Labor Interventions

The moment you have been waiting for is finally here! Know that you have plenty of options for how you will bring your baby into the world.  After you know your options, you can begin to create your preferences for birth.   

Labor Interventions

Interventions are actions that help the labor process along clinically. 

During labor there is a lot going on and you will have wires and cords and IV’s everywhere! Your baby will be monitored either intermittently or continuously. The monitor tracks your baby's heart rate as it responds to contractions for signs of distress.  Your labor and delivery team will use this information to determine if intervention is necessary.

With so much going on, there will be times where you may feel like you need a minute to process what members of your health care team or birth partner or family is saying and that is okay.   Using the B.RA.I.N. can be helpful to make sure that you are making the best choices for you and your baby.  You can ask yourself these questions to help make a decision immediately or maybe it can wait.  

When you are considering your options, refer to the graphic and take a moment to think about what you would like to do.  Not every question they ask you, has to have an answer immediately and if they need one immediately - you will know.

Pain Relievers

Narcotic analgesics, or pain relievers, are only used during early

labor.  These medications can affect the baby. However, they are considered generally safe as long as your are two hours away from delivery. They can take effect quickly and may be given as a shot or IV. They will not remove the pain or sensations from contractions, they just change your perception of them. Being able to feel the sensations from the contractions is important as labor progresses. Pain relievers can help allow you to rest and save energy for delivery.  

Risks should also be considered when choosing pain relievers.  Since pain relievers pass through the placenta to your baby they can effect your baby’s breathing if given too close to the birth.  Some can cause you sleepiness or grogginess; this may cause you to remain in bed for the duration of the side effects. Laboring in bed does not have the same advantages as some upright labor positions have.

Pitocin

Pitocin is a synthetic version of oxytocin and is used to help stimulate contractions.  Three reasons a doctor may use Pitocin are:

• To induce labor, if the health of mom or baby is at risk
• Augment labor, meaning contractions have already begun but aren’t moving quickly enough, creating a potential for infection and other problems.
• To assist in the delivery of the placenta after birth.

Mama’s will typically start to feel contractions in the first hour, but how intense varies.  How much the cervix is dilated when you start Pitocin will also determine how quickly your body responds.  Pitocin is regarded as being very safe and used in many births dail.

However, Pitocin can cause some side effects include uterine rupture and retention of fluid.  More commonly, the side effect is that you will have more intenst conotractions. 

Epidural

An epidural is the most common choice for labor.  Epidurals may lower blood pressure, so you will be given IV fluids prior to starting.   An epidural can typically takes 15-20 minutes to be done after fluids have been given and then another 15-20 minutes for you to feel the full effects.  

• you will be positioned to curve your spine inward in order to create space for the needle.  Once your skin is cleaned and numbed, the needle is guided between your vertebrae into the epidural space. 
• once the needle has been placed, a catheter is fed through the needle to delivery the medication.
• an epidural causes you to lose sensation from under your breasts to your toes.  However the amount of numbness and ability to move varies.
• the urge to push sensation may be felt as pressure or may not be felt at all.

It will take  a couple of hours before you feel “back to normal” after the epidural has ended.  You may also require oxygen. Due to a risk of low blood pressure, which affects the amount of blood and oxygen given to your baby, your baby will be constantly monitored.

Spinal Anesthesia

Spinal anesthesia or a spinal block is similar to an epidural, but the needle goes through the epidural space and into the spinal fluid and a catheter is not use.  The medication is only issued once instead of continuously.

• the medication is delivered through the needle and then the needle is withdrawn.  
• numbness below the injection site is immediate.