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Common intervention and routine care insights

November 11, 2018

 

Stretch and sweeps

Often "undersold", but they are an intervention. For some care providers, these are "routine". A stretch and sweep is a procedure where baby's sac is separated from the cervix in an attempt to stimulate prostaglandin and therefore labour. This is done via your midwives'/OBs fingers inserted into your cervix and "sweeping" left and right, in an attempt to separate the sac from the cervix. I would strongly encourage you to weigh up the benefits and risks and ask your care provider to disclose them all, before consenting to any intervention. There is plenty of information in this article here about the procedure:

https://newbornbaby.com.au/birth-category-page/getting-ready-for-birth/stretch-and-sweep/
Vaginal exams:

These have no evidence to support their use, but they're routinely used in practice. The vaginal exam is actually to check your cervix- position, thinness and openness. Care providers seem to think it's necessary to check, but women don't thin and dilate on a timeline, nor does it give any indication of how much longer labour will be or time until you meet you baby. Here is a rundown of what occurs during a vaginal exam. I still think this nurse/midwife minimises the risks and lack of evidence behind vaginal exams, but you'll get an insight into what they're doing whilst they're in your vagina!! https://www.bing.com/videos/search?q=vaginal+exam&view=detail&mid=7FB73F793CF0F037898B7FB73F793CF0F037898B&FORM=VIRE
Induction of labour:

This is another routine practice which is over-used. First time mums who are induced have about a 45% caesarean rate (AIHW), so it really needs to be used when medically necessary and not just because a baby is "post day", aka you're "overdue". Some great evidence based research to throw towards your care provider if they're suggesting induction without really good medical reason: 

https://www.bellybelly.com.au/birth/induction-of-labour-to-induce-or-not-induce/
https://www.bellybelly.com.au/birth/methods-of-induction-of-labour/
https://www.bellybelly.com.au/birth/reduce-chances-induction-of-labour/
https://midwifethinking.com/tag/induction/
https://midwifethinking.com/2016/07/13/induction-of-labour-balancing-risks/
Epidurals:
I rarely think there is a balance of the risks of an epidural- including more likely to have an instrumental birth, 3rd/4th degree tearing, foetal distress, longer "pushing" stage, baby in posterior position, C-sections. There are other pain relief options which have less risks and you'll also be able to feel where baby is to help "push" them out. More here:

https://www.babycenter.com/0_epidural-pain-relief-for-labor_1489911.bc
Skin to Skin:

This is recommended by the World Health Organisation,  and supported by a wealth of evidence around the world, yet still isn't routinely offered to mothers/babies. Remember that dads benefit too! https://www.naturalchild.org/articles/guest/jack_newman2.html.
Delayed cord clamping:

There is about 1/3 of babies blood still in the placenta, so it's worthwhile understanding the benefits and requesting delayed cord clamping. Many hospitals will delay the clamping, but not nearly enough time is given to ensure baby has all their blood from the placenta.

https://www.bellybelly.com.au/birth/delayed-cord-clamping/

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