Lamaze Magazine 2008 - (Page 20) Celebration Birth Intervention Intelligence Common medical interventions you should know about, just in case By Teri Shilling, MS, CD(DONA), IBCLC, LCCE, FACCE Ybut there are times when your health-care ou may be planning for a natural birth, provider must intervene for health and safety reasons. If such a situation arises, you can continue to manage your labor and birth by asking questions and openly communicating your desires to everyone in attendance. When a medical intervention is suggested, ask about the benefits, risks, alternatives and whether you can do the procedure later or never. Most importantly, listen to your intuition. Everyone, including you, should stop and think before an intervention is requested. Being informed about common interventions that might arise will enhance your ability to make crucial decisions. that the presence of a doula can lower the chance of having a cesarean. Finally, be actively involved in all decision making before and during labor, and ask if each medical intervention or pain-relief option increases the risk of cesarean birth. Some hospitals or health-care providers will not allow a woman to have a vaginal birth after she has had a cesarean (VBAC). But the American Academy of Family Physicians has a policy to expand VBACs, so research your options. INDUCTION What: An artificial way to start labor. Your health-care provider will examine your cervix to see how much it has softened, opened, thinned or moved forward. This process is called the Bishop’s Score. She will also assess your baby’s lung maturity, position and general health. Depending on what she finds, she may use one of the following induction methods: 1. Membrane Stripping or Sweeping. Your health-care provider uses a finger to separate your cervix from the membranes (tissue) around your baby’s head. This may be painful, and sometimes must be repeated. 2. Rupture of Membranes (Amniotomy). The amniotic sac is ruptured manually using a sterile hooked instrument. This intervention alone doesn’t always kickstart labor and sometimes leads to other interventions, since once the membranes are ruptured, most health-care providers want to have the baby born within 24 hours for optimal health and safety. 3. Cervical Ripening. To help soften, thin and open the cervix, your health-care CESAREAN BIRTH What: Major surgery that allows the baby to be removed via incisions into the abdomen and uterus. Why: When there is an urgent threat to the life of the mother or the baby, a cesarean can be a life-saving intervention. Examples include a mother hemorrhaging or a baby not getting enough oxygen. Some nonemergency reasons are prolonged labor (“failure to progress”), a baby in a breech or transverse position, and changes in the baby’s heart rate. Lower your risk: Cesarean rates in the United States have reached an all-time high of almost 30 percent, and the World Health Organization is urging health-care providers to decrease that number. You can lower your risk by choosing a healthcare provider and place of birth with a low cesarean rate. Skilled, continuous labor support is also vital; research has shown LAMAZE MAGAZINE 2008 20 LAMAZE.ORG PHOTO: BEN + MARCOS WELSH/AGEFOTOSTOCK http://LAMAZE.ORG
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