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Medical Interventions

Understanding Interventions in Labor and Birth
Tools , technologies and medications ( often called interventions ) may be used for a variety of reasons during labor and birth . Some are used to assess the health of mother and baby , some for pain management ( see pages 18-20 ), and others because they are policies or routines of the birth facility . More rarely , interventions are used in the event of a medical concern ( see pages 21-27 ).
Electronic Fetal Monitoring
Monitoring the baby ' s heartbeat during labor is done to assess baby ’ s wellbeing . Monitoring may be done intermittently using a fetoscope or a Doppler , but more commonly , an Electronic Fetal Monitoring ( EFM ) machine is used . Continuous monitoring is the most common method . However , in addition to restricting movement


, research shows that for low risk labor , it is unnecessary and increases the likelihood of a cesarean or the use of a vacuum or forceps without improving outcomes . Continuous monitoring is often required when EFM uses discs similar to those pictured here , other interventions that increase risk are used which are held in place with elastic belts or a ( epidurals , Pitocin or other medications ). band . One disc measures and records the baby ’ s heart rate , while the other records pressure Occasionally ( usually when there are concerns changes of the uterus from contractions . with the heart rate ), an internal EFM ( a spiral or scalp electrode attached to baby ’ s scalp ) may be used to track the heart rate more accurately . A thin tube , called an intrauterine pressure catheter ( IUPC ), may also be inserted to measure the strength of the contractions .
Understanding interventions , including why they are used , will help you make the best choices for your birth . When faced with a decision , use the B . R . A . I . N . acronym to help guide you :
Benefits — What are the benefits ? Risks — What are the risks ? Alternatives — What are the alternatives ? Intuition — What is my gut feeling ?
Nothing — What would the results be if we did nothing or waited a while ?
A graph called a “ strip ” or “ tracing ” is recorded by the EFM equipment . Usually , the top line shows baby ’ s heartbeat while the bottom line shows contractions . This allows a care provider to see how baby is reacting to contractions .
Labor and Birth