoid interventions as long as you can.

Here are some ways to avoid the cascade:

  • Consider a home birth with a midwife
  • Be extremely careful about your eating and fitness during pregnancy
  • Labor at home as long as possible
  • Put off getting induced
  • Choose a doctor who will not be pushy when it comes to un-necessary medical interventions
  • Have a well prepped and extremely supportive birth team (birth team page)
  • Stay mobile to the best of your abilities  (see birth plan page)
  • Stay well hydrated and eat something light before you go into the hospital
  • Make sure you eat well and get fit during your pregnancy – I can’t over emphasize this!!!
  • Hire a doula
  • Do all you can to ensure that your baby is in a good birthing position (not “Sunny-side up”)  See:  http://spinningbabies.com/index.php
  • Keep your personal stress down as much as possible
  • Have a short/concise birth plan or guide and discuss it with your doctor before-hand