Top 3 Things You Need To Know About The Cascade Of Interventions

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The cascade of intervention is alive and well in our current birth culture. We want to help you better understand what it is in hopes you can gain perspective as to what’s safe for you. Below you will find our top three things you need to know about the cascade of interventions. So let’s get started!

#1- Interventions are on the table BEFORE labour even begins!

Have you ever noticed that somewhere around the 37/38th week of pregnancy, the conversation starts to change to how your due date is fast approaching and the pressure is on to deliver “on time”? This is quite common and for many moms, this makes the final weeks of pregnancy quite stressful. Stress is the last thing you need when you’re waiting to go into labour.

Many practitioners will offer to do a membrane sweep to help “get things started” well before you’re even at your due date. First, it’s important to be aware that you have the choice to accept or decline a vaginal exam at any time. If you do accept an exam, it’s important to tell your Doctor whether or not you are okay with a sweep as sometimes this is done without prior consent.

Why is this such a big deal? Well, labour and birth is a very delicate balance of hormones and anytime you try to start the process before your baby and your body is good and ready, it can lead to more complications moving forward. For instance, many mothers experience cramping and contractions following the sweep. Typically that wouldn’t be a huge deal if the labour progressed, but sometimes it doesn’t. This can leave the mother exhausted and low on sleep by the time real labour kicks in a few days later. There is also always a risk that your water may break as a result of the sweep. Although this is rare, it can happen and once your water breaks the baby will need to be delivered within a certain time frame which leads you further down the path of a medical induction.

We really encourage you to learn more about the evidence behind due dates so you can make informed choices about going “overdue”. Please take a minute to head over to Evidence Based Birth and read the due dates article so you can understand the absolute risk that goes along with going past your due date.

#2 It’s a snowball effect

The idea behind “The Cascade of Intervention” is that one small thing leads to another, creating the potential for problems during your labour.

For example, even something seemingly small like getting a routine IV can lead to lack of mobility and losing access to shower or bath, which can increase your pain level. This may lead to you asking for an epidural much sooner which can then slow your labour, requiring medical staff to speed it up with medication. This then can increase the risk of fetal distress which means they need to get the baby out as soon as possible resulting in an assisted birth (Vacuum/forceps) or even c-section.

So the idea behind the Cascade of Interventions is that one small thing can snowball into something bigger and then another even bigger intervention. It’s really important to understand that anything that is done to you or denied from you, that you otherwise wouldn’t do on your own, is a form of intervention. Don’t be afraid to ask questions or ask for some time to think about it.

#3- When used appropriately, medical interventions can be life-saving

At the end of the day, anyone working in maternity care shares the same goal, which is healthy moms and healthy babies. We are very thankful to have skilled care providers who can intervene in a true emergency. Interventions are an important part of our maternity care and sometimes birth doesn’t go as planned. That’s okay. No one plans on experiencing days of back labour or prodromal labour that leads to nowhere.

Let’s look at the epidural in these instances. Sometimes the epidural is a helpful option if a mom is exhausted and closing in on the fine line between pain and suffering. We never want women to suffer in labour and birth and the most important thing is that mothers feel educated about her options and can make true informed decisions in the heat of things. That means learning lots of choices prenatally, before you are in the middle of labour and being asked to make decisions, or feeling like you don’t know what your options are. We want you to know what the epidural is and how it may affect your birth and postpartum so you’re not caught off guard, but there is no right or wrong. We always encourage our clients to be educated and open-minded because sometimes birth has a plan of its own!

Our focus in this blog post, along with the work we do with our clients, is to help educate women about the pros and cons of interventions and how to have productive conversations with their care providers so they can build a care plan that works for them.

If you have any questions about your upcoming birth, we’d love to hear from you! We offer private prenatal planning sessions along with the launch of your brand new Build A Better Birth online prenatal planning program that allows you to access education and support from the comfort of your own home!

Just remember, you are the true expert in your own birth, your intuition and your point of view matter, and it’s important that you remain an active participant in your care!