Bradley Birth: Interventions

Bradley Classes are all about helping you to avoid "interventions". Intervention is when doctors have to intervene with your labor with some type of medical procedure. The thought process on avoiding them is that "intervention begets intervention", or one intervention often leads to more interventions. This is where I think Bradley classes get kinda controversial for some people, because as a society, American Birth is filled with interventions. Usually we really like our interventions too. 

So what are some common interventions or procedures/policies and why would they maybe not be the best route for us? I am going to go over some we have talked about in our class in a series of posts. I am not fully sure where we stand on several of these, and please remember I am not sharing this info to tell anyone their way of laboring is wrong etc. I just want to share new things I am learning and processing through. Here we go with the first two:  

• IVs: 

It is very routine for a laboring mother to be hooked up to an IV as soon as she arrives at the hospital to give birth. The thought process here is that we need to keep her hydrated and this helps us introduce pain medicine when it is needed or wanted. The disadvantages to the IV are that it limits the mothers mobility during birth (more on this in a later post, but laying in a bed stalls labor while walking around encourages it), and it can increase the swelling a mother experiences. Often today the IV fluids have dextrose in them, because we are not allowing the mother to eat or drink anything (more on that next), so she needs something! But this gives her a sugar high and then causes exhaustion. Thought you were exhausted from the labor? Chances are that was multiplied by this raising and lowering of your blood sugar.

What would an alternative to an IV be? Well if you labor at home (which I am not doing) then you are able to hydrate yourself with real fluids and light food as needed. If you are in the hospital then an alternative could be a Hep-Lock, which is basically a "port" stuck in your arm that an IV can be plugged into at a moments notice if needed. This allows moms to move about freely without having to bring along the IV tower, and helps her avoid the dextrose.

• NPO (Nothing by Mouth):

Today you are often not allowed to eat or drink during labor at a hospital. The history of this starts back in the 40s when we first starting using local anesthesia during c-sections or when using forceps during labor. The fear was women would throw up and choke on it during the procedure. This was mainly because they used a face mask and it was poor quality. This type of anesthesia is rarely used in birth today, very rarely. And yet, the policy of NPO still stands. They basically decided back then to cut off all fluids and food by mouth, and started administering the IV instead. Today 1 in every 200,000 will aspirate during labor, and even when it happens it rarely causes death anymore because of better technology and treatment.

Why would limiting food and drink during labor matter? It can cause dehydration and ketosis (where the body starts breaking down muscle as food). Studies have shown that women who are able to eat and drink during labor have shorter labor, less of them need augmentation with Pitocin, they require fewer pain meds, and the babies had higher Apgar scores.

This is one of the standard polices that bother me the most I think. It just is dumb. So many women end up having to take pitocin or having a c-section because their bodies wont progress in labor, but the main problem is they are exhausted and no one has fueled the body! You would not have someone run a marathon with no fuel, why would you expect them to labor that way?? I know many women who have said my body just wouldnt progress, it just is like that. And while there may be some people that this condition is true for, majority of our bodies are readily able to birth. We are just expecting it to do it quickly with no fuel and thats dumb. So if you are wondering... I will be trying to labor at home as long as possible (good thing I am only 2 minutes from the hospital) and sneaking food in when I do go in. I refuse to be told my body cant handle labor just because I am starving it. Now if its something else that my body is having issues with ok, but I wont have a c-section just for starvation. No thank you. : )

I will add that in 1999 the World Health Organization began suggesting that women be served light meals during labor, and yet 12 years later we still dont implement it. It shows how Health care today is so slow and does things more out of ritual and tradition than medical necessity. (Pardon the soap box... Ill step down now)


Any opinions on the first two??