What You Need to Know


by Mary Gibbons LM

 

Induction:

Often used for convenience and not necessity. Induction carries some risks, so it should only be done to protect the health of the mom or baby. Can cause long labor, increasing chance of exhaustion. Pitocin: The FDA removed its approval of pitocin for elective induction of labor in 1978. (5) Side effects with its use include: higher rate of complications (5)produces much stronger contractions(3), which increase need for epidurals and can cause fetal distress. It can increase the chance of the baby passing meconium(3). Increase hemorrhage (5), They cause you to be more immobile from being stuck to the IV pole. It can also rarely cause rupture of the uterus which would require emergency c-sections and possible Hysterectomy(3) Babies have higher rates of distress, higher rates of jaundice, lower apgar scores, higher rates of brain damage and death. There is a possible link to autism. (5)

Cytotec, Misoprostol (miso):

There is a direct link to uterine rupture when using this drug. It was created to treat ulcers, has never been proven safe for labor. The manufacture released a bulletin that states “the use for this drug in labor has never been tested, approved, or recommended”, Serious adverse events reported following off-label use of Cytotec in pregnant women include maternal or fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.
Searle has not conducted research concerning the use of Cytotec for cervical ripening prior to termination of pregnancy or for induction of labor, nor does Searle intend to study or support these uses.
They suggest for complete removal of it use in labor. (5,8)

They can also use prostaglandin gel inserts to ripen your cervix. This is usually followed by pitocin.

Artificial Rupture of Membranes:

Often done to induce or speed labor. Increases pain, and increases risk for infections, may place a time-limit on mother. Can cause the umbilical cord to prolapse (fall into the vagina before the baby) which is a very serious complication.

Continuous Fetal Monitoring:

This has not been shown to improve outcomes for baby’s any more than intermittent monitoring.(3) It requires mother to stay in bed which can slow labor and increase pain. It causes the nurses and doctors to look to a machine for information (which can be incorrect) instead of to you. This can cause your care to become impersonal. A trained nurse is just as effective as a monitor. (5) A study that was done in 1982 showed that continuous fetal monitoring had a 74% false positive rate, meaning that when it showed a baby was in distress 74% of the time it really wasn’t.(5) Many doctors have performed emergency c-sections for a baby in distress and delivered completely healthy babies with great agars‘. Many times a simple position change is all it takes to stabilize a babies heart rate.(5)

Demerol, Stadol, Fentanyl:

These are all narcotics. Some studies have shown that they may increase a baby’s chance of abusing drugs in teen years(2). It can cause sleepiness in mother and baby. The side affects have been noted as late as 3 days in the baby in one study (2), and another study says that withdrawal symptoms have been seen to last for up to 2 weeks (5). This can interfere with breastfeeding. It may make mother feel “drugged”. It can causes nausea, vomiting, and low blood pressure.(3) It can contribute to depression after birth(5). Many woman report that pain did not decrease, just there ability to express it did.

Epidural:

An epidural is a method of pain relief used during labor. A tube is place into the lower back by an anesthesiologist, and small amounts of narcotics are given through the tube that numb the stomach, back, legs, and bottom. It has been said that “An epidural is a very short term solution, which may be creating long term problems for out entire society.” Many times epidurals just delay pain. It is not worth it to have pain after the birth when you are trying to bond with your baby. I believe that an epidural has many side effects such as: it can cause a drop in blood pressure (because of this risk you are require to have an IV if getting an epidural so they can treat the low blood pressure), it causes an increased need for pitocin (5), it can cause a fever (which would than cause the baby to have much more testing to determine if there is a infection) It can cause you to need a catheter, It can be administered wrong (2% of the time) and cause a severe headache that can last for up to 6 weeks (5), if given to early it can slow labor, it is much more likely that you will need a c-section if you have an epidural, it is much more likely that you will need a forceps delivery if you have an epidural, it is much more likely that you will need a vacuum- extraction if you have an epidural, pushing usually takes longer with an epidural, very rarely it can cause temporary or permanent paralysis or death. (3) For the baby an epidural can cause a drop in the heart rate, poor muscle tone, breathing problems, decreased suck reflex which can cause trouble breastfeeding, and an increase in jaundice. (5, ) I believe that an epidural is classic proof of the “domino effect” I mentioned earlier.

General Anesthesia:

It will most likely cause breathing problems in the newborn. It can be very quickly administered so it is often used for emergency c-sections.

Episiotomy:

A intentional cut made to the perineum with scissors. An episiotomy is rarely needed. Most women’s bodies will adequately stretch. You may have some slight tearing. When an episiotomy is given, it is usually much deeper and through more muscle than it would have been if you had been allowed to tear naturally. An episiotomy increases blood loss, can become infected, can cause permanent pain, and interfere with breastfeeding because of pain (3).

IV Use, The Restriction of Food and fluids:

Many times women are restricted from eating or drinking during labor. This is said to be so that if a woman needs an emergency c-section she won’t have a risk of throwing up and aspirating it. The chance of this happening is about 7 in ten million births. (5) This does not justify not letting us eat during labor. Many other interventions done routinely have more much risk than this and are ignored. This is just another way for us to be managed in labor. If normal drinking and eating is taking place, there is no need for an IV for Hydration. The liquids that are given in the IV can not replace real food and drink. If you did need a c-section you could always have the contents of your stomach suctioned out.(5). Birth is very physical, and can burn thousands of calories (5). It is important to stay hydrated and nourished before and during labor. It is like preparing for a marathon. Some woman do not feel hungry in the late stages of labor. It is fine to not eat for a few hours. If you become dehydrated you will have dry lips, a racing pulse, and no urination. If you are not well nourished you may be easily discouraged and have lack of energy. You might even have your labor stall. This can all be fixed by eating or drinking. It might helpful to have Gatorade and honey sticks to use in these situations. You may also be asked to have an IV if you are GBS positive. A IV makes it harder to use water as a comfort measure (4) Having an IV in place can make it easier to be given medication without your knowledge, and easier to request it in transition (5), It also restricts movement. If the hospital or doctor feel strongly about it, An IV can always be placed and put on a heparin/saline lock for an emergency or for administering antibiotics if GBS positive.

Forceps Delivery:

Used if you have moved the baby into the birth canal and can’t progress further. These are like giant tongs that are put in to cup the babies head and pull it out. More likely to be used if baby is in distress. Can cause tearing of the vagina, bladder or bowel damage. It can cause bruising, fractures, brain damage, or rarely death in the baby. (6)

Vacuum Delivery:

Used for the same reasons as forceps. It is a giant suction cup place on the baby’s head to help move the baby out of the birth canal. It can cause bruising, possibly increased newborn jaundice, hematomas, or rarely brain hemorrhage in the baby. (7)

Cesarean Section:

The World Health Organization recommends a 5% C-sections rate, and the United States is currently at about 30%. This is a overused procedure based on the malpractice in our country. Sometimes no matter how hard we try or how much we don’t want it a C-section becomes necessary to save a life. Make sure that you understand all risks and benefits to this procedure.

Pitocin to control bleeding:

This is often given in the IV without informing the mother. Causes afterpains (contractions after the birth that help the uterus return to its normal size and reduce bleeding, usually mild in a first baby and increasing in intensity with each birth).

Cord Cutting:

Usually the doctor will cut the cord right away. As long as there is still a pulse in the cord the baby is still being oxygenated from the mothers. If the baby has slight distress it might be better to leave it attached and watch the baby on the mother. Make sure the hospital staff knows if you or the dad want to cut the cord.

Eye Ointment for baby:

An antibiotic given in the babies eyes at birth. It has been said to cause blurriness of vision. Many people do not like to start out their babies life already receiving medications. This drug is given should the mother have Chlamydia or gonorrhea to prevent blindness, mental retardation, or death. Every women is tested for this in pregnancy, but it is possible to contract it after being tested. You can have these diseases and not have symptoms. Some parents like to delay or refuse this medication.

Hepatitis B. Vaccine For Baby:

Many people do not vaccinate and do not want their baby to be given a shot without permission. Hep B. is one of the more debated shots because it is given right at birth before the baby has a chance to develop its own immune system. Hep B is a blood born illness that would be passed by sexual encounters, IV drug use, or possibly blood transfusion. It can be passed during the birth or by breastfeeding. Every woman is tested during pregnancy for Hep B. Many parents feel that the risk of getting this disease is lower than the side effects of the shot.

Vitamin K for baby:

This is given to prevent newborn hemorrhagic disease. This is a vary rare but serious disease. It can be given orally if you do not want the baby to have a shot. One study showed a possible link to the shot and childhood cancers. (5) There has also been other studies that say that they disprove this theory. It seems that if the risk does exist is slight. It is possible to eat a diet high in Vitamin K before birth to increase the amount in your milk. Many parents wait to decide on this shot until after the birth to see if the baby has bruising or molding which may use up the Vitamin K it has naturally.

Bottles or pacifiers for babies:

Can cause “nipple confusion” and interfere with breastfeeding.
Formula is not “the same” as breastmilk, it does not offer the same unique, specific concoction of immunities, antibodies, growth, comfort or nutrition as breastmilk.
There are many situations that could require intervention. If you end up with complications that require drug use, it is likely that the benefits out weigh the side effects. Be sure to be well informed of your options if complications should arise.

(1)The Bradley Method Student workbook.
(2)Immaculalte Deception- Suzanne Arms
(3) Ina Mays Guide to Childbirth, Ina May Gaskin
(4)http://birthing-options.suite101.com/article.cfm/ivs_during_labor
(5) Gentle Birth Choices
(6) http://pregnancy.emedtv.com/delivery/forceps-delivery.html
(7)http://www.healthline.com/yodocontent/pregnancy/risks-vacuum-assisted-delivery.html


Here is a great article from Mother’s Advocate on Avoiding Interventions that are not medically necessary.

Here is an article about the Cascade of Interventions.


B.R.A.I.N

There is a common acrostic used to determine how a couple or laboring mom is to proceed when faced with the promptings of interventions. It is BRAIN.

BRAIN in Birth Interventions