Friday, May 20, 2011

Bradley Birth: Interventions Part 2

It is finally time to finish sharing what all I learned in my Bradley Classes! You can find all the other Bradley Birth posts I have done here.

Last time I started sharing about different Interventions we learned about in class:
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.
So on to the next few:

Electronic Fetal Monitoring (EFM): 

  • This is when the doctors or nurses monitor your baby's vitals electronically. They like to keep an eye on the Baby's heartbeat throughout labor. 
  • This can be done Externally or Internally. 
  • External is done by strapping a monitor onto the Mom's stomach. 
  • Internal is done by sticking a monitor on to the babies head by going through the vagina. 
This is a very common practice today. In majority of movies you see them coming in to check how the baby is doing through the monitor. So this is just normal to us. Most doctors want to do EFM at least 15 minutes of every hour of labor. The external method is more common. 

The reason this is considered an Intervention is because quite often the info they get from EFM leads to other interventions like a c-section. It is very neat that we can now check on Baby and see how he or she is doing, but sometimes we over read the situation.  Often changing positions can calm baby's heartbeat down, or eating a little can make it come back up it drops a little low. But instead of trying these things, EFM is a direct reason many doctors choose to rush a woman into a c-section. So limiting EFM can prevent this misdiagnosis. 

Our doctor requires 15 minutes of the hour. I tried to get him to agree to 10 minutes but it was a no go. Mr.Pate and I decided this is not one we really want to fight, because we feel prepared to not freak out and jump to conclusions or get rushed into something we dont think is best. 

Vaginal Exams:
  • This is when the nurse or doctor exam your vagina. They are looking to see how far dilated a woman is, how far effaced her cervix is, if they can see the baby, etc. 
  • Some doctors or nurses try to do these every hour of labor, and others do it every 3 or 4 hours. 
This one can really put the pressure on. The more you check the more you could get hung up on a number. It is important to remember that the body prepares at different rates. There is not a set 1 cm an hour process here. So even if a woman is "stuck" at 4 cm for several hours, she could suddenly dilate to 10 in 5 minutes. Bradley Classes push you to not rely on vaginal exams and instead to look at the external signs of labor to see how you are progressing (more on this later, but basically what is mom's demeanor etc). The birth process has a lot to do with your mental state, so you dont want to feel defeated. Also, the more vaginal exams you do the more opportunity to introduce bacteria into the vagina or birth canal. 

Our doctor believes in really spreading these out to every several hours and not getting hung up on it. 

  • This is when they cut the area between the vagina and the anus to prevent tearing when the baby comes out. 
  • Some doctors do this automatically and others only do this when they see the need during the pushing phase. 
Episiotomies take longer to recover from and can really hurt. But if you have to have one of these and you are going natural, there is a time when the doctor can cut and you wont even feel it (your perineum will be blanch white from the pressure of pushing and this makes it numb) so be sure to talk to them about this. 

It is important to realize that ripping is not an absolute given. If you have done lots of squatting beforehand, your perineum (the area they would cut) will be more stretched and flexible. This is why you need to be doing those exercises I discussed here

So thats a few more interventions we have discussed. More to come! Any thoughts or questions on these??

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