Interventions During Labor

Introduction

Interventions are certain procedures carried out during different stages of help in the process of childbirth. These interventions are carried out by a doctor, nurse, or midwife. Carefully observing the patient and choosing the right interventions will help to ease the process of childbirth.

What Is an Intervention During Labor?

An intervention is an act from doctors, nurses, or midwives during the birthing process. These actions or interventions help the birth of the baby safely. Interventions help to assist in various stages of labor, and it begins with the induction of labor. Following that, the interventions to support the progressing labor and assisting in the childbirth or the cesarean section surgery.

The situations that require interventions during labor are

• High-risk, complicated pregnancy.

• Water broke, but labor was delayed.

• A slow progression of labor.

• The position of the baby makes vaginal delivery difficult.

• Signs of distress in babies.

What Are the Various Types of Interventions?

The pure interventions during childbirth are to assist in the process of labor and to ensure no harm. The interventions include

• Stripping the Membrane:

In patients with more than 41 weeks of pregnancy and contractions have not started, the process of stripping the membrane helps to trigger uterine contractions normally. The process, also called membrane sweep, is where the doctor or healthcare provider strips off the membrane. It is carried during vaginal examination, might be uncomfortable or painful, and show spots in the first 24 hours.

• Induction of Labor:

It is the process of initiating labor by different methods. Labor is induced with the help of medicines given intravenously or vaginally. The other way to induce labor is by artificially breaking the water. The labor is induced also considering the health of the mother and child.

• Stimulating Labor:

It is done to progress the labor. To increase the contraction, oxytocin is given intravenously to increase the frequency of contractions. The circulating oxytocin causes uterine contractions and production of breast milk.

• Pain Medication:

In many childbirth processes, drugs are given to ease the labor pain. The various pain medications include epidural, narcotics, nitrous oxide gas, and pudendal nerve block.

• Epidural Anesthesia:

Epidural anesthesia is a very effective method of relieving labor pain. 18 balls injection of a local anesthetic through a catheter inserted between the two vertebrae in the lower back. The drug passes through and anesthetizes the nerves in the abdominal area and partially numbs the nerves in the leg. Epidural anesthesia helps in reducing the pain or eliminates it as the contractions continue. It would be great id receiving an epidural as early as possible before the labor progresses.

• Assisted Birth:

Also known as instrumental delivery, where the doctor uses a forceps vacuum cup to assist the laborers.

• Monitoring the Health of the Baby:

In the active phase of labor, the medical team monitors the health of the baby; the heartbeat is listened to with the help of an ultrasound machine. The baby is watched continuously with the help of a fetal monitor. It can be continuous or intermittent. Two sensors were strapped to the abdomen and connected to a machine for monitoring. One sensor monitors the fetal heart rate another other sensor monitors the baby's movements and contractions.

Continuous monitoring is carried out in the following situations

• Epidural during labor.

• Doubtful about the health of the baby.

• Planning a vaginal delivery after a cesarean section.

• High-risk pregnancy.

• Episiotomy:

In this procedure, a cut is made between the vagina, and anus called the perineum. It provides more room for vaginal opening and delivery of the baby. This procedure also reduces the risk of vaginal tears, which is a common birth injury.

• Director Pushing:

Directed pushing is a technique to encourage the mother to take a deep breath at the initiation of the contraction, hold it and slowly release it as the contraction progresses. Researchers have shown that directed pushing is not helpful in childbirth, and holding a breath for a long time may reduce fetal oxygenation. Directed pushing can be helpful if received an epidural or the mother does not have the urge to push.

• Freedom of Movement:

Frequent movement makes childbirth easier. Changing position during labor, walking, and climbing stairs help to fasten the labor and support normal vaginal delivery. These activities distract the mother from discomfort, release the tension in the muscles help in reducing the pain.

Change in position during labor helps to

• Shorten the labor.

• Effective contractions.

• Makes the patient comfortable.

• No need for pain medicine.

• Cesarean Section:

In situations where vaginal delivery is not possible, doctors switch to a cesarian section or C-section birth. A cut is made through the abdomen and uterus, and the baby is born. In complicated pregnancies, cesarian is done as an emergency process to save the life of the child and mother. If vaginal delivery is not possible and the baby shows signs of distress, it is a life-threatening situation, and a cesarean is done.

What Is the Importance of Interventions During Labor?

Every childbirth is unique and needs different interventions for each patient, as per the status of the pregnancy. Most of the interventions are done to reduce the risk for mother and child and to have the best health outcome for the baby, helping to have a better childbirth experience.

What Is the Risk Associated with Interventions During Childbirth?

• Laying the woman in bed or a recumbent position restricts the movement and results in poor-quality contractions. It also increases maternal hypotension and decreases blood flow to the baby. The recumbent position also increases the chance of instrumental childbirth and pain.

• Continuous monitoring of fetal monitoring restricts the patient's movement and increases the chance of cesarean section.

• Frequent vaginal examinations can increase the risk of chorioamnionitis and puerperal infections. Chorioamnionitis is an acute infection of the placenta, resulting in acute inflammation of the placental membranes and chorion. Puerperal infections also called puerperal sepsis are genital tract infections occurring during the time of labor or after 42 days of childbirth.

• Carrying out vaginal examinations more than seven times can cause neonatal sepsis.

• Artificial rupturing of the membrane can result in fetal injury, bleeding, and prolapse cord.

Conclusion

Every childbirth is unique, and the mother passes through various stages that might require certain interventions. The interventions are done to ease the labor and to get a healthy baby delivered. During interventions, care must be taken not to harm the mother and baby. All the possible measures should be taken to avoid interventions.